How you prepare

Upper jaw (maxillary osteotomy)

Surgery on the upper jaw may be performed to correct:

• Significantly receded or protruding upper jaw
• Crossbite
• Too much or too little of the teeth showing
• Open bite
• Reduced facial growth of the middle of the face (midfacial hypoplasia)

Your surgeon cuts the bone above your teeth so that the entire top jaw — including the roof of your mouth and your upper teeth — can move as one unit. The jaw and upper teeth are moved forward until they fit properly with the lower teeth. This can be planned on a computer to determine if additional work, such as orthodontics, will be needed to help correct any remaining fit difference.

An open bite occurs when excess bone grows above the molars, causing what's normally a flat, even surface to become angled. To fix this, your surgeon shaves away or removes the excess bone.

Once the jaw is realigned, plates and screws hold the bone in its new position.

Lower jaw (mandibular osteotomy)

A mandibular osteotomy can correct:

• Receding lower jaw
• Protruding lower jaw

The surgeon makes cuts behind the molars and lengthwise down the jawbone so the front of the jaw can move as one unit. The jaw can then be moved to its new position either forward or backward. Plates and screws hold the jawbone together as it heals.

Chin surgery (genioplasty)

A genioplasty can correct a small chin (deficient chin). A small chin often accompanies a severely receded lower jaw.

Typically, surgeons can alter the jaw and restructure the chin during the same surgery. The surgeon cuts a piece of the chin bone on the front of the jaw, moves it forward, and secures it in a new position with plates and screws.

After the procedure

After surgery, your doctor will provide you with instructions. These usually include:

• What you can eat
• Oral hygiene
• Avoiding tobacco
• Avoiding strenuous activity
• Medications to control pain
• When to return to work or school, which is usually in one to three weeks

Initial jaw healing typically takes about six weeks after surgery, but complete healing can take up to 12 weeks.

After initial jaw healing — at about six weeks — your orthodontist finishes aligning your teeth with braces. The entire orthodontic process, including surgery and braces, may take several years. Once the braces are removed, retainers to hold tooth position may be used.