Surgical Orthodontics: When Jaw Alignment Requires More Than Tooth Movement
Surgical orthodontics — or orthognathic treatment — is the coordinated approach for patients whose skeletal jaw discrepancy is too severe for orthodontic camouflage alone. When the upper and lower jaws differ significantly in size, position, or symmetry, braces or aligners can straighten the teeth but cannot reposition the bone that holds them. Orthognathic surgery, performed by an oral and maxillofacial surgeon in coordination with the orthodontist, physically repositions the maxilla, mandible, or both to establish proper skeletal relationships.
The treatment sequence typically spans two to three years. Pre-surgical orthodontics (12 to 18 months) aligns the teeth within each arch and decompensates the dental positions — removing the compensatory tipping that the body developed to camouflage the skeletal discrepancy. Surgery then repositions the jaws into their ideal relationship. Post-surgical orthodontics (6 to 12 months) fine-tunes the occlusion and finalizes tooth positions within the newly established skeletal framework.
Candidates for surgical orthodontics include patients with severe underbite (mandibular prognathism), severe overbite (maxillary protrusion or mandibular deficiency), open bite where the front teeth do not touch, facial asymmetry, and airway restriction related to retrognathic (set-back) jaw positioning. CBCT 3D imaging at ADSC provides the volumetric skeletal data required for precise surgical planning, including airway dimension analysis that is increasingly recognized as a critical factor in treatment outcome assessment.
Serving Beaverton, Aloha, Hillsboro & Washington County
Aloha Dental Specialty Center is located at 18455 SW Alexander St, Suite B, in Beaverton, Or Oregon. We serve patients from across the Tualatin Valley and greater Portland metro, including Aloha, Hillsboro, Tigard, Lake Oswego, and Tualatin. Our Beaverton office is a 5-minute drive from Aloha, 10 minutes from Hillsboro, and 15 minutes from Tigard via SW 185th Avenue.
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Intel Campuses (Ronler Acres & Jones Farm)
10 to 15 minutes via NW 185th Ave. We accommodate the schedules of tech professionals who need efficient, high-quality specialty care.
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Nike World Headquarters
About 8 minutes via SW Baseline Rd. We frequently see patients from the Nike campus for surgical and implant procedures with sedation options.
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Streets of Tanasbourne & Orenco Station
Easily accessible via US-26 and NW 185th. Local general dentists in these communities regularly refer patients to us for specialty procedures.
Why Local Dentists Refer to Us
We work as a trusted partner to general dentists throughout the Tualatin Valley. When cases require CBCT-guided planning, IV sedation, bone grafting, or other advanced procedures, local providers refer to Dr. Ostovar for his experience with implant procedures and predictable results.
We handle the procedures within our scope and coordinate closely with your general dentist for smooth continuity of care from start to finish.
Office hours: Mon–Fri 8 AM–5 PM (Thu & Fri until 6 PM), Sat 8 AM–2 PM
Understanding Your Investment
At Aloha Dental Specialty Center, we provide transparent pricing before any treatment begins. The cost of your procedure depends on clinical complexity, materials used, and sedation requirements. We walk you through every line item during your consultation so there are no surprises.
What Affects Cost:
- Clinical Complexity: Bone loss, sinus proximity, nerve involvement, or the need for grafting affects treatment planning and surgical time.
- Materials: We use research-backed implant systems, purified bone graft matrices, and high-strength ceramics from established manufacturers.
- Sedation: Options range from local anesthesia to IV sedation, each with different associated costs. We discuss the best option for your comfort and procedure.
Insurance & Financing
We accept most major dental insurance plans and file claims on your behalf. Our team verifies your benefits before treatment and submits pre-treatment estimates with clinical documentation to maximize coverage.
For out-of-pocket costs, we partner with CareCredit and Cherry for flexible payment plans. We also offer our ADSC Dental Savings Plan for patients without insurance.
Recovery & Healing Timeline
Understanding the healing process helps you plan ahead and follow post-operative instructions for the best possible outcome.
First 48 Hours
Mild swelling and tenderness are normal. Apply ice packs in 20-minute intervals and take prescribed or over-the-counter anti-inflammatory medication. Eat soft foods and avoid the surgical site when chewing.
Days 3 to 7
Swelling peaks around day three and then improves. The tissue begins closing over the surgical site. Continue with soft foods and use any prescribed antimicrobial rinse. Most patients return to normal activities during this phase.
Long-Term Healing
Surface tissue heals within two to three weeks. Bone integration and deep healing continue for three to six months. Avoid smoking, follow up as scheduled, and maintain good oral hygiene throughout recovery.
