Orthognathic surgery (jaw advancement)

Orthognathic surgery is the maxillofacial procedure that corrects a discrepancy between the jaws. When the lower jaw is set back (mandibular retrognathia, known as "class II"), a mandibular advancement osteotomy is performed, most often by bilateral sagittal split osteotomy of the mandibular rami: this is what is commonly called "jaw advancement". If it is the upper jaw that is set back, the advancement is done by Le Fort I osteotomy; both jaws can be moved in the same operation (bimaxillary osteotomy), and a genioplasty can complete the procedure to reposition the chin. A jaw discrepancy is not only a matter of appearance: it causes a poor bite (the teeth do not fit together), difficulty chewing, premature tooth wear, and sometimes pain in the jaw joint or snoring with sleep apnoea. By advancing the jaw, the operation restores a proper fit of the teeth, opens the airway and gives the profile a harmonious chin and lower face. The operation is part of a pathway coordinated with the orthodontist: several months of orthodontic preparation first align the teeth on each arch, then the surgery repositions the jaws according to precise planning carried out on CT scan and cephalometric analysis, often in three dimensions. The bones are fixed in their new position with small titanium plates and screws, which remain in place without discomfort. All incisions are made inside the mouth: no scar is visible. At Clinique Pasteur Tunis, orthognathic surgery is performed by experienced maxillofacial surgeons, under general anaesthesia, in an operating theatre meeting international standards, with a short hospital stay and attentive follow-up until bone healing and the end of orthodontic treatment.