Jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, corrects irregularities of the jaw bones and realigns the jaws and teeth to improve the way they work. Making these corrections may also improve your facial appearance.
Jaw surgery may be a corrective option if you have jaw problems that can't be resolved with orthodontics alone. In most cases, you will also have braces on your teeth before surgery and during recovery after surgery until healing and alignment are complete. Your orthodontist can work with your oral and jaw and face (maxillofacial) surgeon to determine your treatment plan.
Jaw surgery is appropriate after growth stops, usually around ages 14 to 16 years for females and ages 17 to 21 years for males.
Why it's done
Jaw surgery may help to:
Make biting and chewing easier and improve chewing overall
Correct problems with swallowing or speech
Minimize excessive wear and breakdown of the teeth
Correct bite fit or jaw closure issues, such as when the molars touch but the front teeth don't touch (open bite)
Correct facial imbalance (asymmetry), such as small chins, underbites, overbites and crossbites
Improve the ability of the lips to fully close comfortably
Relieve pain caused by temporomandibular joint (TMJ) disorder and other jaw problems
Repair facial injury or birth defects
Provide relief for obstructive sleep apnea
Jaw surgery is generally safe when done by an experienced oral and maxillofacial surgeon, often in collaboration with an orthodontist.
Risks of surgery may include:
Relapse of the jaw to the original position
Problems with bite fit and jaw joint pain
Need for further surgery
Need for root canal therapy on selected teeth
Loss of a portion of the jaw
After surgery, you may experience:
Pain and swelling
Problems with eating that can be addressed with nutritional supplements or consultation with a dietitian
A brief time of adjustment to a new facial appearance
What you can expect
Before the procedure
Jaw surgery is performed by oral and maxillofacial surgeons. Surgery is usually done under general anesthesia. The surgery takes place in the hospital and requires a two to four-day stay.
During the procedure
Surgery usually can be performed inside your mouth, so no facial scars show on your chin, jaw, or around the mouth. However, sometimes small incisions may be required outside your mouth.
Your surgeon makes cuts in the jawbones and moves them into the correct position. Once your jaw movement is completed, tiny bone plates, screws, wires, and rubber bands may be used to secure the bones into their new position. These screws — which are smaller than a bracket used for braces — become integrated into the bone structure over time.
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 plates and screws. In other cases, the bone may be reshaped to provide a better fit.
Jaw surgery may be performed on the upper jaw, lower jaw, chin, or any combination of these.
Surgery on the upper jaw may be performed to correct:
Significantly receded or protruding upper jaw
Too much or too little of the teeth showing
Reduced facial growth of the middle of the face (midfacial hypoplasia)
Your surgeon cuts the bone above your teeth 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. This can be planned on a computer to determine if additional work, such as orthodontics, will be needed to help correct any remaining fit difference.
An open bite occurs when excess bone grows above the molars, causing what's normally a flat, even surface to become angled. To fix this, your surgeon shaves away or removes the excess bone. Once the jaw is realigned, plates and screws hold the bone in its new position.
A mandibular osteotomy can correct:
Receding lower jaw
Protruding lower jaw
The surgeon makes cuts behind the molars and lengthwise down the jawbone so the front of the jaw can move as one unit. The jaw can then be moved to its new position either forward or backward. Plates and screws hold the jawbone together as it heals.
Chin surgery (genioplasty)
A genioplasty can correct a small chin (deficient chin). A small chin often accompanies a severely receded lower jaw. Typically, surgeons can alter the jaw and restructure the chin during the same surgery. The surgeon cuts a piece of the chin bone on the front of the jaw, moves it forward, and secures it in a new position with plates and screws
After the procedure
After surgery, your doctor will provide you with instructions. These instructions usually include:
What you can eat
Avoiding strenuous activity
Medications to control pain
When to return to work or school, which is usually in one to three weeks
Initial jaw healing typically takes about six weeks after surgery, but complete healing can take up to 12 weeks.
After initial jaw healing — at about six weeks — your orthodontist finishes aligning your teeth with braces. The entire orthodontic process, including surgery and braces, may take several years. Once the braces are removed, retainers to hold tooth position may be used.
Correcting the alignment of your jaws and teeth with jaw surgery can result in:
Balanced appearance of your lower face
Improved function of your teeth
Health benefits from improved sleep, breathing, chewing, and swallowing
Improvement in speech impairments
Secondary benefits of jaw surgery may include: