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Orthodontic and maxillo-facial surgery

Orthodontic and maxillo-facial surgery

Your teeth are positioned in your upper and lower jaws therefore your bite is affected if a problem exists with the position or shape of the jaws

Jaws can be short or long, too wide or too narrow depending on your genetic makeup or growth. It may not be possible to correct a bad bite using braces alone, because the reason for the bad bite may be the bone structure that has to be addressed. If you have a bad bite it is not just your appearance that will be affected but it may also cause other problems including abnormal tooth wear, periodontal disease, and possible joint pain.

One of the primary complaints patients present with is concern about their side-profile (how they look when viewed from the side). Profile problems can originate from an imbalance between the position and shapes of the upper and lower jaws. Class 1 (straight) profiles are common amongst the European population, but there are variations to this which are also considered normal depending on an individual’s racial origins and mix.

Class 1 Profile

The inclination of the teeth can significantly affect your profile.

An orthodontist corrects crooked teeth and bad bites, while an oral & maxillo-facial surgeon solves problems related to jaw formation and misalignment (skeletal problems). In situations where both conditions are present, it’s common for the two specialists to work together, merging orthodontics and maxillo-facial surgery in a combined treatment plan, commonly known as orthognathic surgery. In other complex cases, input from other dental specialists might also be required. The expected end results of this combined approach to treatment are to improve your facial appearance, the alignment of your teeth, and the upper and lower jaw relationship.

There are many different jaw development and alignment problems that can be solved by orthognathic surgery. These problems may arise from abnormal growth, they may be genetic or even could be caused by an accident or other trauma.

The most commonly corrected problems include:

An unsightly display of gum tissue above the upper front teeth
Each patient’s treatment is planned individually to make sure that the treatment approach is right for them. A full examination of the face and mouth is carried out, which includes impressions of the teeth for models or casts, special x-rays and photographs of the face and teeth. Over a series of appointments with the various specialists, discussions with you will eventually lead to a final treatment plan and the exact course of your treatment will be explained to you.

A protruding upper jaw (sticks out too far) and retrusive lower jaw (set back too far) – Class 2 Profile   A protruding lower jaw (sticks out too far) and retrusive upper jaw (set back too far) – Class 3 Profile

Teeth and jaws that point backwards can cause the lip profile to become more retroclined (less prominent). Teeth and jaws can stick forwards causing the lip profile to become more protrusive (prominent).   Asymmetry (facial imbalance)

In cases where orthognathic surgery is indicated, you may require 12 to 18 months of orthodontic treatment, usually involving braces in order to get your teeth into the best position for optimal surgical results. Surgery is then scheduled when your teeth have been properly aligned. The orthodontic appliances used to align the teeth will usually be left in place during and after the surgical phase to help stabilize the teeth and jaws.

After surgery, most patients are able to return to work or social activities within 2 weeks. Advice on your engagement in sporting activities and foreign travel will be based on your predicted post-surgical recovery rate. The refinements required to bring your teeth into their final desired position may mean you will have few months of orthodontic treatment after the surgery.

Whilst it might seem daunting, it is important to understand that if you require surgical treatment it is because your case requires this kind of approach to achieve the best results. Orthognathic surgery is carried out on a much more frequent basis than most people realise and is considered to be a safe way to achieve a total makeover. After combined treatment most patients get the pleasure of benefiting from improved facial appearance, aesthetic profile, dental health and revitalised confidence.

Case Study

Age: 20 years
Problems: Protruding lower jaw, Class 3 profile and reverse overbite
Solution: Fixed braces and orthognathic surgery on both jaws for 20 months
Result: Lower jaw pushed back, profile improved to Class 1 and alignment of teeth/bite corrected

Before treatment   After treatment


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  • Braces for children - Orthodontic treatment at a suitably young age can be matched to a child’s dental development, to deal with problems that otherwise may result in complex treatment or corrective surgery.
  • Adult orthodontic treatment - Regardless of age, orthodontic treatment will provide straight teeth and a brilliant smile. Aesthetic & invisible braces – there are many different braces designed to be more aesthetically pleasing than the stereotypical braces
  • Teeth whitening & bleaching – Tooth whitening is a method of lightening the colour of teeth with the need to remove any surface tooth material.
  • Implants to replace missing teeth – Dental implants are titanium screws that can be inserted into the jaw bone under local anaesthetic, after which a crown is secured onto the implant.
  • Botox® - Botox® is used to temporarily relax muscles mainly in the upper forehead and around the eyes in order to reduce the appearance of smoker’s lines around the mouth, relax the platysma bands on the neck and improve the appearance of the chest area, preventing premature wrinkles and smoothing out existing wrinkles.
  • Dermal Fillers – Dermal fillers provide gentle volumising and contouring, creating a naturally attractive effect to smooth out and fill lines and wrinkles.
  • Sculptra™ - Sculptra™ is a long-lasting, clinically-proven treatment that can smooth deep lines and wrinkles and restore facial volume lost to the agei ng process.
  • Skin peels – A skin peel is an agent which, when applied to treat acne vulgaris, melasma, sun damage, depressed scars, uneven skin tones and hyper-pigmentation, removes the outer surface revealing fresher layers which ultimately give you a more youthful, healthier appearance
  • Medical microdermabrasion – A powerful exfoliation, effectively and safely removing dead skin cells from the outer layer of the skin. A vacuum is also used to encourage collagen production.
  • Visia skin analysis – Complexion analysis which creates a 3D image of your face, from which it is possible to closely examine and detect specific skin characteristics, as well as produce a customized report with recommendations for treatment regimes to ensure optimum skin health.
  • Hair Removal - Unwanted hair is something that everybody faces, whether you are a man or woman, young or old. Although it is a perfectly natural part of life, it has been indoctrinated into us that it is unattractive. The methods we use for hair removal are: Waxing, Electrolysis Intense Pulse Light and Laser technology.
  • Mesotherapy – The art of using skin prick delivery techniques to supply vitamins, nutrition and homeopathic medicine for facial/ body rejuvenation, relief for under-eye circles and abags, reduction of fat and muscle building.
  • Skin tightening – Skin tightening techniques, such as Endermologie, Accent® radio-frequency and mesotherapy are safe and comfortable solutions for used to sculpting, contouring, tightening and rejuvenating the skin and body. Applications for these treatments include cellulite treatment, skin tightening, complete body contouring and post liposuction smoothing.
  • Laser & IPL therapies - Intense Pulsed Light (IPL) is broadband light energy that enables large areas to be treated with a single discharge. Intense Pulsed Light, in combination with laser, is ideal for the treatment of quick treatment of large areas. It can be used for permanent hair reduction, skin rejuvenation, acne treatment, tattoo removal, thread vein removal.
  • Colonic hydrotherapy - Colonic Hydrotherapy is an effective treatment, which releases accumulated congestion in the bowel, loosening and flushing out toxins and waste. It works by using a combination of warm, purified water introduced into the bowel and gentle abdominal massage. It is, in short, a detoxification of the colon.
  • Laser lipo – Laser lipo is a minimally invasive type of ultrasound lipoplasty technology that is fast replacing Liposuction. With its level of versatility, laser lipo can significantly reduce stubborn areas of fat and precisely sculpt areas of the body with less bruising and downtime than with other lipo treatments.
Dr Peter Ilori High Wycombe Beaconsfield Ealing Denham Buckinghamshire Bucks Berkshire Berks Middlesex London South East