Orthognathic Surgery

Jaw misalignment, or malocclusion, can lead to many issues, ranging from difficulties in chewing and speaking to facial asymmetry and even breathing problems. While orthodontic treatments like braces can address mild misalignments, severe cases often necessitate a more comprehensive approach. Orthognathic surgery, a procedure that involves surgical repositioning of the jaws, offers a lasting solution to correct significant jaw misalignments. This guide will delve into the details of orthognathic surgery, its indications, procedures, recovery, and outcomes.

Understanding Orthognathic Surgery

Orthognathic surgery, derived from the Greek words “ortho” (straight) and “gnathos” (jaw), is a specialized procedure aimed at correcting structural abnormalities of the jawbones to improve their alignment. Typically performed by oral and maxillofacial surgeons in collaboration with orthodontists, this surgery addresses severe malocclusion cases that cannot be adequately corrected with traditional orthodontic treatments like braces alone.

Candidates for orthognathic surgery often experience significant functional impairments and aesthetic concerns due to jaw misalignment. Common indications include severe overbite or underbite, open bite, crossbite, facial asymmetry, and associated issues like difficulty chewing, speaking, or breathing.

The procedure involves careful evaluation and planning, including dental impressions, X-rays, and sometimes advanced imaging techniques like cone-beam computed tomography (CBCT). Orthodontic treatment may precede surgery to align the teeth within each jawbone, facilitating the surgical correction.

During orthognathic surgery, the surgeon makes incisions inside the mouth to access the jawbones, performs precise cuts (osteotomies) to reposition them, and stabilizes the bones with titanium plates, screws, or wires. The recovery process involves managing swelling and discomfort, adhering to a soft diet, and attending regular follow-up appointments to monitor progress and ensure optimal outcomes.

Indications for Orthognathic Surgery

Candidates for orthognathic surgery often experience significant functional impairments and aesthetic concerns due to jaw misalignment. Some common indications include:

  • Severe malocclusion cannot be adequately corrected with orthodontic treatment alone.
  • Difficulty in chewing, biting, or swallowing.
  • Speech problems result from jaw misalignment.
  • Temporomandibular joint (TMJ) disorders.
  • Facial asymmetry is caused by disproportionate jaw size.
  • Obstructive sleep apnea is due to airway obstruction related to jaw position.

Pre-Surgical Preparation

Pre-Surgical PreparationPre-surgical preparation for orthognathic surgery is crucial to ensure optimal outcomes and patient safety. It involves a comprehensive evaluation to assess the dental and skeletal relationships and plan the surgical approach accordingly. This evaluation typically includes dental impressions, X-rays, photographs, and sometimes advanced imaging techniques like cone-beam computed tomography (CBCT) to obtain detailed three-dimensional images of the jaw structures.

Orthodontic treatment may be initiated before surgery to align the teeth within each jawbone, which helps facilitate the surgical correction process and ensures better postoperative occlusion. The orthodontist and oral surgeon work closely to coordinate the timing of orthodontic treatment and surgery for seamless integration of care.

In addition to diagnostic tests and treatment planning, pre-surgical preparation involves educating the patient about the procedure, potential risks, and expected outcomes. Patients are provided with detailed preoperative care instructions, including fasting guidelines, medication management, and lifestyle modifications.

Furthermore, patients may undergo preoperative medical evaluations to assess their overall health and identify any underlying medical conditions affecting the surgical outcome or anesthesia administration. This comprehensive approach to pre-surgical preparation helps minimize risks, optimize surgical outcomes, and ensure a smooth recovery process for the patient.

The Orthognathic Surgery Procedure

Orthognathic surgery is performed under general anesthesia in a hospital setting. The specific surgical approach varies depending on the type and severity of the jaw misalignment. Generally, the procedure involves the following steps:

  • Incisions: The surgeon makes incisions inside the mouth to access the jawbones, minimizing visible scarring.
  • Osteotomies: The surgeon carefully cuts and repositions the jawbones into the desired alignment using specialized instruments.
  • Fixation: Once the jaws are properly aligned, small titanium plates, screws, or wires are used to stabilize the bones in their new position.
  • Closure: The incisions are closed with dissolvable sutures, and any necessary postoperative instructions are provided to the patient.

