Changing jaw lines
Orthognathic surgery is a corrective jaw surgery that straightens or realigns your jaw and corrects related skeletal deformities that a patient may need.
This type of surgery, done by an oral and maxillofacial surgeon (OMS) in a hospital setting which involves straightening and realigning the jaws using surgical plates or templates, screws, and wires.
The main purpose is to correct a severe malocclusion (improper bite) that may be causing functional problems in daily behavior, such as speech, chewing food or even sleep apnea. You might also experience headaches, joint pain or periodontal (gum) discomfort.
Before & After Surgery
Before the procedure
Jaw surgery is performed by oral and maxillofacial surgeons. Surgery is usually done under general anesthesia. Surgery takes place in the hospital and requires a two- to four-day stay.
During the procedure
Surgery usually can be performed inside your mouth, so no facial scars show on your chin, jaw or around the mouth. However, sometimes small incisions may be required outside your mouth. Your surgeon makes cuts in the jawbones and moves them into the correct position. Once your jaw movement is completed, tiny bone plates, screws, wires and rubber bands may be used to secure the bones into their new position. These screws — which are smaller than a bracket used for braces — become integrated into the bone structure over time.
In some cases, extra bone may be added to the jaw. Your surgeon transfers the bone from your hip, leg or rib and secures it with plates and screws. In other cases, bone may be reshaped to provide a better fit.
Jaw surgery may be performed on the upper jaw, lower jaw, chin or any combination of these.
Upper jaw surgery
Surgery on the upper jaw may be performed to correct:
- Significantly receded or protruding upper jaw
- Too much or too little of the teeth showing
- Open bite
- Reduced facial growth of the middle of the face (midfacial hypoplasia)
Your surgeon cuts the bone above your teeth so that the entire top jaw — including the roof of your mouth and your upper teeth — can move as one unit. The jaw and upper teeth are moved forward until they fit properly with the lower teeth. This can be planned on a computer to determine if additional work, such as orthodontics, will be needed to help correct any remaining fit difference.
An open bite occurs when excess bone grows above the molars, causing what's normally a flat, even surface to become angled. To fix this, your surgeon shaves away or removes the excess bone.
Once the jaw is realigned, plates and screws hold the bone in its new position.
Lower jaw surgery
A mandibular osteotomy can correct:
- Receding lower jaw
- Protruding lower jaw
The surgeon makes cuts behind the molars and lengthwise down the jawbone so the front of the jaw can move as one unit. The jaw can then be moved to its new position either forward or backward. Plates and screws hold the jawbone together as it heals.
A genioplasty can correct a small chin (deficient chin). A small chin often accompanies a severely receded lower jaw.
Typically, surgeons can alter the jaw and restructure the chin during the same surgery. The surgeon cuts a piece of the chin bone on the front of the jaw, moves it forward, and secures it in a new position with plates and screws.
After the procedure
After surgery, your doctor will provide you with instructions. These usually include:
- What you can eat
- Oral hygiene
- Avoiding tobacco
- Avoiding strenuous activity
- Medications to control pain
- When to return to work or school, which is usually in one to three weeks
Initial jaw healing typically takes about six weeks after surgery, but complete healing can take up to 12 weeks.
After initial jaw healing ― at about six weeks ― your orthodontist finishes aligning your teeth with braces. The entire orthodontic process, including surgery and braces, may take several years. Once the braces are removed, retainers to hold tooth position may be used.
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