Orthognathic Surgery
Orthognathic surgery, also called jaw correction surgery or jaw alignment surgery, is a treatment used when orthodontics alone cannot correct severe bite or jaw misalignment. While braces can effectively straighten teeth, sometimes the problem lies deeper — in the way the upper and lower jaws grow and fit together.
When the jaws are out of alignment, patients may experience difficulty chewing, speaking, breathing, or sleeping, as well as facial imbalance. This can affect both function and appearance, sometimes impacting confidence and emotional well-being. In such cases, orthodontic surgery — often involving both braces and surgery — may be the most effective solution.
Who Is a Candidate for Orthognathic Surgery?
You might benefit from orthognathic jaw surgery if you have one or more of the following:
- Severe overbite, underbite, or open bite not correctable with braces alone
- Facial asymmetry or disproportion
- Difficulty chewing, biting, or swallowing
- Chronic jaw pain, TMJ issues, or excessive tooth wear
- Breathing issues such as sleep apnea related to jaw position
- Speech problems caused by jaw misalignment
- History of jaw injury or congenital jaw deformity
Improrant
This surgery is generally performed once jaw growth is complete (typically in late teens or adulthood).
Common Conditions Treated
Overbite Surgery (Class II Malocclusion)
When the lower jaw is underdeveloped or set back, an overbite surgery (usually a Bilateral Sagittal Split Osteotomy of the lower jaw) repositions it forward to improve the bite and facial balance.
Underbite Surgery (Class III Malocclusion)
An underbite may be caused by an overgrown lower jaw, an underdeveloped upper jaw, or both.
- Orthognathic surgery upper jaw: A Le Fort I osteotomymoves the upper jaw forward to correct deficiency.
- Orthognathic surgery lower jaw: In cases of excessive lower jaw growth, the jaw is shortened and repositioned backward.
Open Bite Correction
When upper and lower teeth do not meet in the front, jaw correction surgery can remove or reposition bone segments so teeth close properly.
Gummy Smile Reduction
For severe cases caused by vertical overgrowth of the upper jaw, face alignment surgery may involve removing a small section of upper jaw bone and securing it in a higher position.
Top 5 Types of Teeth Orthodontic Braces: Pros, Cons & What to Expect
The Treatment Process – Step by Step
1. Pre-Surgical Orthodontics
Before jaw alignment surgery, patients usually wear braces for 12–18 months to position teeth correctly for surgical alignment.
Note:
The bite may seem to worsen during this phase — this is intentional for optimal surgical results.
2. Diagnostics and Planning
Your oral and maxillofacial surgeon will:
- Review your medical and dental history
- Take photos, dental impressions, and bite records
- Order imaging (X-rays, CBCT scans) for 3D planning
- Use virtual surgical planning (VSP) for precise jaw movements
3. The Surgery
Orthognathic surgery is performed under general anesthesia, often in a hospital setting.
- Duration: 1–4+ hours, depending on complexity
- For complex cases involving both jaws, a double orthognathic surgerymay be required.
- The surgeon repositions one or both jaws, securing them with small biocompatible plates and screws.
4. Post-Surgical Orthodontics
After healing, braces are worn for several months to fine-tune the bite.
Recovery Timeline
Timeframe | What to Expect |
|---|---|
Days 1–7 | Swelling, bruising, facial stiffness; liquid diet recommended |
Weeks 2–4 | Gradual return to soft foods; reduced swelling; may return to work/school |
6 Weeks | Bone healing well underway; normal activity levels resume |
3-6 Months | Continued improvement in bite, speech, and facial appearance |
9-12 Months | Complete bone healing |
Tip:
Good nutrition, hydration, and rest are essential for recovery.
Risks and Possible Complications
All surgical procedures have risks. For orthodontic surgery, these may include:
- Temporary or permanent numbness in the lips, cheeks, or tongue
- Infection or bleeding
- Relapse (partial return of the jaw to its original position)
- TMJ discomfort
- Need for revision surgery (rare)
Your surgeon will discuss these in detail and explain strategies to minimize risks.
Cost and Insurance
The cost of orthognathic surgery varies widely depending on your location, surgeon, and procedure complexity. Expect prices roughly:
- Single jaw surgery: $15,000–$25,000CAD
- Double orthognathic surgery: $25,000–$40,000CAD
These estimates typically include hospital fees, anesthesia, surgeon and orthodontist fees, and pre/post-surgical care.
Many insurance plans cover surgery deemed medically necessary (e.g., for sleep apnea or severe bite issues), but cosmetic procedures often require out-of-pocket payment. Check your insurance policy carefully.
