Q: Dr. Eppley, I already had orthognathic surgery several years ago which involved moving my two jaws forward. Now I’m considering that augmentation was too much and I would like to revert the procedure and move my two jaws inward and upward. I’ve already had braces for years and they are not an option anymore, in part because I already have veneers in my teeth. I hear some doctors perform this surgery without braces in cases where the bite is already correct. Would this be an option? Thanks.
A: Doing double jaw orthogathic surgery without braces is known as non-orthodontic orthognathic surgery. You are correct in that it is rarely performed and many maxillofacial surgeons will not do it. If your teeth have a good interdigitation (occlusion), and they should from prior orthodontic work, then you can have orthognathic surgery a second time without them. The key is that both jaws have to be moved together with the teeth fixed into occlusion during the operation. (using preoperatively fabricated splints or the Omnimax inter maxillary fixation system) Provided that the jaws can be moved in the desired direction (moving the maxilla back is the harder one), then the surgery can be done without the preoperative application of orthodontic brackets.
Dr. Barry Eppley