Orthognathic Surgery

Orthognathic (Jaw) Surgery

Orthognathic surgery or corrective/re-alignment jaw surgery is a surgical procedure done by a Maxillofacial and Oral Surgeon to correct minor and major skeletal and dental irregularities, functional malocclusions of the jaw as well as post-traumatic malocclusions and facial asymmetry. Orthognathic surgery is performed to treat a range of conditions to improve mastication (chewing), speech impediments (speaking), breathing and facial harmony. While cosmetic aspects may be dramatically enhanced as a result of the surgery, orthognathic surgery is not a cosmetic procedure and is done to correct functional problems of the jaw to restore function and normal physiology.

Why would orthognathic surgery be needed?

Orthognathic surgery could be performed to treat both minor and major discrepancies of the jaw caused by facial trauma, congenital defects, overjet, backbite, temporomandibular disorders, periodontal disease, the early loss of permanent teeth, and other jaw and occlusal abnormalities.

Jaw realignment surgery is done to treat jaw irregularities that cause symptoms such as:

  • Difficulty with chewing, biting or swallowing
  • Chronic temporomandibular joint (TMJ) pain and associated headaches
  • Excessive wear of the teeth
  • Open bite
  • “parrot “or “bulldog” jaw
  • Inability to make the lips meet without straining, (incompetent lips)
  • Chronic mouth breathing
  • Sleep apnoea

A specialist Maxillofacial and Oral Surgeon would be the most capable of diagnosing jawbone irregularities. Dr Kruger can perform a detailed clinical examination and take panoramic or cone beam 3D x-rays of the jaws to assess and advise you on whether or not surgery would be required to improve the function of your jaws.

What does orthognathic surgery involve?

Orthognathic surgery is performed under general anaesthetic to correct and align the jaws. The surgery may be performed on either the upper jaw, (maxillary or Le Fort I osteotomy) or the lower jaw, (BSSO – bilateral sagittal split osteotomy), or both jaws, (bi-maxillary surgery). Dr Kruger will make several cuts into the jawbones above the teeth via intra-oral access. He will then move the jaw forward or backward (depending on the pre-operative assessment and analysis) so that they align adequately. In some cases, he may need to use a bone graft to help the healing of the bone. Once in the correct position, he will secure the new position of the jaw into place with trans-osseus wires, specialised plates and screws. Wiring of the jaws or inter-maxillary fixation (IMF) is only performed in unusual circumstances.

After a short hospital stay, patients are discharged to recover at home on a liquid diet for a few days. Patients can only have soft foods for a 4-6-week period. Most patients recover quickly, and most are back at school or the workplace after 7-10 days. There is no facial scarring because surgery is performed via intra-oral access.

The candidates for surgery most often need to be assessed by a specialist Orthodontist before the operation and full fixed appliance orthodontic treatment, (braces) for a period of 12-15 months might be required before surgery can be performed. This might be necessary to obtain the desired result that will ensure long term stability.

Dr Herman E.C. Kruger


He is a Registered Specialist in Maxillofacial and Oral Surgery in private practice and part-time public service and manages disease processes, trouma and injuries as well as congenital defects involving the mouth, jaws and facial bones. Read more about Dr Kruger.


Physical Address:
36 St James Road, East London, 5201, Eastern Cape, South Africa
Tel: 043 722 6212
Fax: 043 743 3994

Email: fkhamissa@sainet.co.za