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.

Benefits

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.

Types

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
  • Crossbite
  • 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.

  • Experience. Mayo Clinic oral and jaw and face (maxillofacial) surgeons have vast experience in treating complicated jaw problems and have made major improvements in previous techniques. Every year, people from around the world come to Mayo Clinic for life-changing jaw surgery.
  • Advanced technology. Three-dimensional CT scanning, computer-guided treatment planning and temporary orthodontic anchoring devices help in the movement of teeth to decrease your time in braces. Sometimes these efforts completely eliminate the need for jaw surgery.
  • Comprehensive care. With Mayo Clinic's comprehensive and coordinated approach to care, a skilled team cares for you from diagnosis to surgical treatment.
  • Research. Mayo Clinic researchers continue to evaluate new ways to correct jaw-related issues.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

Why Choose Mayo Clinic

What Sets Mayo Clinic Apart

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

At Mayo Clinic in Arizona, doctors trained in ear, nose and throat disorders (otorhinolaryngology) perform jaw surgery in adults.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Minnesota, doctors trained in oral and maxillofacial surgery and orthodontics perform jaw surgery and orthodontics in children and adults.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Among numerous studies, oral and maxillofacial surgeons and orthodontists at Mayo Clinic completed research projects on the long-term outcome of a procedure called the maxillary quadrangular osteotomy in non-cleft and congenital cleft lip and palate patients.

See a list of publications by Mayo Clinic doctors on jaw surgery on PubMed, a service of the National Library of Medicine.

Feb. 21, 2014