In adult patients (over 18 years) the growth of the jaws can no longer be influenced. Malocclusion is not only caused by a malpositioning of the teeth, but often also by an incorrect jaw position. For this reason, in extreme cases, a purely orthodontic treatment may not lead to a perfect result. In such cases, a combined orthodontic and surgical treatment is a possible alternative. Establishing an ideal position of the teeth and jaws by a surgical intervention is thus possible. The average treatment time including surgery in our office is 18 months  and is usually done using invisible braces (WIN Lingual). Since we treat several patients per month with combined orthodontic and maxillofacial surgery, a professional approach and extensive clarification prior, during and after the treatment is out of question.

This patient was treated combining surgery with orthodontics over a total treatment time of 13 months.

Due to the mandibular retrognathism, the patient complained about various problems. Firstly, it was not possible to close her lips in a relaxed state. This led to increased mouth breathing with an increased risk of colds. The position of the lower jaw caused the patient's temporomandibular joints to be overloaded, which led to a cracking (disk displacement). 

As already mentioned above, a combined treatment (surgery and orthodontics) not only leads to an improvement of the tooth position, but also to a visible change in facial esthetics. In principle, this leads to the ideal positioning of the jaws, patients need to be educated on the changes beforehand. If this is not desired, surgical treatment is not recommended.

In what cases is a surgical treatment in adult patients indicated?

Lateral crossbite

A lateral cross bite causes a displacement of the lower jaw. Among other things, this leads to asymmetrical adjustments in the temporomandibular joint and thus possible temporomandibular joint problems.


An increased step between the upper and lower anterior teeth increases, among other things, the acute risk of trauma to the upper anterior teeth and can lead to an incompetent lip closure with an increased risk of infection.

Anterior crossbite

A anterior cross bite is usually caused by the excessive growth of the lower jaw and ensures, among other things, that the anterior teeth cannot occlude properly and may furthermore cause abrasions on the teeth.

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