Recovery and Postoperative Care

Recovery and Postoperative CareRecovery and postoperative care following orthognathic surgery are critical phases in the overall treatment process aimed at ensuring a smooth and successful recovery while maximizing the long-term benefits of the procedure. Patients can expect some degree of swelling, bruising, and discomfort in the immediate aftermath of surgery, which can be managed with prescribed pain medications and cold compresses applied to the face.

Initially, a liquid or soft diet is typically recommended to minimize strain on the healing jawbones. To prevent infection and promote healing, patients are advised to adhere to strict oral hygiene practices, including gentle brushing and rinsing with prescribed mouthwash. Follow-up appointments with the oral surgeon and orthodontist are essential to monitor progress, assess occlusion, and make any necessary adjustments to orthodontic appliances.

As swelling subsides and healing progresses, patients gradually transition to a more regular diet and resume normal activities under the guidance of their healthcare providers. Physical therapy exercises may be prescribed to improve jaw mobility and muscle strength.

Throughout the recovery period, patients are encouraged to communicate openly with their healthcare team, promptly reporting any concerns or unusual symptoms. While the initial recovery phase can be challenging, patients typically experience significant improvements in jaw function, aesthetics, and overall quality of life in the months following surgery. Compliance with postoperative instructions and regular follow-up care are key factors in achieving optimal outcomes and long-term satisfaction with the results of orthognathic surgery.

Long-Term Outcomes

While the initial recovery period can be challenging, the long-term benefits of orthognathic surgery are often life-changing. Patients experience improved facial harmony, enhanced chewing and speech function, and a boost in self-confidence. Maintaining good oral hygiene, attending regular dental check-ups, and following postoperative instructions are essential to ensure the best possible outcome.


Orthognathic surgery is a highly effective treatment option for correcting significant jaw misalignments that cannot be adequately addressed with orthodontic treatment alone. This comprehensive approach can significantly enhance the quality of life for individuals with severe malocclusion by addressing functional and aesthetic concerns. If you believe you may benefit from orthognathic surgery, consult an experienced oral and maxillofacial surgeon to explore your options and develop a personalized treatment plan.

Dentofacial orthodontics

Dentofacial orthodontics stands out as a specialized area focused on correcting misalignments within the teeth and the overall structure of the face. Dentofacial orthodontics goes beyond traditional orthodontic treatments, considering the interplay between the teeth, jaws, and facial structure to achieve optimal function and aesthetics. This holistic approach addresses dental alignment and issues related to facial symmetry, jaw positioning, and overall facial harmony.

The Role of Dentofacial Ortho in Correcting Facial and Dental Misalignments

Enhancing Facial Symmetry and Harmony

One of the primary roles of dentofacial orthodontics is to enhance facial symmetry and harmony. By evaluating the relationship between the teeth, jaws, and facial structure, dentofacial orthodontists can identify discrepancies that contribute to an unbalanced appearance. Through a combination of orthodontic appliances, such as braces or aligners, and sometimes surgical interventions, they work to correct these discrepancies, creating a more harmonious facial profile. This may involve adjusting the position of the teeth to align with the natural contours of the face and repositioning the jaws to achieve proper balance and proportion.

Furthermore, dentofacial orthodontics can address underbites, overbites, and crossbites, which affect dental alignment, facial aesthetics, and function. By correcting these malocclusions, dentofacial orthodontists can improve the smile’s appearance and functionality, enhancing overall facial aesthetics and boosting self-confidence.

Improving Dental Functionality and Bite Alignment

Another crucial role of dentofacial orthodontics is to improve dental functionality and bite alignment. Misalignments within the teeth and jaws can lead to various functional issues, including difficulty chewing, speaking, and maintaining proper oral hygiene. Dentofacial orthodontists can identify and address these issues by carefully analyzing the relationship between the teeth and jaws to restore optimal dental function.

Through the use of orthodontic appliances, such as braces or clear aligners, dentofacial orthodontics aims to gradually shift the teeth into proper alignment, ensuring a balanced bite and occlusion. This improves chewing efficiency and reduces the risk of developing dental problems such as tooth decay, gum disease, and temporomandibular joint disorders (TMJ). Additionally, by aligning the teeth and jaws correctly, dentofacial orthodontics can alleviate excessive wear and tear on the teeth, preserving their longevity and overall oral health.