Questions during recovery? Call us at (503) 822-0096. We are available for post-operative concerns.
Orthognathic Surgery: Skeletal Repositioning and Healing Biology
Orthognathic surgery involves osteotomies — controlled surgical cuts through the jawbone — that allow the repositioned segments to be fixated in their planned positions using titanium plates and screws. The Le Fort I osteotomy separates the maxilla from the skull base, enabling three-dimensional repositioning of the entire upper jaw. The bilateral sagittal split osteotomy (BSSO) divides the mandibular ramus, allowing advancement, setback, or rotation of the mandibular body. Genioplasty repositions the chin independently. These procedures are performed through intraoral incisions, leaving no external scars. Healing follows the standard bone repair cascade: hematoma formation, inflammatory response, callus formation, and remodeling — with rigid internal fixation providing stability during the 6 to 8 week primary healing period. The maxillomandibular complex achieves clinical union by eight weeks and full remodeling by six months. Modern virtual surgical planning (VSP) uses CBCT data to simulate the osteotomies and final jaw positions digitally, with patient-specific cutting guides and fixation plates manufactured before the surgery — eliminating intraoperative guesswork.
Why Choose ADSC?
Surgical orthodontic cases at ADSC benefit from the integrated multi-disciplinary model. The orthodontic and surgical phases are planned collaboratively from the initial consultation, with CBCT imaging, digital models, and cephalometric analysis informing a unified treatment architecture. The on-site availability of oral surgery, periodontics, and advanced imaging eliminates the coordination delays that fragment care when these specialties operate in separate offices. Post-surgical orthodontic finishing is performed with the surgical result in clear view, allowing precise occlusal adjustment to the achieved skeletal relationship.
Your IPR Interproximal Reduction Treatment Steps
- Consultation & Exam: Comprehensive ipr interproximal reduction evaluation with CBCT 3D imaging at our Beaverton office.
- Treatment Plan: Our experienced dental team discusses your ipr interproximal reduction options, timeline, and costs. We use advanced 3D imaging and evidence-based protocols across general dentistry, endodontics, and pediatric care.
- Treatment: Procedure performed with comfort options including sedation if needed.
- Follow-Up: Post-treatment monitoring and care coordination for best healing.
Schedule Your Appointment Today
Book a consultation with our team at Aloha Dental Specialty Center in Beaverton, OR. Call (503) 822-0096 Office hours: Monday through Friday 8 AM to 5 PM (until 6 PM Thursday and Friday), Saturday 8 AM to 2 PM. or request an appointment online.
Related Services at Aloha Dental Specialty Center:
Dental Implants · Oral Surgery · Root Canal · Invisalign · Periodontics · Pediatric · TMJ Treatment · Sedation · Cosmetic · Emergency · Sleep Apnea
A Note from Your Dental Team
In my experience, the patients who get the best results from ipr interproximal reduction are those who come in with realistic expectations and follow their post-treatment instructions carefully. I’d rather spend extra time explaining what to expect than have a patient be surprised later.
“Every patient I see has a different story, a different set of concerns, and a different definition of what ‘success’ looks like. That’s why I don’t believe in one-size-fits-all treatment plans. When you come in for a consultation, I’ll listen first, examine second, and recommend third.
I also won’t recommend a procedure you don’t need. If your tooth can be saved with a filling instead of a crown, I’ll tell you that. If watchful waiting is appropriate, I’ll explain why. My job isn’t to sell treatment — it’s to give you my honest clinical judgment so you can make an informed decision.
If you have questions about whether this treatment is right for you, or if you’ve been told you need this procedure by another dentist and want a second opinion, call us at (503) 822-0096. We’re happy to take the time to explain everything — no rush, no pressure.”
— Aloha Dental Specialty Center, Beaverton, OR
I know many patients feel anxious about dental procedures — you’re not alone in that. What I hear most often after treatment is: “That was so much easier than I expected.” We’re here to make this as comfortable as possible for you.
Typical Healing Timeline:
Days 1-3: Initial healing, mild swelling managed with ice and medication. Days 4-7: Swelling subsides, gradual return to normal diet. Weeks 2-4: Soft tissue heals completely. Months 2-6: Bone remodeling and full integration (for surgical procedures). Individual recovery varies — we provide detailed post-op instructions specific to your procedure.
For additional clinical information, visit the American Dental Association (ADA).
Last reviewed: March 2026. Clinical information on this page reflects current evidence-based dental practices.
