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What is orthognathic surgery?

Orthognathic surgery is corrective jaw surgery. In a treatment sometimes called surgical orthodontics, the orthodontist prepares the alignment of the teeth, and an oral and maxillofacial surgeon repositions the upper jaw (maxilla), the lower jaw (mandible), or both when indicated. Depending on the diagnosis, this approach may help improve:

  • Chewing a functional and efficient bite
  • Nasal breathing improved airways
  • Mouth closure at rest muscular balance
  • Facial harmony improved proportions and aesthetics

Orthodontics and surgery are planned together when a jaw discrepancy cannot be corrected by moving teeth alone. The timeline and steps vary from patient to patient.

Planification 3D pour chirurgie orthognathique des machoires

Who is it indicated for?

Patients after age 16-18 who have completed their growth and for whom the jaw discrepancy is too significant to be compensated by simply moving the teeth.

Chirurgie du prognathisme

Prognathism

Lower jaw too far forward relative to the upper jaw, sometimes creating a more concave profile.

Retrognathism surgery

Retrognathism

Recessed lower jaw, sometimes making the profile appear more convex or the chin look recessed.

Facial asymmetry surgery

Facial asymmetry

Lateral deviation of one or both jaws creating a visible facial imbalance.

Anterior open bite surgery

Anterior open bite

Inability to close the front teeth together, affecting chewing and speech.

Bimaxillary surgery for sleep apnea

Sleep apnea

For some patients, jaw advancement may be part of treatment for obstructive sleep apnea after a specialist assessment.

Vertical maxillary excess surgery

Vertical excess

Face too long with excessive gummy smile or difficulty closing the lips at rest.

How does it actually work?

1

Orthodontic preparation (6-18 months)

The patient wears fixed appliances (“braces”). Dr Benguira aligns the teeth to an ideal arch form. Sometimes, this makes the misalignment more visible temporarily.

2

3D planning with the surgeon

The patient sees the surgeon again 2 months before the operation. Thanks to virtual surgical planning (VSP), every movement is calculated to the millimeter with 3D-printed surgical guides.

3

Surgery (2-4 hours)

Under general anesthesia. All incisions are made inside the mouth, no visible scarring. Hooks are placed for retaining elastics for 4 weeks.

4

Orthodontic finishing (6-12 months)

4 to 6 weeks after the operation, the final orthodontic movements resume as jaw mobility returns to normal.

Illustration 3D avant et apres chirurgie orthognathique mandibulaire Schema anatomique apres chirurgie orthognathique repositionnement mandibulaire

The 3D planning revolution

Virtual surgical planning (VSP) helps the team visualize jaw movements and prepare the procedure around each patient’s anatomy.

Millimetric precision

Exact calculation of jaw movements in all 3 dimensions of space.

Preoperative visualization

The patient can see the anticipated result even before the procedure.

3D-printed guides

Custom surgical guides for optimal precision during the procedure.

Frequently asked questions about surgery

This term describes treatment that combines orthodontics with jaw surgery, also called orthognathic surgery. Dr Benguira plans the orthodontic care with an oral and maxillofacial surgeon, who performs the operation when it is indicated.

Not necessarily. The options depend on growth, tooth and jaw position, function, and the patient’s goals. An assessment helps compare orthodontic and surgical approaches.

A chin that looks recessed may reflect lower jaw position or the shape of the chin itself. Orthognathic surgery changes jaw position; genioplasty changes the chin. The diagnosis determines which approach may be appropriate.

Before-and-after images can illustrate changes in facial profile and bite. Individual results depend on the diagnosis and treatment plan; another patient’s images cannot predict your result.

The surgery is performed under general anesthesia, so there is no pain during the procedure. After the operation, swelling and discomfort are normal for 2 to 3 weeks, well managed with prescribed medication.

No. All incisions are made inside the mouth. No scars are visible on the face.

Return to work in 2-3 weeks. Return to sports in 6-8 weeks. Swelling gradually decreases over several weeks, with final results visible after a few months.

In some cases, orthodontic mini-screws (TADs) can help move teeth and avoid surgery. If the discrepancy mainly concerns jaw position, the orthodontist and surgeon assess the available options together.

Costs depend on the treatment plan, where surgery takes place, and applicable fees. Coverage for surgery and orthodontics varies with RAMQ criteria and your insurance plan. Our team can help you identify the questions to ask the relevant organizations before treatment.

Mini-screws: avoid surgery?

For moderate cases, orthodontic mini-screws (TADs) allow previously impossible tooth movements, sometimes offering an alternative to surgery:

  • Camouflage orthodontics (dental compensation)
  • Absolute anchorage for large-scale movements
  • Molar intrusion to close an open bite

Only a complete evaluation can determine the best approach for your case.

Discover mini-screws (TADs) →
Mini-vis orthodontiques TADs avec broches en bouche

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Dr David Benguira

Certified orthodontist with over 20 years of experience, Dr Benguira completed his orthodontic training at the Université de Montréal after a doctorate in dental medicine. A recognized specialist on the North Shore, he combines clinical expertise and cutting-edge technology to deliver exceptional results for every patient.

Quebec Dental Board Quebec Association of Orthodontists Invisalign Certified LightForce Certified
Learn more sur Dr Benguira →
Dr David Benguira, orthodontist in Saint-Eustache
450.983.4233 Book appointment