Orthognathic jaw surgery, also known as corrective jaw surgery, addresses functional and aesthetic concerns caused by jaw misalignment, skeletal deformities, and temporomandibular joint (TMJ) disorders. The Advanced Head and Neck, Cranial/Orbital/Maxillofacial Surgery Program at Scripps Prebys Cancer Center provides comprehensive surgical expertise utilizing advanced techniques and computer-aided planning to achieve optimal functional and aesthetic outcomes related to the bite, airway, and facial profile.
UNDERSTANDING ORTHOGNATHIC JAW SURGERY
Orthognathic jaw surgery corrects severe jaw misalignment that cannot be addressed with orthodontics alone. These procedures restore proper bite function, improve breathing, enhance facial aesthetics, and relieve pain associated with jaw dysfunction. Advanced surgical planning ensures precise positioning and optimal results.
LEFORT 1 MAXILLARY OSTEOTOMY
The LeFort 1 osteotomy is one of the most common corrective jaw procedures, repositioning the upper jaw (maxilla) to correct vertical, horizontal, and/or transverse discrepancies. This procedure involves cutting the upper jaw bone above the tooth roots and repositioning it to achieve proper alignment with the lower jaw and improve facial proportions. In some scenarios, additional bone cuts are made in between the teeth to widen the upper jaw bone and/or help coordinate the alignment of the upper and lower jaw. LeFort 1 surgery is frequently used to correct open bite, deep bite, and anterior-posterior jaw discrepancies.
BILATERAL SAGITTAL SPLIT MANDIBULAR OSTEOTOMY
Bilateral sagittal split osteotomy (BSSO) is the most common procedure for correcting deformities involving the lower jaw (mandible). This technique involves making precise cuts on both sides of the mandibular ramus and repositioning the lower jaw. BSSO is highly effective for treating underbite, overbite, and jaw asymmetry. The lower jaw is moved forward, backward, or rotated to achieve proper bite alignment, facial balance and in many instances airway expansion.
SLIDING GENIOPLASTY
Sliding genioplasty reshapes and repositions the chin to improve facial aesthetics and proportions. This procedure involves cutting the chin bone and moving it forward, backward, or vertically in order to achieve better facial balance and often to improve skeletal support of the lower lip. Genioplasty is often combined with other jaw surgeries to optimize overall facial harmony.
GENIOGLOSSUS ADVANCEMENT
Genioglossus advancement repositions the tongue muscle attachment to enlarge the airway and treat sleep apnea and breathing disorders. This procedure moves the genial tubercle (where the tongue muscle attaches to the mandible) forward, from helping to expand the airway. It is often performed as an adjunct to maxillomandibular advancement for obstructive sleep apnea, which involves LeFort 1 maxillary and BSSO mandibular advancement.
TOTAL ALLOPLASTIC TMJ REPLACEMENT
Total alloplastic temporomandibular joint (TMJ) replacement addresses severe TMJ disorders, arthritis, and joint degeneration. This advanced procedure involves replacing the damaged joint with a custom prosthetic implant designed to restore function, improve chewing function, reduce pain, and improve jaw mobility. Alloplastic joint replacement is performed with the goal of providing long-term stability and improved outcomes for complex TMJ cases. It is often combined with additional orthognathic procedures, such as contralateral sagittal split mandibular osteotomy and LeFort 1 osteotomy to improve the occlusion and the airway.
SURGICALLY ASSISTED RAPID PALATAL EXPANSION AND DISTRACTION OSTEOGENESIS MAXILLARY EXPANSION (DOME)
These advanced techniques expand the upper jaw to correct a narrow palate and improve airway dimensions. Surgically assisted rapid palatal expansion (SARPE) combines surgical release with orthodontic expansion, while distraction osteogenesis maxillary expansion (DOME) uses a combination of surgical release and skeletally anchored orthodontic expander to widen the maxilla. Both procedures have the potential to enhance breathing, improve bite alignment, and expand the airway space.
LEFORT 3 OSTEOTOMY
LeFort 3 osteotomy repositions the entire midface to correct severe vertical maxillary excess or deficiency. This comprehensive procedure is used for complex craniofacial deformities and severe facial imbalance involving the orbits and sometimes the nasal bridge. LeFort 3 surgery provides dramatic improvement in facial aesthetics and function for patients with significant midface skeletal discrepancies. It can be combined with LeFort 1 maxillary osteotomy, BSSO mandibular osteotomies, and genioplasty in cases of severe malocclusion, facial imbalance and/or airway obstruction.
MAXILLARY AND MANDIBULAR BONE DISTRACTION
Bone distraction osteogenesis gradually lengthens jaw bones through controlled surgical separation and natural bone formation. This technique is particularly valuable for severe deficiencies, reconstruction after tumor removal, and complex deformities. Distraction allows precise control and often reduces the need for bone grafts.
ADVANCED SURGICAL PLANNING AND EXPERTISE
Dr. Ravi Garg and our surgical team utilize state-of-the-art computer-aided design and manufacturing (CAD/CAM) technology to virtually plan every procedure before surgery. This advanced planning optimizes surgical precision, predicts outcomes, and improves operative efficiency. Combined with our multidisciplinary approach including orthodontics, prosthodontics, and sleep medicine, we deliver comprehensive corrective jaw surgery care. If you're considering corrective jaw surgery, we invite you to schedule a consultation to discuss your options.