Corrective Jaw Surgery (Orthognathic Surgery)

Orthognathic surgery is a surgical correction that can fix substantial abnormalities of the maxilla (upper jaw), the mandible (lower jaw), or both. Reasons for the abnormality are varied and can be caused by such things as a growth defect, birth defect, or traumatic injury to your jaw.

When routine orthodontic treatment is unable to correct a malocclusion (bad bite), orthognathic surgery will typically be performed by an Oral and Maxillofacial Surgeon. This may involve reconstruction of the maxilla or mandible, mandibular ramus, maxilla osteotomy or mandibular osteotomy.

The following classifications of malocclusion may require orthognathic surgery:

Class I Occlusion – This is the least destructive of the classes of malocclusions and involves a condition where the lower anterior incisors are situated directly behind the upper anterior incisors when biting down.

Class II Malocclusion – Referred to as an overbite, this condition is similar to a Class I occlusion, but the lower incisors are significantly behind the uppers during the biting process, sometimes hitting the soft tissue behind the upper incisors. It can result in bone damage, tooth loss, excessive wear of your teeth, and discomfort.

Class III Malocclusion – Known as an underbite, this occurs when your lower anterior incisors and lower jaw are beyond the upper teeth. This condition will cause the lower jaw to be more prominent than the upper.

Reasons for orthognathic surgery

Five powerful muscles control the opening and closing of your jaw. Because malocclusions produce destructive forces among these muscles, a tremendous force is generated when chewing, clenching or grinding of the teeth, resulting in misalignment. The aesthetic appearance of teeth as well as their functionality can be intensely damaged if left untreated, resulting in issues such as:

  • Tooth Wear – When an overbite is present, the pressure and wear on your teeth will not be even, leading to migraines, tooth loss or TMJ.
  • Chronic Jaw, Muscle Pain & Headache – Misalignment of teeth generally will alter how the facial muscles interact. Sometimes, the meniscus cartilage that performs as a buffer between the jawbones can be painfully damaged.
  • Loose Teeth – An overbite can cause uneven pressure to be exerted in unintended spaces or damage soft tissue. This can cause adjacent teeth to become loose, causing pain and reduced functionality of your teeth.
  • Tooth Sensitivity – Enamel can become thinner and nerves of teeth less protected as teeth are damaged by constant use. Sensitivity to hot or cold food or drinks can then develop./li>
  • Difficulty Swallowing, Chewing or Biting Food – Any of these issues can be related to poor alignment of the upper and lower jaws and cause muscle pain.

What does orthognathic surgery involve?

Once it is determined that you are a candidate for orthognathic surgery by your dentist, it will be necessary to have a total photographic analysis completed. This will include panorex x-rays, cephalometric x-rays, impressions, models and radiographs. This type of surgery will require the cooperation of your oral & maxillofacial surgeon, your orthodontist, as well as your dentist. Because this corrective surgery impacts proper jaw function as well as the aesthetics of the face, they will need to work together in order to obtain the desired results.

Before surgery, orthodontic braces will likely be used to align the arches and straighten your teeth. Retainers may also be necessary following the surgery. Maxillary surgery involves moving the upper jaw and securing it with wires, tiny plates, rubber bands and screws. For the mandible surgery, bone grafts will be necessary to align the lower jaw and place it into the proper position. General anesthesia is typically applied and the surgery will require a great deal of aftercare. You will receive post treatment instructions as well as any necessary pain medications. In some situations, a modified diet may also be required.

If you have questions about corrective jaw surgery, please contact our office.