Surgical treatment, particularly orthognathic surgery, is the gold standard for addressing moderate to severe skeletal malocclusions. Unlike orthodontics, which focuses on aligning teeth, surgery corrects the underlying bone structure, providing significant functional and aesthetic benefits.

Key Benefits of Surgery

1. Correction of Mandibular Position and Proportions

• Class II (overbite):
  • Advancement of the mandible or recession of the maxilla.
  • Achieves a balanced facial profile with improved jaw proportions.
• Class III (reverse bite):
  • Advancement of the maxilla or recession of the mandible.
  • Improves harmony between the upper and lower jaws.
• Open bite:
  • Corrects vertical discrepancies by repositioning the maxilla or mandible.
  • Ensures that the upper and lower teeth fit together correctly when biting.

2. Improved Facial Aesthetics

• Restores facial symmetry in cases of mandibular asymmetry.
• Improves facial balance by correcting vertical maxillary excess (long face) or mandibular deficiency (weak chin).
• Refines specific features such as the jaw line or the middle third of the face according to the patient’s aesthetic goals.

3. Functional Improvements

• Chewing and biting:
  • Correctly aligns teeth, improving chewing efficiency.
• Speech:
  • Resolves pronunciation problems associated with severe malocclusions.
• Airway and breathing:
  • Treats obstructive sleep apnoea syndrome (OSAS) by advancing the maxilla or mandible, increasing airway space.

4. Stability and Long-Term Results

• Provides permanent correction of skeletal problems, ensuring a stable foundation for aligned teeth.
• Reduces the risk of relapse compared to non-surgical options in severe cases.

5. Complete Bite and Smile Alignment

• Works in conjunction with orthodontics to achieve optimal alignment of teeth and jaws.
• Solves severe problems such as crowding, gapping or crossbite by creating sufficient jaw space.

6. Complex Case Resolution

• TMJ Disorders:
  • Relieves tension or dysfunction in the temporomandibular joint caused by malocclusions.
• Facial trauma or congenital conditions:
  • Corrects deformities or discrepancies resulting from trauma, cleft lip/palate or syndromes such as hemifacial microsomia.

Advanced Techniques for Surgical Success

1. Maxillomandibular Advancement (MMA):
   • Used in severe cases of Class II, Class III or OSAS.
   • Repositions both jaws for balanced results.
2. Osteogenic Distraction:
   • Ideal for gradual bone elongation in cases of significant mandibular deficiencies.
3. Condylectomy or Genioplasty:
   • Addresses condylar hyperplasia or improves the aesthetics of the chin.
4. Personalised surgical planning:
   • Advances in 3D imaging and surgical simulation ensure precise results tailored to the patient’s anatomy.

who benefits most from surgery?

• Patients with moderate to severe skeletal discrepancies that cannot be corrected with orthodontics alone.
• Those seeking functional (chewing, breathing, speech) and aesthetic improvements.
• People with recurrent problems such as relapses after orthodontics or persistent symptoms of sleep apnoea.

Conclusion

Orthognathic surgery offers transformative results for patients with skeletal malocclusions. By correcting the jaw structure from the root, the surgery achieves a harmonious balance between functionality, aesthetics and long-term stability. At Birbe Clinic, we specialise in personalised surgical solutions, ensuring that each patient achieves their best smile and functionality.

Article written by Birbe’s Editorial Board