Types of Jaw Surgery and the Reasons for Each

Jaw surgery may be recommended if you have a jaw issue that can’t be addressed with orthodontics alone. Orthodontics is a specialized type of dentistry concerned with the positioning of the jaws and teeth.

Your orthodontist and oral surgeon will work together to help develop a treatment plan that’s appropriate for your condition.

Some examples of things that jaw surgery can help with include:

• adjusting your bite, which is how your teeth fit together when your mouth is closed
• correcting conditions that affect the symmetry of your face
• helping ease pain due to a temporomandibular joint (TMJ) disorder
• repairing an injury or congenital condition involving the face, such as a cleft palate
• preventing further wear and tear to your teeth
• making activities like biting, chewing, or swallowing easier
• addressing breathing problems, such as mouth breathing and obstructive sleep apnea

The optimal time for jaw surgery is after the jaw has stopped growing, typically in the late teens or early 20s.

Maxillary osteotomy is the surgery that’s done on your upper jaw (maxilla).

Conditions that may call for maxillary osteotomy include:

• an upper jaw that protrudes or recedes significantly
• an open bite, which is when your back teeth (molars) don’t touch when your mouth is closed
• a crossbite, which is when some of your bottom teeth sit outside of your upper teeth when your mouth is closed
• midfacial hyperplasia, which is a condition where growth in the middle portion of your face is reduced

Procedure overview

During this procedure, your surgeon will:

1. make an incision in the gums above your upper teeth, allowing them to access the bones of your upper jaw
2. cut into the bone of your upper jaw in a way that allows them to move it as a single unit
3. move this portion of your upper jaw forward so that it aligns and fits properly with your lower teeth
4. place plates or screws to hold the adjusted bone in its new position
5. use stitches to close the incision in your gums

Mandibular osteotomy refers to surgery that’s performed on your lower jaw (mandible). It’s most often done when your lower jaw protrudes or recedes significantly.

Procedure overview

When you have a mandibular osteotomy, your surgeon will:

1. make an incision into your gums on each side of your lower jaw, just behind your molars
2. cut the bone of the lower jaw, which allows the surgeon to carefully move it into a new position
3. move the lower jawbone either forwards or backwards into a new position
4. place plates or screws to hold the adjusted jawbone in its new position
5. close the incisions in your gums with stitches

Bimaxillary osteotomy is the surgery performed on both your upper and your lower jaw. It’s done when a condition affects both jaws.

Procedure overview

The techniques used for this surgery include those that we’ve discussed for the maxillary and mandibular osteotomy procedures.

Because operating on both the upper and lower jaw can be complex, your surgeon may use 3-D modeling software to help plan the surgery.

Genioplasty is surgery on the chin. It can help correct a receding chin. It may sometimes be performed with a mandibular osteotomy for a receded lower jaw.

Procedure overview

During a genioplasty, your surgeon will:

1. make an incision into your gums around your lower lip
2. cut part of the chinbone, which allows them to move it
3. carefully move the chinbone into its new position
4. place small plates or screws to help hold the adjusted bone in its new position
5. close the incision with stitches

Your doctor may recommend TMJ surgery if other treatments haven’t been effective at relieving your TMJ symptoms.

There are a few types of TMJ surgery:

• Arthrocentesis. Arthrocentesis is a minimally invasive procedure that involves using small needles to inject fluid into the TMJ. This can help lubricate the joint and wash out any lingering debris or byproducts of inflammation.
• Arthroscopy. During arthroscopy, a thin tube called a cannula is inserted into the joint. The surgeon then uses a thin scope (arthroscope) and small tools to operate on the joint.
• Open joint surgery. Open joint surgery (arthrotomy) is the most invasive type of TMJ surgery. For this procedure, an incision is made in front of your ear. Your doctor can then work to replace or remove affected TMJ components.

Below, we’ll explore what you can expect when you have jaw surgery.

Before surgery

In many cases, an orthodontist has placed braces or aligners onto your teeth in the months before your surgery. This helps align your teeth in preparation for your procedure.

You’ll likely have a few appointments before your surgery. These help your orthodontist and surgeon plan out your procedure. Preparation can include taking measurements, molds, or X-rays of your mouth.

Sometimes, 3-D modeling on a computer is used as well.

During surgery

Jaw surgery is performed using general anesthesia. That means you’ll be asleep during your procedure.

Most surgeries take 2 to 5 hours, but the exact length of time depends on the specific procedure being performed.

During jaw surgery, most of the incisions are made inside your mouth, although in some cases very small incisions will be made on the outside.

Overall, scarring on your face or chin is unlikely.

Recovery

Most people stay in the hospital for 1 to 4 days after their surgery.

When you’re able to leave the hospital, your doctor will give you instructions for eating and oral hygiene. It’s important to follow these instructions carefully during recovery.

After your surgery, it’s normal to experience swelling, stiffness, and discomfort in your face and jaw. These should go away over time.

In the meantime, your doctor will prescribe medications to help ease these symptoms.

In some cases, you may experience numbness in your top or bottom lip. This is usually temporary and will go away over a period of weeks or months. In rarer cases, it may be permanent.

Recovery can take anywhere between 6 and 12 weeks. After several weeks of recovery, your orthodontist will continue aligning your teeth with braces.

When your braces are removed, your orthodontist will give you a retainer to help keep your teeth aligned.

Having surgery on your jaw is generally very safe.

However, as with any surgery, it has some risks. Your surgeon should inform you of these risks before your procedure.

The potential risks of jaw surgery include:

• a bad reaction to the anesthesia
• excessive bleeding
• infection at the surgical site
• injury to the nerves of the jaw
• fracture of the jaw
• problems with bite or alignment following surgery, which could require an additional procedure
• relapse of the jaw back to its original position
• new TMJ pain

Some surgeries may have an increased risk compared to others.

A 2019 study found that people who underwent a bimaxillary osteotomy had an increased risk for complications compared to those who underwent a maxillary or mandibular osteotomy alone.

The cost of jaw surgery can vary depending on several factors. These include things like:

• the surgeon
• the procedure
• your location

Also, remember that the total cost of jaw surgery includes several components, such as:

• the surgeon’s fee
• facility fees
• anesthesia fees
• any additional tests that are performed
• any medications that are prescribed

Always check with your insurance provider to see what’s covered before you schedule your jaw surgery. Many insurance companies will cover jaw surgery if it will treat a documented, specific health condition or problem.

Jaw surgery is typically performed to help readjust or correct the alignment of your jaw. It can involve your upper jaw, lower jaw, or both.

There are many types of jaw surgery available. Your orthodontist and surgeon will work together to plan out a procedure that addresses your specific condition.

Although jaw surgery is generally safe, there are some risks associated with it. Your surgeon should make you aware of these before your surgery.

The cost of jaw surgery can depend on several factors, such as the specific surgeon and type of surgery. Always be sure to confirm what your insurance covers before scheduling your procedure.