Can Jaw Angle Reduction Be Performed Without Losing The Shape Of The Angle?

Q: Dr. Eppley, I went to see a maxillofacial surgeon to get jaw reduction (my jaw is too square and X rays show that my angles do stick out). He told me that he needed to do a small resection of the angles (osteotomy) because my angles were too square to burr them. and with the burring technique, only 2 or 3mm could be burred which would barely show. Is it possible to round off the angles with the osteotomy technique? or will it be a straight cut leaving the angles straight looking cut and unnatural? is it possible to preserve some angles with that technique? Also, what really surprised me is that he said that since the bone is so far and hard to get to due to the muscles, he might need to put some screws; I did not understand why. I thought that screws were used to put bones back into a new position; which would not be the case with angles osteotomy? I am confused. Thank you for your answers.

A: I can only speak for what I do, I can not explain what your surgeon said or their technique.  When you cut off the angles, no matter how small, there will be a rounding effect created. Burring in the jaw angle area can be difficult because of the surgical  access. Therefore, I choose to use a reciprocating saw and perform an outer table ostectomy, which thins the bone but preserves most of the angle’s shape. I have never used screws for this technique nor can I envision why they would be needed.

Dr. Barry Eppley

Indianapolis, Indiana