Related Dental Services
Frequently Asked Questions
If your upper and lower jaws are significantly misaligned in a way that tooth movement alone cannot correct — severe underbite, open bite, facial asymmetry, or airway restriction from jaw position — surgical orthodontics may be indicated. A combined clinical and radiographic evaluation, including CBCT imaging and cephalometric analysis, determines whether orthodontics alone can achieve a stable result or whether surgical repositioning is needed.
Surgery is performed under general anesthesia, so the procedure itself is painless. Post-surgical discomfort includes facial swelling (peaking at day three), jaw stiffness, and moderate soreness managed with prescribed analgesics. Most patients describe the recovery as uncomfortable rather than acutely painful. Swelling resolves substantially within two weeks.
Most patients return to desk work within two to three weeks and normal activities within six weeks. A soft or liquid diet is required for the first two to four weeks as jaw motion gradually increases. Full bony healing takes six to eight weeks, with complete remodeling continuing for several months. Athletic and strenuous activities are restricted for six to eight weeks.
Yes — and that is part of the goal. Jaw repositioning changes facial proportions and profile. Patients with underbite gain a more balanced profile, those with long faces achieve improved vertical proportions, and asymmetric patients gain improved facial symmetry. Virtual surgical planning allows you to see a prediction of the post-surgical facial result before committing to treatment.
Orthognathic surgery for functional indications (TMJ dysfunction, obstructive sleep apnea, inability to achieve functional occlusion without surgery) may be covered partially by medical insurance. Dental insurance orthodontic benefits cover the orthodontic component. Coverage varies significantly between carriers. The administrative team assists with medical pre-authorization and benefit verification.
Braces are placed to align the teeth within each arch and to decompensate dental positions. Decompensation means removing the tilting and shifting that your teeth developed over time to compensate for the jaw discrepancy. This stage may temporarily make the bite feel worse — which is expected and necessary for the surgical correction to work properly.
Pre-surgical orthodontics typically takes 12 to 18 months. The duration depends on the starting alignment, the degree of decompensation needed, and the complexity of the surgical plan. Once the teeth are in their planned pre-surgical positions and the surgical team confirms readiness, the surgery is scheduled.
Modern orthognathic surgery uses rigid internal fixation (titanium plates and screws) rather than jaw wiring. Elastic bands between the upper and lower braces may be used for the first few weeks to guide the bite into position, but the jaw is not immobilized. This allows limited jaw opening for oral hygiene and liquid nutrition from the beginning.
Yes. Maxillomandibular advancement surgery (MMA) is one of the most effective surgical treatments for obstructive sleep apnea, expanding the pharyngeal airway by physically advancing both jaws. The airway benefit is a significant factor in treatment planning for patients whose jaw position contributes to airway restriction.
VSP uses CBCT data to create a 3D digital model of your skull, plan the osteotomies on screen, simulate the jaw repositioning, and manufacture custom cutting guides and fixation hardware that ensure the surgical result matches the planned outcome. This technology improves surgical accuracy, reduces operative time, and enhances predictability.
As with any surgery, risks include bleeding, infection, and adverse anesthetic reaction. Specific to orthognathic surgery, temporary numbness (paresthesia) of the lower lip or chin from inferior alveolar nerve proximity is common and usually resolves within weeks to months. Permanent nerve injury is rare when experienced surgeons use modern techniques and 3D-guided planning.
The combined cost of orthodontic treatment and surgery can range from $20,000 to $40,000 or more, depending on the scope of the surgical plan. Medical insurance coverage for the surgical component and dental insurance coverage for the orthodontic component can significantly reduce out-of-pocket costs. Detailed cost projections are provided after the treatment plan is finalized.
Yes. Post-surgical orthodontics typically lasts six to twelve months. This phase fine-tunes the tooth positions and bite relationships within the newly established skeletal framework. It involves detailed adjustments to achieve best interdigitation (how the upper and lower teeth mesh together) and stable occlusal contacts.
In select cases, Invisalign can manage the pre-surgical and post-surgical orthodontic phases. Surgical hooks (temporary attachments for intra-operative elastic fixation) are bonded to selected teeth. However, the majority of surgical orthodontic cases still use fixed braces because the level of tooth control required for surgical coordination is more predictable with bracket-and-wire mechanics.
This is expected and is called decompensation. Your teeth have spent years tilting and shifting to camouflage the jaw discrepancy. Pre-surgical braces remove this camouflage, exposing the true skeletal relationship — which temporarily worsens the bite. This is necessary for the surgery to achieve best correction. The worsened bite resolves immediately with the surgical jaw repositioning.