Types of Orthognathic Surgery

Lower  jaw surgery

The lower jaw is split in a vertical plane on each side behind the last molar tooth. The tooth bearing part of the lower jaw can now be repositioned forward, backward, or sideways as planned, to establish the most favourable relationship. The operation is carried out almost entirely from inside the mouth to minimize visible scars on the skin of your face. The incision on the bone is performed with a small saw to allow the surgeon to split the jaw in a controlled manner. It is then moved to its new position and fixed with small bone screws and or plates. It is often necessary to make a small “stab” incision (a few millimeters long) low down on the side of the cheek to allow the screws to be inserted. The gum inside the mouth is sutured back into place using dissolvable stitches that may take 2-3 weeks to dissolve.

Light elastics (usually one on each side) are placed between the teeth to guide the jaw into the “new” bite. Very rarely it may be necessary to wire the teeth together for a short period of time. Lower jaw surgery may be performed as a single procedure or in combination with other orthognathic procedures.

The surgical procedure for the advancement of the lower jaw is demonstrated in the figure. Note the small titanium screws on the side of the jaw used to fixate the jaw segments during the healing phase of the bone.

The surgical procedure used to set the tooth bearing segment of the jaw back (shorten the jaw) is demonstrated in the figure. Note the small piece of bone that is removed to allow the backward repositioning of the jaw.

Upper jaw surgery

The incision is made inside your upper lip through the gum above your teeth to gain access to the bone of the jaw. The upper jaw is then cut with a small saw to allow the surgeon to mobilize the jaw. Once the jaw is mobilized it can be placed into its pre-planned position and fixed by means of small plates and screws. The gum is sutured back into place with dissolvable stitches that may take 2-3 weeks to dissolve.

Light elastics (usually one on each side) are placed between the teeth to guide the jaw into the “new” bite. Very rarely it may be necessary to wire the teeth together for a short period of time. Upper jaw surgery may be performed as a single procedure or in combination with other orthognathic procedures.

This figure demonstrates the surgical procedure used for the repositioning of the upper jaw. In this case the upper jaw is advanced.

Chin surgery

In this case the incision is made inside the lower lip through the gum to gain access to the bone of the chin. The bone is then cut with a small saw to mobilize the chin. The chin segment can now be repositioned depending on the aesthetic requirement. The repositioned chin segment is held in position by means of plate and or screw fixation. The gum is sutured back into place with dissolvable stitches that may take 2-3 weeks to dissolve. Chin surgery is usually performed in combination with other orthognathic procedures.

*The small titanium plates and screws used to hold the bone segments together are usually left in place and very rarely need to be removed.

The figure demonstrates the surgical technique used to reposition the chin. In this case the chin segment is advanced.