Jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, realigns the jaws and teeth to improve the way they work and to improve your appearance. Jaw surgery may be a corrective option if you have moderate to severe jaw problems that can't be resolved with orthodontics alone.
Orthognathic surgery is a combination of jaw surgery and orthodontics. Correcting jaws that don't align properly is a common reason for jaw surgery.
Jaw surgery is appropriate after growth stops, usually around age 13 to 15 for females and age 16 to 18 for males.
Jaw surgery may help to:
- Make biting and chewing easier and improve chewing overall
- Minimize excessive wear and breakdown of the teeth over years of use
- Correct facial imbalance, improving the appearance of deficient chins, underbites, overbites and crossbites
- Restore balance (symmetry) to middle and lower facial features
- Improve "gummy" smiles, where the lips don't fully close or pull upward and show large areas of the gums
- Improve "toothless" smiles, where the lips cover all the teeth
- Reduce the risk of temporomandibular joint (TMJ) disorder and other jaw problems
- Repair and correct post-traumatic facial injury, defects and abnormalities
- Provide relief for sleep apnea
Jaw surgery usually can be performed entirely inside your mouth, so no facial scars show on your chin, jaw or around the mouth. Your surgeon makes cuts in the jawbones and moves them into the correct position. Once your jaws are properly aligned, screws and bone plates secure the bones into their new position.
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 temporary wires.
Jaw surgery takes place in the hospital and requires a one- to two-day stay. Complete recovery at home typically takes three to six weeks.
In most cases, an orthodontist places braces on your teeth before surgery. Braces are usually on for nine to18 months before surgery to level and align your teeth. After your jaw heals from surgery — typically about six weeks after surgery — your orthodontist finishes aligning your teeth and eventually removes the braces. The entire orthodontic process, including surgery, may last 12 to 24 months.
Jaw surgery may be performed on the upper jaw, lower jaw or both.
Upper jaw (maxillary osteotomy)
A maxillary osteotomy may be performed to correct these issues:
- Significantly receded upper jaw
- Too much or too little of the teeth showing
- Open bite
From inside the mouth, your surgeon cuts the bone above your teeth (below both eye sockets) 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.
Once the jaw is realigned, tiny screws and plates hold the bone in its new position. These screws — which are smaller than a bracket used for braces — become integrated into the bone structure over time.
An open bite occurs when excess bone grows above the molars, causing what's normally a flat, even surface to become angled. When you bite down, your molars touch but your front teeth don't touch each other, making chewing difficult. To fix this, your surgeon shaves away or removes the excess bone.
Lower jaw (mandibular osteotomy)
A significantly receded lower jaw can be corrected by a procedure called mandibular osteotomy.
In this procedure, the surgeon makes cuts behind the molars and lengthwise down the jawbone so the front of the jaw can move as one unit. As a result, the jaw slides smoothly to its new position. Screws hold the jawbone together until it heals.
Chin surgery (genioplasty)
A deficient chin often accompanies a severely receded lower jaw. Deficient chin can be fixed by a procedure called genioplasty, where your surgeon cuts your chin bone and secures it in a new position. Typically, surgeons can alter the jaw and restructure the chin during the same surgery.
Feb. 21, 2014
- Cook AJ. Decision Support System. Mayo Clinic, Rochester, Minn. July 19, 2013.
- Corrective jaw surgery. American Association of Oral and Maxillofacial Surgeons. http://www.aaoms.org/conditions-and-treatments/corrective-jaw-surgery/. Accessed Aug. 14, 2013.
- Neligan PC. Plastic Surgery. 3rd ed. London, England: Saunders Elsevier; 2013. http://www.clinicalkey.com. Accessed Aug. 15, 2013.
- Wolford LM, et al. Planning for combined TMJ arthroplasty and orthognathic surgery. Atlas of the Oral and Maxillofacial Surgery Clinics. 2011;19:243.
- Keller EE (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 26, 2013.
- Salinas TJ (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 15, 2013.
- Stork JT, et al. Maxillary quadrangular Le Fort I osteotomy: Long-term skeletal stability and clinical outcome. International Journal of Oral & Maxillofacial Surgery. In press. Accessed Sept. 16, 2013.