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Jaw Surgery Before and After Case Studied

Orthognathic Surgery #1

This patient had a severe class III skeletal malocclusion (underbite) with mandibular asymmetry. She underwent lefort I osteotomy and bilateral sagittal split osteotomy to correct her malocclusion, facial asymmetry, and improve her facial balance and esthetics.

3D skull model: jaw highlighted in red, golden-brown tones, blue background

Lateral skull X-ray with dental implants, cervical spine, and visible maxillary sinus

Panoramic dental X-ray showing full dentition and jaw

Orthognathic Surgery #2

23 year old male with a large Class III malocclusion (mandible larger than maxilla) who had jaw pain, difficulty chewing, and esthetic concerns. Bilateral Sagittal Split Osteotomy and Lefort I osteotomy were performed resulting in improved esthetics, occlusion, and pain.

Lateral cephalometric X-ray with dental implants, cervical spine, and 100 mm scale bar

Patient with dental retractor, braces on upper/lower teeth, beard visible

Intraoral view of healthy pink gingiva and aligned maxillary/mandibular teeth.

Orthognathic Surgery#3: Revision Jaw Surgery

This unfortunate young man was involved in a significant motorcycle accident that resulted in multiple facial fractures. These fractures were treated by another surgeon and resulted in a poor occlusion where the maxilla was entirely inside the mandible (opposite of normal orientation). This patient could not chew as a result and lost over 30lbs. He was treated with revision jaw surgery via a segmental Lefort I osteotomy (upper jaw surgery) that resulted in an improved occlusion that allows him to chew and swallow. He has regained most of his weight and will complete orthodontic treatment to further improve his occlusion (bite).

Grayscale lateral X-ray of skull with surgical markers on cranium and dental structures

Lateral X-ray of skull with surgical markers, dental structures, and cervical spine visible

Intraoral view of healthy pink gingiva and not aligned maxillary/mandibular teeth.

Orthognathic Surgery#4

This patient had a large Class II skeletal malocclusion (maxilla larger than mandible). She had difficulty biting into foods and had esthetic concerns about her jaw discrepancy. She was treated with Bilateral Sagittal Split Osteotomy in conjunction with orthodontic treatment. This led to significant improvements in her occlusion, ability to bite/chew foods, and esthetics.

Lateral cephalometric radiograph showing dental appliances. Used for orthodontic assessment of jaw alignment.

Orthognathic Surgery #5: Mandibular Advancement

This patient had a Class II skeletal malocclusion (maxilla larger than mandible) with an anterior open bite. She had difficulty biting into foods and had esthetic concerns about her jaw discrepancy. She was treated with Bilateral Sagittal Split Osteotomy in conjunction with orthodontic treatment. This led to significant improvements in her occlusion, ability to bite/chew foods, airway, and esthetics.

Orthognathic Surgery #6: Class III Malocclusion with Mandibular Asymmetry

This patient had a class III skeletal malocclusion (mandible larger than maxilla) as well as mandibular asymmetry and a flattened occlusal plane altering her smile esthetics. She underwent double jaw surgery resulting in correction of the skeletal, functional, and esthetic concerns.

Intraoral view: dental retractor holding lips, teeth with braces

Intraoral view: dental retractor, upper/lower teeth with braces

3D skull model in golden-brown tones, blue background, dental structures visible

3D skull model in golden-brown tones with orthodontic wires on teeth, blue background

Lateral skull X-ray showing dental work, cervical spine, and intact maxillary sinus

Orthognathic surgery #7

This patient had severe Obstructive Sleep Apnea (OSA) causing excessive daytime sleepiness and decreased quality of life. He underwent Maxillomandibular Advancement (MMA) to treat his OSA.

Frontal view: male patient with neutral expression, eyes obscured

3D skull model with jaw highlighted in red and purple, blue background

orthognathic surgery #8: TMJ Total Joint Replacement with Orthognathic Surgery

This 22 year old patient had Idiopathic Condylar Resorption (ICR), anterior open bite malocclusion, and a restricted airway. Following Bilateral TMJ total joint replacement and segmental Lefort I osteotomy she has an improved occlusion, a much larger airway (see images), and improved function. She can open to 43mm and bite into foods with her front teeth for the first time in years.

Frontal view: female patient with brown hair tied up, smiling, black top, eyes obscured

Frontal view: female patient with light brown hair, neutral expression, black top, eyes obscured

Lateral skull X-ray with tongue depressor in oropharynx, showing soft tissue and airway

Sagittal CT scan with airway measurements: 6.0 mm and 9.0 mm at nasopharynx

Sagittal CT scan showing airway measurements: 14.0 mm, 16.7 mm, 18.5 mm at nasal/oral cavity

Orthognathic surgery #9:

This 16 year-old patient had a recessed mandible and chin with airway restriction and retained wisdom teeth. Due to the young age of the patient there was only mild snoring but no obstructive sleep apnea. However, we treated her as if she would develop OSA as she aged (typical presentation). This involved a Bilateral Sagittal Split Osteotomy (BSSO) advancement with advancement genioplasty performed with genioglossus advancement to further open the airway. We also removed her wisdom teeth at the same time. Note the drastic improvement in the airway despite only modest advancement of the mandible to balance esthetics with airway improvement.