Surreal illustration of jaw puzzle pieces being assembled.

Beyond Braces: Reshaping Jaws for a Perfect Smile?

Mira Elwood in Health & Wellness December 2025 • 4 min read.

"Exploring Maxillofacial Surgery as an Alternative to Traditional Orthodontics"

For years, orthodontics has primarily focused on straightening teeth using braces and aligners. However, what happens when the problem isn't just crooked teeth, but a fundamental mismatch between the size of the teeth and the jawbones that house them? This condition, known as teeth-arch discrepancy, can lead to crowding, misalignments, and even impact facial aesthetics.

Traditionally, orthodontists have addressed teeth-arch discrepancies by extracting teeth to create space. But what if there was a way to actually increase the size of the jaw, providing a more natural and potentially more stable solution? Enter maxillofacial surgery, which offers innovative techniques to reshape the jaws and create the necessary space for a harmonious and functional bite.

This article explores the possibilities and limitations of using maxillofacial surgery to treat teeth-arch discrepancies. We'll delve into techniques like distraction osteogenesis, which can actually lengthen the jawbones, and discuss the benefits and risks of this approach compared to traditional orthodontics.

What is Maxillofacial Surgery?

Surreal illustration of jaw puzzle pieces being assembled.

Maxillofacial surgery is a specialized field of surgery that focuses on treating diseases, injuries, and defects of the head, neck, face, jaws, and oral and maxillofacial regions. In the context of orthodontics, maxillofacial surgeons work alongside orthodontists to correct skeletal imbalances that contribute to malocclusion (bad bite) and facial asymmetry.

One of the key techniques used in maxillofacial surgery for treating teeth-arch discrepancies is distraction osteogenesis. This innovative approach, pioneered by Gavriil Ilizarov in the 1950s, involves surgically creating a fracture in the jawbone and then gradually separating the bone segments over time. As the bone is distracted, new bone fills in the gap, effectively lengthening the jaw.

Here are the main benefits of Maxillofacial Surgery:

Addresses severe skeletal discrepancies: Unlike braces, which primarily move teeth, maxillofacial surgery can correct underlying jaw imbalances.
Creates space without extractions: In many cases, surgery can eliminate the need to extract healthy teeth to relieve crowding.
Improves facial aesthetics: Correcting jaw imbalances can enhance facial symmetry and improve overall appearance.
Enhances long-term stability: By addressing the root cause of the problem, surgery can lead to more stable and predictable results compared to tooth-only movement.

There are two main types of distraction osteogenesis used to address teeth-arch discrepancies: Maxillary Distraction: This procedure focuses on widening the upper jaw. It is often used to correct transverse deficiencies, where the upper jaw is too narrow relative to the lower jaw. Maxillary distraction can improve nasal breathing and tongue posture in addition to dental alignment. Mandibular Distraction: This technique aims to lengthen the lower jaw. It is typically used to address crowding in the lower arch or to correct a receding chin.

Is Maxillofacial Surgery Right for You?

Maxillofacial surgery offers a powerful set of tools for addressing complex teeth-arch discrepancies and achieving lasting improvements in dental alignment and facial aesthetics. However, it is not a one-size-fits-all solution.

The decision to undergo maxillofacial surgery should be made in consultation with a qualified orthodontist and maxillofacial surgeon. They will carefully evaluate your individual needs, assess the severity of your teeth-arch discrepancy, and discuss the potential benefits and risks of surgery compared to other treatment options.

If you're struggling with severe crowding, a misaligned bite, or facial asymmetry, maxillofacial surgery may be the key to unlocking a healthier, more confident smile. By working closely with your orthodontic team, you can determine if this innovative approach is the right choice for you.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1051/orthodfr/2016040, Alternate LINK

Title: Possibilités Et Limites Du Traitement De La Dysharmonie Dents-Arcades Par Chirurgie Maxillo-Faciale

Subject: General Medicine

Journal: L'Orthodontie Française

Publisher: John Libbey Eurotext

Authors: Christian Paulus

Published: 2017-02-23

Everything You Need To Know

What is maxillofacial surgery, and how does it relate to orthodontics?

Maxillofacial surgery is a specialized area of surgery that addresses issues in the head, neck, face, jaws, and oral and maxillofacial regions. In the realm of orthodontics, maxillofacial surgeons collaborate with orthodontists to rectify skeletal imbalances contributing to malocclusion and facial asymmetry. It's a significant alternative to traditional orthodontics that focuses on teeth alignment using braces and aligners. This surgical approach can correct jaw issues directly rather than solely focusing on teeth movement, offering solutions for complex problems like teeth-arch discrepancies.

What is teeth-arch discrepancy, and why is maxillofacial surgery important in treating it?

Teeth-arch discrepancy refers to a mismatch between the size of teeth and the jawbones that house them. This can lead to crowding, misalignments, and aesthetic issues. Maxillofacial surgery becomes important because it provides a way to address this root cause. Traditional orthodontics might extract teeth to create space, but maxillofacial surgery, such as distraction osteogenesis, can expand the jaw, offering a more natural and potentially more stable solution. This approach can prevent the need for tooth extractions while improving facial aesthetics and enhancing long-term stability.

Can you explain distraction osteogenesis, and how is it used in maxillofacial surgery?

Distraction osteogenesis is a surgical technique where a fracture is created in the jawbone, and then the bone segments are gradually separated over time. This process stimulates new bone growth in the gap, effectively lengthening the jawbone. It's a key technique used in maxillofacial surgery to treat teeth-arch discrepancies. Maxillary and mandibular distraction are the two primary forms. Maxillary distraction widens the upper jaw while mandibular distraction lengthens the lower jaw. Both correct skeletal imbalances, improve dental alignment, and enhance facial aesthetics.

What are the differences between maxillary and mandibular distraction?

Maxillary distraction focuses on widening the upper jaw. It's particularly useful in cases where the upper jaw is too narrow. The expansion can improve nasal breathing and tongue posture, in addition to dental alignment. Mandibular distraction is employed to lengthen the lower jaw. This technique addresses lower arch crowding and corrects receding chins. These methods provide direct solutions for underlying jaw imbalances that traditional orthodontics alone cannot address.

What are the main advantages of maxillofacial surgery?

Maxillofacial surgery offers several benefits, including addressing severe skeletal discrepancies, creating space without extractions, improving facial aesthetics, and enhancing long-term stability. By correcting jaw imbalances, surgery can eliminate the need to extract healthy teeth, leading to improved facial symmetry and appearance. This approach addresses the root cause of the problem, potentially leading to more stable and predictable outcomes than solely relying on braces or aligners. It is important to consult with a professional to determine if it is the right approach for the individual needs.