Surgical orthodontics, also called orthognathic treatment, combines orthodontic tooth movement with corrective jaw surgery for selected patients whose bite or facial skeletal relationship cannot be addressed predictably with orthodontic appliances alone. At COCO Smiles Orthodontics in Miami, Dr. Sibel Eljach evaluates the orthodontic portion of care and coordinates with an oral and maxillofacial surgeon when a surgical consultation is appropriate. Surgery is not a routine part of orthodontic treatment. A recommendation follows a detailed diagnosis, discussion of non-surgical alternatives, and collaboration among the patient’s care providers.
When Surgical Orthodontics May Be Considered
Surgical orthodontics may be considered after jaw growth is substantially complete when a significant skeletal discrepancy contributes to an underbite, overbite, open bite, crossbite, facial asymmetry, or another functional concern. Some patients first seek care because of difficulty biting or chewing, uneven tooth wear, lip closure concerns, or dissatisfaction with a jaw relationship. Similar appearances can have different causes, so photographs, digital models, panoramic and cephalometric imaging, and sometimes CBCT records may be used to understand the teeth, jaws, roots, airway, and surrounding anatomy. Dr. Eljach explains whether orthodontics alone, growth monitoring, restorative coordination, or a combined surgical plan should be explored.
How Orthodontic and Surgical Care Are Coordinated
Combined treatment is planned in stages. Before surgery, braces or another fixed orthodontic appliance commonly positions the teeth within each jaw so the surgeon can align the jaws according to the coordinated plan. During this phase, the bite may temporarily look or feel different as dental compensations are corrected. The oral and maxillofacial surgeon performs the surgical procedure and provides procedure-specific consent, hospital, recovery, and medication instructions. After the surgeon confirms healing is progressing appropriately, Dr. Eljach resumes orthodontic adjustments to refine the bite. Communication between the orthodontic and surgical teams is important throughout planning and active care.
Planning, Recovery, and Retention
Treatment timing depends on the diagnosis, appliance sequence, surgical plan, healing, and individual response. Patients should maintain regular dental care and follow both teams’ instructions for oral hygiene, nutrition, activity, and appointments. Questions about surgical risks, anesthesia, hospitalization, recovery, and costs should be reviewed directly with the surgeon, while Dr. Eljach explains the orthodontic goals and responsibilities. Once tooth positions and the bite are finalized, retainers help maintain the orthodontic result. Long-term follow-up may involve the orthodontist, surgeon, general dentist, and other specialists according to the patient’s needs.
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Frequently Asked Questions
Does a severe bite always require jaw surgery?
No. Treatment depends on the cause of the bite relationship, growth, oral health, goals, and the limits of orthodontic tooth movement. Dr. Eljach reviews appropriate non-surgical and surgical paths after diagnosis.
Who performs orthognathic surgery?
An oral and maxillofacial surgeon performs the jaw surgery. Dr. Eljach plans and manages the orthodontic phases and coordinates records and timing with the surgeon.
Will I need braces before and after surgery?
Many combined plans include orthodontic treatment before surgery to prepare tooth positions and after surgery to refine the bite. The exact appliance and sequence are individualized.
When can surgical orthodontic treatment begin?
Jaw surgery is generally considered after relevant facial growth is substantially complete. Evaluation and planning can begin earlier when monitoring or coordinated records would be helpful.
How long does combined treatment take?
Timing varies with the diagnosis, pre-surgical tooth movement, surgical scheduling, healing, and post-surgical refinement. The orthodontist and surgeon provide individualized estimates after coordinated planning.
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