How do I know whether I need surgery or whether orthodontics is enough?

We assess it at the first appointment with the 3D study: we see whether the problem lies in the teeth or in the jaws. Many mild or moderate cases are solved with orthodontics alone; when the difference between the jaws is large, combining it with surgery gives the best functional and aesthetic result.

Does orthognathic surgery leave scars?

In the vast majority of cases the operation is done from inside the mouth, so there are no visible scars on the face.

How long does the whole treatment take?

It depends on each case. Adding up the orthodontics before and after surgery, it usually takes between a year and a half and two and a half years.

At what age can the surgery be done?

Once the jaws have finished growing, usually at the end of adolescence or in adulthood. In children, dentofacial orthopaedics can guide growth and, in some cases, avoid surgery or make it simpler.

Can it be done with aligners?

In selected cases, yes. Braces are the most common choice, because they allow very precise control before and after surgery; we decide on the 3D study of your case.

Who performs the surgery?

A maxillofacial surgeon, with whom we plan the case jointly. We handle the orthodontics from start to finish and check the result in 3D.

Orthognathic surgery and orthodontics in Málaga

When the problem is not only in the teeth but in the position of the jaws, orthodontics alone is not enough. We combine orthodontics and orthognathic surgery, planned in 3D together with the maxillofacial surgeon, to correct the bite, the function and the balance of the face.

Book your first appointment

First assessment appointment with a no-obligation quote · Clínica Áncora, Málaga

What orthognathic surgery is

It is the surgery that places the upper jaw, the lower jaw or the chin in the right position when the difference between them is too large to correct by moving the teeth alone. It is performed by the maxillofacial surgeon, almost always from inside the mouth, and orthodontics prepares the bite before the operation and finishes it afterwards.

The goal is not only aesthetic: a bite that fits together lets you bite and chew properly, spreads the forces across all the teeth and protects the temporomandibular joint.

When it is indicated

Skeletal Class III: a protruding lower jaw or a retruded upper jaw; the lower teeth sit in front of the upper ones.
Skeletal Class II: a retruded lower jaw, with a large gap between the upper and lower front teeth or a profile with a weak chin.
Skeletal open bite: the front teeth do not meet because of the way the jaws have grown.
Asymmetries of the jaw and the face.
Some cases of obstructive sleep apnoea, in which moving the jaws forward widens the airway.

It is considered once the jaws have finished growing. In children, dentofacial orthopaedics uses growth to guide it and, in some cases, avoids surgery or makes it simpler.

How the treatment works, step by step

3D study: CBCT, intraoral scan and photographs. We assess the case together with the maxillofacial surgeon and plan the surgery virtually.Before starting, you know what will move and by how much.
Orthodontics before surgery: we align and coordinate both dental arches so that they fit together once the jaws are in place.With braces or, in selected cases, with aligners. In some cases the surgery can be done at the start.
Orthognathic surgery: performed in hospital by the maxillofacial surgeon, under general anaesthesia and with a short hospital stay.
Orthodontics after surgery: a few months to fine-tune the last details of the bite.
Retention and 3D follow-up: retainers to keep the result and a CBCT superimposition to measure it.

3D planning and follow-up

With the CBCT taken before and after, we superimpose both scans in 3D and measure, in millimetres, how much the jaws, the teeth and the chin have moved. The colours show how much each area has changed.

3D superimposition of the CBCT before and after orthognathic surgery, front view, with a colour map of the changes — 3D superimposition before and after surgery · front view

3D superimposition of the CBCT before and after orthognathic surgery, side view of the lower jaw and the teeth — 3D superimposition before and after surgery · side view

A team effort

The orthodontist and the maxillofacial surgeon decide on the treatment plan together. Dr Manuel Fernández Cano handles the orthodontics from start to finish, coordinates the planning with the surgeon and checks the result in 3D, also taking care of the temporomandibular joint.

The case in the photos

Open bite and Class III: when closing the mouth, the front teeth did not meet. After orthodontics and orthognathic surgery, the incisors fit together and the bite also closes at the sides.