Types of Surgical Orthodontics (Orthognathic Surgery)

Orthognathic surgeries are procedures to correct a misalignment of the jaw. An orthodontist in Melbourne, FL might recommend orthognathic surgery if the maxilla (upper jaw) or mandible (lower jaw) are misaligned. Orthognathic surgeries are more commonly performed in children, because the procedures are easier to do before the jaw is fully grown.

Kids who need corrective jaw surgery will usually receive additional orthodontic treatments. After the operation is performed, headgear or braces may be needed. Here’s a look at some of the most common types of orthognathic surgery we perform at Melbourne Orthodontics in Melbourne.

Reasons Jaw Surgery May Be Recommended

Some orthodontic problems can be corrected with braces or headgear alone. However, a more serious misalignment of the jaw may require surgery. Here are some of the reasons why your Melbourne orthodontist might recommend jaw surgery:

  • Chronic pain in the jaw or temporomandibular joint
  • Terrible headaches from jaw pain
  • Obstructive sleep apnea
  • Facial injury
  • Trouble biting, chewing or swallowing food
  • Lower jaw has severely receded
  • Certain types of birth defects
  • Severe underbite, overbite, or open bite

Upper Jaw Surgery (Maxillary Osteotomy)

A maxillary osteotomy is a major corrective surgery on the upper jaw. It can be used to fix an upper jaw that has severely receded. During this procedure, the maxillofacial surgeon cuts, breaks and moves the upper jaw. The upper jaw is then fixed in place with metal plates and titanium screws.

Lower Jaw Surgery (Mandibular Osteotomy)

Lower jaw surgery involves moving the lower jaw forward or backward to bring it into alignment with the upper jaw. The direction that the lower jaw is moved depends on the patient’s bit alignment. This procedure is most commonly performed to correct an underbite.

Chin Surgery (Genioplasty)

A genioplasty is a procedure to restructure a severely receded lower jaw and chin. Patients who need a genioplasty performed generally need lower jaw surgery as well. Thus, the two procedures are often combined into one surgery.

Surgeries for TMD

Your temporomandibular joint is the joint that connects the lower jaw to the skull. Temporomandibular Joint Dysfunction (TMD) is a painful condition that impacts the muscles that control the jaw, and the jaw itself. There are two types of orthognathic surgery that can be performed to correct this condition.


This is a specialized type of operation called a “keyhole” surgery. The orthognathic surgeon makes a small incision in front of the ear. A tiny camera called an arthroscope is then inserted into that incision. The surgeon can then remove scar tissue around the temporomandibular joint that may be causing the painful condition.


This is a more involved surgical procedure for correcting TMD. The surgeon repositions the lower jaw. The cartilage disc in the temporomandibular joint is also repositioned. Then the surgeon injects a steroid into the joint. A sterile fluid is also used to wash out the joint and remove any potential debris in it that is contributing to the condition. However, the main goal of this operation is to reposition the cartilage disc, so it functions properly.

Risks of Avoiding Jaw Surgery

If a severe jaw problem is left untreated, it can lead to more serious dental issues and health problems in the future. Letting a bite problem or misalignment go untreated can lead to these potential problems:

  • Crooked or crowded teeth
  • Severe headaches
  • Increased risk of tooth decay and gum disease
  • Slurred or lisping speech
  • Difficulty chewing and swallowing food
  • Structural changes to the mouth
  • Dry mouth or bad breath
  • Temporomandibular joint dysfunction (TMD)

Orthognathic Surgery and Insurance

Insurance companies may or may not pay for orthognathic surgery, depending on whether the procedure is medically necessary or cosmetic in nature. Some people elect to have jaw surgery to improve the appearance and symmetry of their face. However, insurance companies generally won’t pay for these surgeries, because they are elective.

If your jaw problem causes sleep apnea, speech disorders, severe pain or breathing issues, insurance companies will generally consider those medically necessary and will cover some costs.

Contact Your Melbourne Orthodontist Today

If you’ve been suffering from any of the symptoms described above related to jaw misalignment, it’s a good idea to head to the orthodontist in Melbourne for an exam. Contact Melbourne Orthodontics today to schedule an appointment.