Corrective jaw surgery
Orthognathic surgery repositions the upper jaw, lower jaw and/or chin when its expected benefit is greater than that of a less invasive option.
The treatment plan is developed with the orthodontist. It aims for a stable bite, effective chewing and balanced facial proportions. Photographs alone cannot determine a plan: examination, imaging and bite analysis are essential.
Dr Ernenwein’s philosophy is to reserve jaw osteotomy for patients who genuinely need skeletal correction. In selected borderline discrepancies, enhanced orthodontics combined with targeted alveolar surgery or skeletal anchorage may sometimes achieve a satisfactory result with lighter surgery.
When may surgery be considered?
- Lower jaw positioned too far forward or backward.
- Upper jaw that is narrow, prominent or underdeveloped.
- Facial asymmetry or an open bite.
- Chewing difficulty, dental wear or lip closure problems caused by the discrepancy.
The treatment pathway
Most pathways include orthodontic preparation, surgery and orthodontic finishing. Planning may use photographs, digital dental models and three-dimensional imaging when clinically indicated.
Can jaw surgery be avoided?
Sometimes, but only after joint assessment with the orthodontist. Options for selected mild-to-moderate discrepancies may include orthodontic camouflage, temporary skeletal anchorage with miniscrews or miniplates (including Bollard-type plates), or alveolar corticotomy with or without bone augmentation depending on the periodontal tissues. These approaches can facilitate specific tooth movements and may avoid two-jaw surgery in carefully chosen cases.
Systematic reviews support a temporary acceleration of orthodontic movement with corticotomy, but long-term evidence remains limited. Skeletal anchorage can also be a less invasive alternative in selected open-bite or Class III cases. Neither approach replaces orthognathic surgery when the skeletal discrepancy is substantial or the facial objective cannot be achieved orthodontically.
Procedure and recovery
Surgery is performed under general anaesthesia, usually through incisions inside the mouth. Swelling, a modified diet, tiredness and temporary discomfort are expected. Hospital stay, time away from work and return to chewing depend on the operation.
Benefits, limitations and risks
Expected benefits, alternatives and risks—including bleeding, infection, altered sensation, bite problems and possible additional procedures—are discussed for the individual patient. Anaesthetic assessment and regular follow-up are required.
What to bring
- Referral letter and orthodontic summary.
- Existing X-rays or CT scans and reports.
- Medication list, allergies and relevant medical history.
- Questions about goals, timing, travel and recovery.
Frequently asked questions
Is orthodontic treatment always required?
It is common because it prepares the dental arches and helps stabilise the result. Specific cases may follow a different jointly agreed protocol.
Can the outcome be guaranteed?
No. A realistic objective is defined after assessment, but every operation has limitations, uncertainty and individual variability.
Related information
Medical sources
- SFSCMFCO — orthognathic surgery pathway
- SFSCMFCO — imaging in orthognathic surgery
- Hassan et al., 2015 — systematic review of corticotomy-assisted orthodontics (PubMed)
- Kuc et al., 2024 — review of periodontal effects of CAOT/PAOO (PubMed)
- Malara et al., 2021 — skeletal anchorage for open bite versus surgery (PubMed)
- De Clerck et al., 2010 — bone-anchored maxillary protraction with miniplates (PubMed)
Last editorial review: August 2026. This page provides general information and does not replace an examination, diagnosis or personalised treatment plan.