Orthognathic Surgery: A Complete Guide to Jaw Correction

Introduction

Orthognathic surgery, commonly known as corrective jaw surgery, is a specialized procedure performed to correct severe jaw misalignment, bite issues, and facial asymmetry. It is often recommended when orthodontic treatments such as braces alone cannot resolve the problem.

This surgical procedure is typically carried out by an oral and maxillofacial surgeon in coordination with an orthodontist to improve jaw function, chewing ability, speech clarity, and facial aesthetics. Beyond cosmetic enhancements, orthognathic surgery can also address breathing difficulties and conditions like obstructive sleep apnea.

In this comprehensive guide, we will explore the different types of orthognathic surgery, the conditions it treats, the surgical process, recovery, risks, and long-term benefits.

Understanding Orthognathic Surgery

Orthognathic surgery is performed to reposition the upper jaw (maxilla), lower jaw (mandible), or both. The goal is to achieve proper alignment between the teeth and jaws for improved function and appearance.

Common Jaw Conditions That Require Orthognathic Surgery

Overbite (Class II Malocclusion)

An overbite occurs when the upper teeth excessively overlap the lower teeth. In severe cases, it can lead to difficulty biting, chewing, and speaking.

Underbite (Class III Malocclusion)

An underbite happens when the lower jaw extends beyond the upper jaw, affecting facial balance and making chewing and speaking difficult.

Open Bite

An open bite results in a gap between the upper and lower teeth when the mouth is closed. This can lead to speech impediments and difficulty chewing.

Facial Asymmetry

Jaw misalignment can cause one side of the face to appear larger or more developed than the other, leading to functional and aesthetic concerns.

Obstructive Sleep Apnea (OSA)

Jaw abnormalities can contribute to obstructed airways, causing breathing problems and sleep disorders such as sleep apnea.

Temporomandibular Joint (TMJ) Disorders

Misaligned jaws can put stress on the TMJ, leading to chronic pain, headaches, and jaw stiffness.

Who Needs Orthognathic Surgery?

Orthognathic surgery is recommended for individuals who:

• Experience difficulty chewing, swallowing, or speaking due to jaw misalignment.
• Have chronic jaw pain, headaches, or TMJ disorders.
• Suffer from breathing problems or sleep apnea caused by jaw positioning.
• Have noticeable facial asymmetry or imbalance.
• Have undergone orthodontic treatment but still require surgical intervention for full correction.

Types of Orthognathic Surgery

Maxillary Osteotomy (Upper Jaw Surgery)

Maxillary osteotomy is performed to correct upper jaw misalignment, including overbites, crossbites, and open bites. The surgeon makes precise cuts in the upper jaw, moves it into the correct position, and secures it with plates and screws.

Mandibular Osteotomy (Lower Jaw Surgery)

Mandibular osteotomy is used to correct underbites and lower jaw misalignment. The lower jaw is repositioned to align properly with the upper jaw, improving bite function and facial balance.

Bilateral Sagittal Split Osteotomy (BSSO)

BSSO is a common technique used to move the lower jaw forward or backward. It allows for precise adjustments and a stable result.

Genioplasty (Chin Surgery)

Genioplasty is often performed alongside jaw surgery to reshape or reposition the chin for better facial harmony.

Two-Jaw Surgery (Bimaxillary Osteotomy)

Some patients require surgery on both the upper and lower jaws to achieve optimal alignment and function. This procedure is more complex but yields significant improvements in facial structure and bite mechanics.

The Orthognathic Surgery Process

1. Initial Consultation and Diagnosis

A specialist will conduct a thorough assessment, including:

• X-rays and 3D imaging to analyze jaw position.
• Impressions and bite analysis to evaluate misalignment.
• Discussion of treatment goals and expected outcomes.

2. Pre-Surgical Orthodontic Treatment

Most patients need to wear braces for 12 to 18 months before surgery to properly align the teeth in preparation for jaw repositioning.

3. Surgical Procedure

The surgery is performed under general anesthesia and typically lasts between 2 to 5 hours, depending on the complexity. The surgeon makes precise incisions inside the mouth to avoid visible scars and then repositions the jaw using surgical plates, screws, or wires.

4. Post-Surgery Recovery

After surgery, patients stay in the hospital for 1 to 3 days for monitoring. Swelling and discomfort are common in the first few weeks. A liquid or soft-food diet is required for the initial recovery period.

Recovery After Orthognathic Surgery

1. Immediate Post-Surgery Care

Patients will experience swelling, mild discomfort, and restricted jaw movement. Pain management includes prescribed medications and ice packs.

2. Dietary Adjustments

A strict liquid and soft-food diet is necessary for the first few weeks. Recommended foods include:

• Smooth soups and broths
• Blended fruits and vegetables
• Mashed potatoes
• Yogurt and protein shakes

3. Healing and Jaw Mobility

Swelling peaks within the first 48 hours and gradually subsides over several weeks. Patients will slowly regain normal jaw function through guided exercises.

4. Post-Surgical Orthodontics

Braces may need to be worn for a few months after surgery to finalize tooth alignment.

5. Follow-Up Appointments

Regular check-ups with the surgeon and orthodontist ensure proper healing and alignment adjustments if needed.

Benefits of Orthognathic Surgery

1. Improved Bite and Chewing Ability

Correcting jaw alignment enhances the efficiency of chewing and prevents excessive wear on teeth.

2. Better Speech Clarity

Many patients experience improved pronunciation and speech function after surgery.

3. Relief from TMJ Disorders and Jaw Pain

Proper jaw positioning alleviates stress on the temporomandibular joint, reducing chronic pain and discomfort.

4. Enhanced Facial Aesthetics

Jaw correction can significantly improve facial symmetry and overall appearance, boosting self-confidence.

5. Improved Breathing and Sleep Quality

For patients with sleep apnea, jaw surgery opens the airway, leading to better breathing and restful sleep.

Risks and Considerations

Although orthognathic surgery is highly successful, it does come with some risks, including:

• Swelling, bruising, and temporary numbness in the jaw or lips.
• Infection or minor bleeding (rare but possible).
• Slight relapse or shifting of the jaw post-surgery.
• Temporary difficulty with speech and eating during the recovery phase.

Choosing a skilled oral and maxillofacial surgeon minimizes these risks and ensures a smooth recovery.

Alternatives to Orthognathic Surgery

For mild cases of jaw misalignment, non-surgical treatments may be an option, such as:

• Orthodontic treatment – Braces or aligners can correct minor alignment issues.
• Dental prosthetics or crowns – In some cases, reshaping teeth can improve bite function.
• Botox or fillers – These can temporarily correct minor jaw asymmetry but do not address functional issues.

Conclusion

Orthognathic surgery is a life-changing procedure that improves both function and appearance for individuals with severe jaw misalignment. Whether correcting an overbite, underbite, or facial asymmetry, the benefits of this surgery extend beyond aesthetics, improving chewing ability, speech, and overall health.

While recovery requires patience and dedication, the long-term results make it a worthwhile investment. Consulting an experienced oral and maxillofacial surgeon is the first step towards achieving a well-aligned jaw and a confident smile.