Surgical orthodontics, also known as orthognathic surgery, is a specialized procedure where, just as an orthodontist repositions teeth, an oral and maxillofacial surgeon repositions one or both jaws. Since moving the jaws also shifts the teeth, orthognathic surgery is typically performed alongside orthodontics to ensure that the teeth are properly aligned after the procedure.
The primary objective of orthognathic surgery is to correct a wide range of minor and major facial and jaw irregularities. Benefits often include:
Improved ability to chew, speak, and breathe
Enhanced appearance in many cases
Conditions That May Indicate the Need for Corrective Jaw Surgery
Here are some signs that may suggest a need for corrective jaw surgery:
Difficulty chewing or biting food
Difficulty swallowing
Chronic jaw or jaw joint (TMJ) pain and headaches
Excessive wear of the teeth
Open bite (space between the upper and lower teeth when the mouth is closed)
Unbalanced facial appearance from the front or side
Facial injuries or birth defects
Receding chin
Protruding jaw
Inability to make the lips meet without straining
Chronic mouth breathing and dry mouth
Sleep apnea (breathing problems during sleep, including snoring)
Steps in Orthognathic Surgery
Pre-surgical Orthodontics
During the pre-surgical phase of treatment, your teeth will be moved into a new position, ensuring they fit together properly when the jaws are surgically repositioned. This phase typically lasts 6 to 18 months and involves:
Regular visits to your orthodontist for adjustments and evaluations
As your teeth are being moved, you might feel as though your bite is worsening. However, when the oral and maxillofacial surgeon realigns your jaws, your teeth will shift into their correct positions. After surgery, final orthodontic adjustments are usually necessary to fine-tune your bite.
Following the removal of your braces, you may need to wear a retainer. If you still have your wisdom teeth or if your teeth are crowded, some teeth may need to be removed before starting orthodontic treatment to create space for proper movement.
The Surgical Procedure
Orthognathic surgical procedures can last anywhere from one to several hours, depending on the type and extent of surgery needed. Here’s a brief overview:
Lower Jaw Surgery: The rear section of the jawbone behind the teeth is separated, allowing the tooth-bearing portion to be moved forward or backward.
Upper Jaw Surgery: The jaw can be repositioned forward or backward, or it can be raised or lowered as necessary.
Certain surgical movements may require separating the jaw into several parts, with bone added or removed for proper alignment and stability. Other facial bones contributing to imbalances may also need repositioning, augmentation, or reduction. Most incisions are made inside the mouth to avoid visible external scars. If external incisions are necessary, they are carefully concealed within natural skin creases.
During Healing
After leaving the hospital or surgical facility, you should be able to return to work or school as soon as you feel comfortable—often within two weeks. Your appearance may change somewhat due to jaw repositioning and associated swelling, so be prepared for initial surprise from family and friends. It won’t take long for them to adjust to the “new” you.
Regular follow-up visits with both the oral and maxillofacial surgeon and orthodontist are essential for monitoring your healing process. Key points during this phase include:
Initial healing takes approximately 6 weeks; full recovery may extend from 9 to 12 months.
Maintaining excellent oral hygiene is critical during the healing phase. Your surgeon and orthodontist will provide guidance and may recommend special oral care devices.
The post-surgical phase of orthodontic treatment usually begins 4 to 8 weeks after surgery to fine-tune your bite.
Most patients can expect their braces to be removed within 6 to 12 months following surgery.
