“When is corrective jaw surgery needed?”
My son has a misaligned bite, and his orthodontist let him know that he may need more than braces to correct it. I am looking to get a second opinion. When is corrective jaw surgery really needed?
11 Answers
David Bell
Oral and Maxillofacial Surgeon
That is a great question. Reading between the lines, it sounds like you and your son want to know if he can get by without having the surgery. The answer is yes. In fact, the vast majority of surgeries that are performed in the US are not lifesaving and are intended to improve the quality of a person's life.
Importantly, while it is always possible to camouflage your son's "malaligned bite" the real question is the following: "to what degree will the functional and cosmetic aspects of his treatment be compromised with a non-surgical approach, and how stable will the outcome be 10, 20, 40 years from now?" What about his airway? Considered another way, what are the options, risks, and benefits for your son considering each approach?
The fact that your son's orthodontist even mentioned that surgery may be necessary likely suggests that he might benefit greatly. I make this statement because 95% of my practice has been devoted to performing orthognathic surgery and orthodontists typically will not even raise the question unless it is a significant concern.
Finally, I would caution against an approach that advocates "let's try and do it without surgery". Such an approach typically leads to prolonged treatment time, frustration, and anxiety. Worse yet, to relapse due to instability.
There is no substitute for making a well-informed decision based on the goals, needs, and values of your son, considering the resources of your family, and for the thought process and decision-making to be guided by science and not guesswork.
I wish you the best of luck.
David Bell, D.D.S., M.D.
Importantly, while it is always possible to camouflage your son's "malaligned bite" the real question is the following: "to what degree will the functional and cosmetic aspects of his treatment be compromised with a non-surgical approach, and how stable will the outcome be 10, 20, 40 years from now?" What about his airway? Considered another way, what are the options, risks, and benefits for your son considering each approach?
The fact that your son's orthodontist even mentioned that surgery may be necessary likely suggests that he might benefit greatly. I make this statement because 95% of my practice has been devoted to performing orthognathic surgery and orthodontists typically will not even raise the question unless it is a significant concern.
Finally, I would caution against an approach that advocates "let's try and do it without surgery". Such an approach typically leads to prolonged treatment time, frustration, and anxiety. Worse yet, to relapse due to instability.
There is no substitute for making a well-informed decision based on the goals, needs, and values of your son, considering the resources of your family, and for the thought process and decision-making to be guided by science and not guesswork.
I wish you the best of luck.
David Bell, D.D.S., M.D.
Orthodontics can move the teeth safely within a certain envelope of movement. Beyond that, they would endanger the teeth and move them out of the bone. When the jaw discrepancy makes it impossible to correct the bite relationship with braces alone, then jaw surgery needs to be considered. I would see a board certified OMFS that performs that kind of surgery on a regular basis (orthognathic surgery) to see if that seems appropriate, and to discuss what type of surgery would be involved. Typically, you would not entertain that surgery until they are done growing. Be careful of an orthodontist that does NOT work with surgeons doing that type of work and tells you "we can fix it without surgery, no problem!" as the long term results could be devastating to your son down the road.
Corrective jaw surgery (for orthodontic purposes) is indicated when orthodontic-only treatment is unable to produce a functional and stable result. This is commonly seen where one of the jaws has grown excessively too much or too little in one or more of three planes of space.
Second opinions are great. At least the Orthodontist is telling you ahead of time that there may be more that just braces to properly correct your child bite. Orthognathic or corrective jaw surgery is usually needed when the upper and lower teeth will not come together correctly even after orthodontic correction. If the teeth are moved with orthodontics to far (in the alveolar bone that supports the teeth) trying to provide proper occlusion, the roots may be pushed out of the alveolar bone and soft tissue trying to compensate for skeletal bone deficiencies. The teeth and bone have to be physiologically positioned together to function properly. Orthognathic surgery can move the structural part of the jaws so the teeth in the alveolar bone align properly and remove the skeletal causes of a patients malocclusion. Talk with your Orthodontist and Oral Surgeon, They have a lot of patient education photos and diagrams of the types of corrective jaw surgery's that are most common and it will make things a lot clearer for you to understand.
