Upper jaw osteotomy (Le Fort I)

When the upper jaw (the maxilla) sits too far back, too far forward, too high, too low or is tilted, the teeth do not fit together properly and the balance of the face is altered. A Le Fort I osteotomy moves the upper jaw into the correct position. The operation is performed under general anaesthesia, through an incision inside the mouth, above the upper teeth: no scar is visible on the face. The surgeon makes precise cuts in the bone, moves the jaw according to a plan prepared in advance (models, surgical splints, sometimes computer simulation), then secures it with small titanium plates and screws that stay in place. It is usually part of a treatment combining an orthodontist and a maxillofacial surgeon: braces are worn before and after the operation. It may be combined with a lower jaw osteotomy when both jaws need to be moved. At Clinique Pasteur Tunis, this surgery is performed by maxillofacial surgeons in the operating theatre, with post-operative monitoring suited to facial surgery and coordination with the patient's orthodontist.