Facial Harmony and Symmetry

Facial SymmetryOne of the primary goals of dentofacial orthodontics is to enhance facial harmony and symmetry by optimizing the relationship between the teeth, jaws, and surrounding soft tissues. Facial aesthetics play a crucial role in overall self-confidence and social interactions, and even minor discrepancies in tooth alignment or jaw position can significantly impact a person’s appearance. Dentofacial orthodontists carefully evaluate facial proportions, lip support, smile arc, and midline alignment to determine each patient’s most suitable treatment approach.

By correcting dental and skeletal discrepancies, dentofacial orthodontics can improve the alignment of the teeth and enhance the overall balance and proportion of the face. This may involve repositioning the jaws to achieve proper occlusion (bite) and facial symmetry, which can transform a person’s appearance. Through meticulous planning and advanced techniques, dentofacial orthodontists strive to create natural-looking smiles that complement the individual’s unique facial features, resulting in a more confident and aesthetically pleasing appearance.

Functional Optimization: Improving Oral Health and Functionality

Beyond the cosmetic benefits, dentofacial orthodontics is crucial in optimizing oral health and functionality. Misaligned teeth and jaws can contribute to various dental issues, including difficulty chewing, speech impediments, and an increased risk of tooth decay and gum disease. By correcting these malocclusions, dentofacial orthodontists help alleviate discomfort and improve overall oral function, leading to better oral hygiene and a reduced risk of dental problems in the long term.

Furthermore, properly aligned teeth and jaws promote more efficient chewing and digestion, positively affecting overall health and nutrition. Dentofacial orthodontics can help prevent excessive wear and tear on the teeth and reduce the risk of temporomandibular joint (TMJ) disorders by ensuring the teeth come together properly and evenly distribute bite forces. This comprehensive approach to oral health enhances the patient’s quality of life and contributes to their overall well-being.

Psychosocial Impact: Boosting Confidence and Self-Esteem

Confidence and Self-EsteemThe psychological impact of dentofacial orthodontic treatment should be noticed. For many individuals, living with dental or facial misalignments can take a toll on self-confidence and self-esteem, leading to social anxiety and a reluctance to smile or engage in social activities. Dentofacial orthodontics improves the smile’s physical appearance and profoundly affects the patient’s emotional well-being.

Dentofacial orthodontists help patients achieve a more symmetrical and attractive smile by correcting dental and facial discrepancies, boosting confidence and self-esteem. Feeling proud of their smile, patients are more likely to smile openly, communicate confidently, and engage in social interactions without reservation. This newfound confidence can have far-reaching effects on various aspects of life, including personal relationships, academic and professional success, and overall happiness and fulfillment.

Emerging Trends in Dentofacial Orthodontics

As technology advances, dentofacial orthodontics is witnessing the emergence of innovative techniques and tools that enhance treatment outcomes and patient experiences. One notable trend is the increasing use of digital technology in treatment planning and delivery. Digital impressions, cone-beam computed tomography (CBCT) scans, and 3D imaging allow dentofacial orthodontists to obtain detailed anatomical information, enabling more precise diagnosis and treatment planning. Moreover, computer-aided design and manufacturing (CAD/CAM) technology facilitates the fabrication of customized orthodontic appliances, such as clear aligners and lingual braces, tailored to each patient’s unique dental anatomy.

Another promising trend in dentofacial orthodontics is the integration of interdisciplinary treatment approaches. Collaboration between orthodontists, oral surgeons, periodontists, and other dental specialists allows for comprehensive care of complex cases involving both dental and skeletal discrepancies. This team-based approach ensures that all aspects of the patient’s oral health and facial aesthetics are addressed, leading to more predictable outcomes and improved patient satisfaction.

Additionally, a growing emphasis is on minimally invasive techniques in dentofacial orthodontics. Techniques such as temporary anchorage devices (TADs) and accelerated orthodontic treatment modalities enable shorter treatment times and reduced patient discomfort. Furthermore, biomechanics and materials science advancements have developed low-friction brackets, heat-activated wires, and other orthodontic appliances that minimize friction and discomfort during tooth movement.


In conclusion, dentofacial orthodontics is a dynamic and evolving field that continues to evolve in response to technological advancements and changing patient demographics. From digital treatment planning and interdisciplinary collaboration to minimally invasive techniques and specialized care for patients of all ages, dentofacial orthodontists are at the forefront of innovation, striving to deliver optimal outcomes and improve the lives of their patients.