Jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, corrects irregularities of the jaw bones and realigns the jaws and teeth to improve the way they work. Making these corrections may also improve your facial appearance.
Jaw surgery may be a corrective option if you have jaw problems that can't be resolved with orthodontics alone. In most cases, you also have braces on your teeth before surgery and during recovery after surgery until healing and alignment are complete. Your orthodontist can work with your oral and jaw and face (maxillofacial) surgeon to determine your treatment plan.
Jaw surgery is appropriate after growth stops, usually around ages 14 to 16 years for females and ages 17 to 21 years for males.
Jaw surgery may help to:
Jaw surgery is generally safe when done by an experienced oral and maxillofacial surgeon, often in collaboration with an orthodontist.
Risks of surgery may include:
After surgery, you may experience:
In most cases, an orthodontist places braces on your teeth before surgery. Braces are usually on for 12 to18 months before surgery to level and align your teeth in preparation for surgery.
Your orthodontist and oral and maxillofacial surgeon work together to develop your treatment plan. X-rays, pictures and models of your teeth are part of the planning for your jaw surgery. Occasionally, the difference in the way teeth fit together will require either reshaping of the teeth, covering the teeth with crowns or both to complete correction.
Three-dimensional CT scanning, computer-guided treatment planning and temporary orthodontic anchoring devices may be used to help in the movement of teeth and decrease your time in braces. Sometimes these efforts completely eliminate the need for jaw surgery.
Sometimes virtual surgical planning (VSP) will be used to guide your surgeon to fit and correct the jaw segment position during the procedure for the most optimal result.
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.
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.
Surgery on the upper jaw may be performed to correct:
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.
A mandibular osteotomy can correct:
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 surgery, your doctor will provide you with instructions. These usually include:
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.
In upper jaw surgery, the surgeon makes cuts in the upper jaw, moves it forward, backward, up or down as needed and secures it with plates and screws.
The lower jaw is divided and the front section is moved forward or backward and secured with plates and screws.
In surgery to remedy a small chin (genioplasty), the front part of the lower jaw is divided and that piece is moved forward and secured with plates and screws.
Correcting alignment of your jaws and teeth with jaw surgery can result in:
Secondary benefits of jaw surgery may include: