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Surgical Orthodontics

Jaw surgery or orthognathic surgery is ideally indicated whenever growth is completed and the bite is off due to a significant jaw discrepancy. Usually, an orthodontist can compensate for jaw discrepancies unless the discrepancies are severe, in which case jaw surgery may be necessary. Just prior to surgery the orthodontist and oral surgeon work in unison to plan the surgery and perform the surgery on study models to replicate the movements which will be done in the mouth. In the old days the jaws were wired together for a period of time but today this is a rare occurrence but still necessary in some cases.

Since growth must be completed prior to surgery females should be at least 16 years of age and males late teens to early 20s depending upon the affected jaw. Jaw surgery often changes the facial appearance. Generally, surgery is performed in a hospital by an oral surgeon and may last several hours. The surgery may be a single jaw, upper or lower, or in some cases both jaws are involved. Typically, the braces will be on for approximately 9–12 months before the surgery to decompensate for the jaws, allowing the bite to match the jaws. Most times this makes the bite worse until surgery aligns both the jaws and bite together. After surgery, the braces will remain on for another 6–9 months to finalize the bite correction. Retainers are then worn once the braces have been removed.

The surgery most often is covered at least in part by medical insurance but the oral surgeon should predetermine coverage prior to treatment.