Orthognathic surgery

Orthognathic means “straight jaws”. Orthognathic surgery is surgery on the tooth bearing bone to align the teeth. Either the lower jaw, the upper jaw or both can be operated on to bring the teeth into alignment. There are many conditions seen by craniofacial surgeons that benefit from jaw shifting surgery.

Orthognathic surgery is performed as a team. Prior to any intervention, a meeting is held with the surgeon, orthodontist and patient to decide if the teeth can be aligned by orthodontics alone or if surgery is also required. This is critical because the orthodontist will move the teeth in different directions depending on what is decided. Photos, dental models and cephalometric xrays are taken as baseline record. About one year of orthodontic treatment with braces is usually required before the surgery and following surgery a further 6 months of braces helps fine tune dental alignment.

Examples of cases

Case 1. Mandibular advancement >>
Case 2. Maxillary advancement >>
Case 3. Bimaxillary osteotomy >>

Case 1.
A BSSO (bilateral sagittal split osteotomy) has been performed and the lower jaw brought forward 12 mm to align the teeth. This also helps with lip competence at rest and greatly improves facial appearance.

Mandibular advancement - Pre Op	Mandibular advancement - Post Op

Case 2.
This boy with a cleft lip and palate has a marked underbite (note the preoperative cephalometric position of the teeth. I have performed a Le Fort I osteotomy and advanced the maxilla 8 mm to bring the teeth into alignment.

Maxillary advancement - PreOp Xray	Maxillary advancement - PreOp	Maxillary advancement - PostOp

Case 3.

This is a 3D reconstruction of a skull of a person on whom I have performed surgery on both the upper and lower jaws. The maxilla was vertically long with the teeth visible at rest and it has been “impacted” upwards. The mandible has been advanced. The plates holding the Le Fort I and sagittal split osteotomies can be seen.

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