Advances in Orthognathic Surgery
Recent technology has improved safety and outcomes:
- 3D virtual surgical planningallows precise bone movement simulations.
- Custom cutting guides and fixation platesincrease accuracy.
- Minimally invasive surgical techniquesreduce swelling and recovery time.
- Use of computer-aided design/manufacturing (CAD/CAM)for surgical guides.
Benefits of Jaw Correction Surgery
- Improved chewing, biting, and swallowing
- Enhanced speech clarity
- Better breathing and sleep quality
- Balanced, harmonious facial appearance
- Reduced tooth wear and jaw joint strain
Increased confidence and self-esteem
Long-Term Results and Maintenance
Studies show orthognathic surgery results are stable long term when combined with orthodontics and proper aftercare. However, occasional follow-ups ensure your bite remains balanced. Some patients may require minor orthodontic adjustments years later.
Psychological and Social Benefits
Beyond physical improvements, many patients report enhanced self-esteem, confidence, and social comfort after face alignment surgery. Correcting jaw deformities can positively impact mental health by improving facial aesthetics and reducing speech or chewing difficulties.
Alternatives to Orthognathic Surgery
For patients who are still growing or have milder issues, options may include:
- Orthodontic treatment alone (braces or aligners)
- Orthopedic appliances in children/teens
- Cosmetic chin surgery (genioplasty)
- Dental restorations to camouflage bite discrepancies
Case Studies: Understanding Different Procedures
- Case 1: A 22-year-old with a severe overbite undergoes overbite surgery repositioning the lower jaw forward, combined with braces before and after surgery.
- Case 2: A 30-year-old with a pronounced underbite receives orthognathic surgery upper jaw to advance the maxilla and restore facial balance.
- Case 3: A 28-year-old with facial asymmetry benefits from double orthognathic surgery, correcting both jaws for improved bite and symmetry.
Orthognathic Surgery as a Team Effort
Successful jaw correction surgery requires collaboration between:
- Dentist– Maintains oral health before and after surgery
- Orthodontist– Aligns teeth before and after surgical correction
- Oral & Maxillofacial Surgeon– Performs the surgical procedure
Final Thoughts
Jaw alignment surgery is a life-changing treatment for those with severe bite or jaw misalignment. By combining orthodontics with surgical precision, orthognathic surgery restores function, health, and facial balance.
If you’re looking for expert orthodontic care to prepare for or maintain results from orthognathic surgery, York Orthodontics can help. While York Orthodontics does not perform surgery, we work closely with experienced oral surgeons to ensure your teeth are optimally aligned before and after surgical treatment, giving you the best possible outcome.
Contact us today for a complimentary consultation to discuss your orthodontic treatment plan.
FAQs
Yes, some patients pursue face alignment surgery primarily to improve facial balance. However, surgeons usually recommend it when functional issues are also present, as insurance coverage is less likely for purely cosmetic cases.
It can — especially if your jaw position affects tongue placement or bite. Some patients notice clearer pronunciation, but temporary speech changes are common during healing.
It can — especially if your jaw position affects tongue placement or bite. Some patients notice clearer pronunciation, but temporary speech changes are common during healing.
It can — especially if your jaw position affects tongue placement or bite. Some patients notice clearer pronunciation, but temporary speech changes are common during healing.
It can be more complex and involve longer healing, but when performed by an experienced surgical team, the complication rates are similar. The key difference is a slightly longer operating time and more swelling post-op.
Usually, yes. They are biocompatible and safe to keep in place permanently. Removal is rare unless they cause irritation.
Short domestic flights may be possible within 2–3 weeks if cleared by your surgeon. For long flights, wait at least 4–6 weeks due to swelling, sinus pressure, and risk of clotting.
Light walking can begin within days, but high-impact sports or contact activities should wait 3–6 months to avoid jaw injury.
They are often used interchangeably, but orthodontic surgery refers to jaw surgery combined with orthodontics to correct bite and jaw alignment.
Surgery is usually recommended after jaw growth completes, but some exceptions apply with specialized assessment.
Typically 1–4 hours, depending on whether one or both jaws are operated on.
Temporary numbness is common due to nerve manipulation but typically improves within months; permanent numbness is rare.
Most patients start with liquids, progress to soft foods within 2–4 weeks, and usually resume normal eating after 6–8 weeks.
Yes, repositioning the jaws can open the airway and reduce obstructive sleep apnea symptoms in many patients.