Corrective Jaw Surgery (Orthognathic Surgery)

Orthognathic surgery refers to the surgical correction needed to fix substantial abnormalities of the maxilla (upper jaw), the mandible (lower jaw), or both. The abnormality may be a birth defect, a growth defect, or the result of traumatic injuries to the jaw area.

Orthognathic surgery is generally performed by an Oral and Maxillofacial Surgeon to correct malocclusion (bad bite) in cases where routine orthodontic treatment has not or will not be effective. Orthognathic surgeries include the reconstruction of the mandible or maxilla, mandibular ramus, maxilla osteotomy, and mandibular osteotomy.

There are several classifications of malocclusion (the improper coming together of teeth) which may require orthognathic surgery:

Class I Occlusion –This malocclusion means that the lower anterior incisors sit directly behind the upper anterior incisors when the patient bites down. This is considered less destructive than Class II and Class III malocclusions.

Class II Malocclusion – This is identified when the lower anterior incisors lie significantly behind the upper anterior incisors during the biting process; in some cases hitting the soft tissue behind the upper incisors. This is commonly referred to as an overbite and can cause discomfort, bone damage, excessive wear of the front teeth, and tooth loss.

Class III Malocclusion – This is commonly known as an underbite and occurs when the lower anterior incisors and lower jaw are positioned beyond the upper teeth, making the lower jaw much more prominent than the upper jaw.

Reasons for orthognathic surgery

The malocclusion of the teeth can create greatly destructive forces among the five powerful muscles that control the closing and opening of the jaw. These muscles generate a tremendous force when clenching, grinding or chewing. Misalignment can seriously damage the function and aesthetic appearance of the teeth in many ways if left untreated, such as:

  • Tooth Wear – In the case of an overbite, the pressure and wear on the teeth is not spread evenly. This can also lead to TMJ, migraine headaches, and tooth loss.
  • Chronic Jaw, Muscle Pain & Headache – The misalignment of the teeth alters the way the facial muscles interact. In some cases, the meniscus cartilage which acts as a buffer between the jawbones can be painfully damaged.
  • Loose Teeth – When uneven pressure is continually exerted in unintended places or soft tissue is damaged by an overbite, adjacent teeth may become loose in their sockets which causes pain and reduces proper function.
  • Tooth Sensitivity – As teeth become damaged by constant use, the enamel becomes thinner and the nerves are less protected. This lack of protection can lead to sharp pains when hot or cold foods are eaten.
  • Difficulty Swallowing, Chewing, or Biting Food – Each can be associated with muscle pain and/or poor alignment of the upper and lower jaws.

What does orthognathic surgery involve?

When the dentist identifies a patient as a candidate for orthognathic surgery, a complete photographic analysis is initially undertaken. This includes panorex x-rays, cephalometric x-rays, models, impressions, and radiographs. Your oral & maxillofacial surgeon, your orthodontist and your dentist will work together and consider how the corrective surgery will impact both proper jaw function and the aesthetic appearance of the entire face.

Generally, orthodontic braces are necessary to align the arches and straighten the teeth prior to the surgery, and additionally, retainers may be used after the surgery. During maxillary surgery, the upper jaw is moved and may be secured in position using tiny plates, wires, rubber bands and screws. Surgery on the mandible is performed using bone grafts to align the lower jaw into the correct position. Orthognathic surgery generally requires a general anesthesia and a good deal of aftercare. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your recovery. You may also be provided with a modified diet (if required).

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Testimonials

I had an entire dental replacement procedure done over the last 18 months. All new crowns to replace my worn teeth. BridgeCreek Prosthetic Dentistry did an amazing job and it was life changing for me. I now feel excited to smile again after many years of hiding. Dr Butler and his staff are just fantastic! Caring, attentive and professional. The entire experience was positive and it has given me a new found confidence in my appearance.

Thank you BridgeCreek

Ed G.

Dr. Waguespack gave me the smile I always dreamed of which also gave me the confidence to truly enjoy it.
From my very first (tearful!) consultation, he brought compassion, expertise, and steady reassurance to every step of my journey, from recommending Invisalign to the final restoration. He answered every question with patience, listened with care, and never made me feel rushed. He was precise and detail-oriented with a sharp eye for fine-tuning every area of my dental work. That level of care and artistry made my new smile not just beautiful, but truly mine.
My process with Dr. W wasn’t just about misaligned teeth or a crooked smile - it was about helping me feel like myself again. I always felt respected, supported, and genuinely cared for and not just by Dr. Waguespack but by his entire office team. They were warm, professional, and made every visit a pleasure.
I’ll be recommending Dr. Waguespack to anyone in need of prosthodontic care or even a thorough consultation. I don’t just have a beautiful smile now, I have a renewed comfort in being myself that shows in every photo, every laugh, and every moment where I feel free to simply be me.
Gratitude to Dr. Waguespack and all the caring people at BridgeCreek Prosthetic Dentistry.

Barbara V.

I have been seeing Dr. Butler and his staff at BridgeCreek Prosthetic Dentistry for over five
years for regular dentistry and other oral health issues. Dr. Butler's approach to dentistry has
been perfect for my needs, as he understand and treats serious problems when they arise,
but also takes a conservative approach when it is warranted, and does not perform
unnecessary treatments or interventions. This has saved me not only significant sums of
money over what other care providers recommended for my oral health needs, but has also
saved me from a lot of unnecessary procedures and the pain and inconvenience related
thereto.

I would recommend Bridgecreek Prosthetic Dentistry to anyone, no matter what level of oral
health care you need.

Jeremy S.

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