Corrective jaw surgery is needed if there is a skeletal deformity you should see an Oral-Maxillofacial Surgeon to have him evaluated
Hi,
Corrective jaw surgery is usually recommended in their (boys) late teens due their growth cycle. If not corrected, he may develop TMJ due to his malocclusion.
Corrective jaw surgery is usually recommended in their (boys) late teens due their growth cycle. If not corrected, he may develop TMJ due to his malocclusion.
Orthodontic treatment is a great way to fix misaligned teeth, but the orthodontist can only maneuver the teeth positions within the confines of the jaw bone. If the upper and lower jaws are not aligned properly, the orthodontist can sometimes camouflage very minor discrepancies. Moderate to severe discrepancies will require jaw surgery to align the jaws properly so
that he can have a successful orthodontic treatment.
that he can have a successful orthodontic treatment.
Good evening,
Corrective jaw surgery (orthognathic surgery) is needed if the bite is not correctable with braces alone. This is typically a result of over or undergrowth of one or both of the jaws and/or some form of asymmetry. Surgery is performed to move one or both of the jaws to their ideal position. In some of these cases, orthodontics can be performed to "camouflage" the discrepancy and line up the teeth, however, the teeth will not be in an ideal position.
Hope this helps!
Corrective jaw surgery (orthognathic surgery) is needed if the bite is not correctable with braces alone. This is typically a result of over or undergrowth of one or both of the jaws and/or some form of asymmetry. Surgery is performed to move one or both of the jaws to their ideal position. In some of these cases, orthodontics can be performed to "camouflage" the discrepancy and line up the teeth, however, the teeth will not be in an ideal position.
Hope this helps!
Hi there,
That’s a good question, but a little complicated to answer without examining your son in person. A brief answer would be that Orthognathic surgery is indicated if the malocclusion is due to a skeletal discrepancy, i.e., misalignment of the jaws to each other or to the rest of the skull, and not due to the actual misalignment of the teeth. Usually, this cannot be corrected with braces alone.
There are some orthodontic skeletal growth therapies that can be achieved at an early age while the skull and jaws are still developing. However, after a certain age when skeletal growth has completed, if the skeletal discrepancy is severe, then most patients can never get a correction of the deformity without corrective jaw surgery. If patients do not want to have extensive surgery, then some can have minimal surgery to camouflage their problem, and some can do some camouflage orthodontic braces only. There are multiple different options for care.
Hope I answered some of your questions.
Sincerely,
Tarek Korban, DMD, MD
That’s a good question, but a little complicated to answer without examining your son in person. A brief answer would be that Orthognathic surgery is indicated if the malocclusion is due to a skeletal discrepancy, i.e., misalignment of the jaws to each other or to the rest of the skull, and not due to the actual misalignment of the teeth. Usually, this cannot be corrected with braces alone.
There are some orthodontic skeletal growth therapies that can be achieved at an early age while the skull and jaws are still developing. However, after a certain age when skeletal growth has completed, if the skeletal discrepancy is severe, then most patients can never get a correction of the deformity without corrective jaw surgery. If patients do not want to have extensive surgery, then some can have minimal surgery to camouflage their problem, and some can do some camouflage orthodontic braces only. There are multiple different options for care.
Hope I answered some of your questions.
Sincerely,
Tarek Korban, DMD, MD
It does depend on the procedure that is needed to correct a malocclusion (bad bite). Often, it is best to wait until all facial growth is complete. The orthodontist needs to be involved early to prevent dental compensation that will develop due to misalignment of the jaws that will need to be corrected or prevented prior to surgery. 18 years is the average age for a male for completion of facial bone growth. With the biologic bells curve, variables do exist.
Dr. Bob
Dr. Bob
Othognatic surgery or corrective jaw surgery is best when the patient passes a growth spurt to prevent any relapse. How to measure it? The easiest way for a boy is when the shoe size does not change anymore.
