Corrective Jaw Surgery (Orthognathic Surgery)

Orthognathic surgery, or corrective jaw surgery, is used to treat malocclusion (“bad bite”) in conjunction with orthodontic treatment. Orthognathic surgery may be required if there is a moderate to severe abnormality in the development of the jaws which prevents the bite from being corrected by orthodontic treatment alone. The procedure may be performed after completion of growth during teenage years (as early as 13 to 15 years in females and 14 to 16 years in males). The procedure may also be performed during adulthood.

THE ABNORMAL JAW PATTERNS MAY RESULT IN:

• crowding of the teeth
• uncomfortable or ineffective bite and chewing pattern
• excessive loading causing wear and breakdown of teeth and gums over years (known also as a “traumatic bite”)
• open bites
• cross bites
• underbites
• overbites
• excessive “gummy” smiles and lip incompetence (lips don’t fully close over teeth at rest)
• deficient or “toothless smiles” where the lips cover the teeth even during a full smile
• facial and dental asymmetries
• receded and deficient lower jaw and chin
• temporomandibular joint (TMJ) disorders
• obstructive sleep apnoea.

Orthognathic surgery may also be beneficial for patients who have abnormal bites and jaw appearance following deformity after an accident or previous surgery. Patients with congenital birth defects such as cleft lip and palate may also benefit from corrective jaw surgery.

Your orthodontist will refer you for a consultation if your bite cannot be corrected with orthodontic treatment alone. When orthognathic surgery is indicated, this is usually carried out in conjunction with orthodontic treatment.

Teeth need to generally be aligned into their correct position before orthognathic surgery can be performed, a process that usually takes approximately 12 to 18 months. Corrective jaw surgery is then performed and braces will remain, during and after surgery, for another 6 months or so before treatment may be completed. The average treatment time can vary from 12 to 24 months, depending on the nature and severity of the abnormality.

In some instances, the abnormality may be so severe it interferes with daily function. Surgery may then be indicated before any orthodontic treatment (this is referred to as “surgery first”) or after a brief period of orthodontics (“early surgery”). These early surgical interventions are not suitable for all patients. OralMax surgeons have experience with these techniques and will discuss with you whether you may be a suitable candidate. Orthodontic treatment will still be necessary after the surgery to obtain an optimal functional bite.

Orthognathic surgery may be performed in conjunction with Invisalign treatment in suitable cases. However, not all patients requiring surgery are suitable for Invisalign. Your referring orthodontist and OralMax surgeon will discuss your individual circumstances with you during your consultation.

Before you undergo orthognathic surgery, your OralMax surgeon will plan several appointments with you. The pre-surgery appointments will include the taking of dental moulds, new photographs and radiographs to be used in conjunction with planning software to prepare for the surgery. Our OralMax Surgeons may also plan your surgery using the latest three dimensional software technology and custom made splints and plates.

Orthognathic surgery is performed in a major hospital under general anaesthesia. Corrective jaw surgery may involve the maxilla (upper jaw), the mandible (lower jaw), the chin, or a combination of these, depending on the nature and extent of the abnormality. A combination procedure involving both jaws is referred to as bimaxillary osteotomy.

The surgery is usually performed entirely inside the mouth to avoid facial scars. The jaws are sectioned and repositioned before being secured into the new position with titanium plates and screws. If you have impacted wisdom teeth, these may be removed at the same time. The jaws are not wired together after the surgery. A fully normal diet may be resumed within 6 weeks.

Patients spend 1 to 2 nights in hospital and usually require 2 to 3 weeks to convalesce, depending on the nature and extent of the surgery.