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Surgical Procedures

Orthognathic (Jaw) Surgery

Orthognathic (jaw) surgery is needed when jaws don’t meet correctly and/or teeth don’t seem to fit with jaws. Teeth are straightened with orthodontics and corrective jaw surgery repositions a misaligned jaw. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

Who Needs Orthognathic Surgery?

People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly. Jaw growth is a gradual process and in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that can affect chewing function, speech, long-term oral health and appearance. Injury to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved. Orthognathic surgery may be required for the jaws when repositioning is necessary.

Difficulty in the following areas should be evaluated:

  • Difficulty in chewing, biting or swallowing
  • Speech problems
  • Chronic jaw or TMJ pain
  • Open bite
  • Protruding jaw
  • Breathing problems such as sleep apnea 

Any of these symptoms can exist at birth, be acquired after birth as a result of hereditary or environmental influences, or as a result of trauma to the face. Before any treatment begins, a consultation will be held to perform a complete examination with x-rays. During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment. When you are fully informed about the aspects of your care, you and your dental team can make the decision to proceed with treatment together.

Technology & Orthognathic Jaw Surgery

Drs. Sullivan, Tiwana and Ritto use modern computer techniques and three-dimensional models to show you exactly how your surgery will be approached. Using comprehensive facial x-rays and computer video imaging, we can show you how your bite will be improved and even give you an idea of how you’ll look after surgery. This helps you understand the surgical process and the extent of the treatment prescribed. Our goal is to help you understand the benefits of orthognathic surgery.

If you are a candidate for corrective jaw surgery, Drs. Sullivan, Tiwana and Ritto will work closely with your dentist and orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional, and healthy dental-facial relationship.


What Is Facesfirst?

Corrective jaw surgery treatment planning has three essential goals

  • Get the teeth in a normal bite
  • Orient the upper and lower jaws so they are spatially correct
  • Normalize the soft tissue expression, changing the spatial relationships of the jaw to get the most pleasing results possible. 

Our FacesFirst philosophy makes the expression of the face the highest priority.

The Difference?

Oral and maxillofacial surgeons tend to treat the x-ray that they are looking at rather than the face itself. For many of these surgeons, numbers drive treatment planning, rather than having a firm understanding of how the surgical movements of the upper and lower jaw impact the final form of the face. This is important not only looking at the front view, but also in the profile view.


FacesFirst is our unique philosophy. It places the emphasis on the final position of the upper jaw. The upper jaw, or maxilla, is what dictates the smile. It is incredibly important to place the upper incisors in their ideal position. The vertical position of the upper jaw will dictate how much tooth is shown at rest as well as smiling. Maximizing the width of the upper jaw fills out the smile line, making it far more aesthetic and eliminating areas where the cheek can be seen when one is smiling broadly. The smile is everything.


The upper jaw dictates the final position of the lower jaw and therefore the facial profile. With FacesFirst, the upper jaw determines the smile aesthetics and the lower jaw determines the profile aesthetics. Harmonious positioning is the key to the best possible aesthetic outcome.