Invisalign Instead of Orthognathic Surgery?

I had metal braces as a teen, along with: headgear (that I didn't wear enough) to move my top jaw forward and an expander on my top jaw. My lower jaw was never treated.

My orthodontist at the time refused to do anything and insisted on doing orthognathic surgery. I'm still not sure about orthognathic surgery, since my insurance provider will not cover it and it would wipe out my saving or leave me with debt.

Can Invisalign be used to help pull my upper jaw forward to the point where I would have a functional bite?

Doctor Answers 8

Invisalign is not a substitute for Orthognathic Surgery

Unfortunatley if you have skeletal discrepencies Invisalign will not address this.  Invisalign may be used to straighten and align the teeth, but the underlying skeletal deformity will not be addressed

Phoenix Oral & Maxillofacial Surgeon
4.7 out of 5 stars 13 reviews

Jaw misalignment and Invisalign

It sounds like you have a skeletal problem where your upper jaw is too far behind your lower jaw (or the lower is too far in front of the upper).  Invisalign does not address jaw alignment problems at all, and so would not be a reasonable alternative.   Sometimes, if the discrepancy is not too great, a mild underbite can be corrected by extacting one front or two back lower teeth and using conventional appliances to pull the lower front teeth back into a normal bite.  However, this "camoflage" treatment does not actually correct the skeletal problem and will not appreciable affect the facial profile.  An experienced orthodontist can evaluate your case and discuss all the options with you.

Brian Povolny, DDS, PhD
Seattle Orthodontist
5.0 out of 5 stars 2 reviews

Orthognathic surgery best for skeletal problems

It depends -- if your top jaw is smaller, or your bottom jaw bigger, you may have a skeletal (not dental) problem. How do you know?

Take a photograph of your profile (stand next to a plain wall and take a side-view photo from both sides). Look at the photograph closely. Is your chin farther forward than the skin above your upper lip?

If that upper jaw area is set back from your nose and chin, you have a skeletal mis-alignment and orthognathic surgery is best for you.

My friends and patients who I have sent for this procedure are nervous on the front end and can not believe how great the improvements are from this procedure. Most say it's the best thing they've ever spent their money on.

Susan Goode Estep, DMD
Atlanta Dentist
5.0 out of 5 stars 3 reviews


In my experience orthognathic surgery is necessary to alter the jaw.  To adjust the jaw there is no substitute for orthognathic surgery.  Invisalign is a possible alternative to traditional braces in some patients to prepare them for orthognathic surgery.  However, in my opinion Invisalign is not able to address any malocclusion caused by a misalignment of your jaw.  I recommend continuing to use RealSelf to get additional opinions and advice.  If you decide to get a second opinion be sure to research board certified oral maxillofacial surgeons.  Then schedule a consultation for a thorough exam because without a physical exam is it almost impossible to give a definitive answer on what procedure would be needed to improve the functionality of your bite.

Be well and good luck!


Morgan E. Norris, III, MD, FACS
Houston Plastic Surgeon
4.6 out of 5 stars 26 reviews

Alternatives to Orthognathic Surgery

Your orthodontist should of treated both arches when you were an adolescent. As an adult you should seek a new evaluation from an orthodontist, have them take a panoramic and cephalometric radiograph to assess what can be done to help improve your bite. Braces and the use of elastics/rubber bands can help your bite slightly, but if you have a skeletal abnormality it can only be fixed by orthognathic surgery. Your teeth sit on the bone, you can't move the bone, you can only tip the teeth.

Jacqueline Fulop-Goodling, DMD
New York Orthodontist
3.8 out of 5 stars 15 reviews

Some cases may be treated without Orthognathic surgery

From your description it sounds like you have a maxillary deficiency or Class 3 tendency or bite. That would mean the lower jaw protrudes farther forward than your upper jaw. Most of the time you cannot straighten the teeth without the surgery. If you had the opposite situation, you could possibly straighten the teeth and leave your skeletal relationship as a class 2 bite. I would say invisalign may be inneffective for you and you may need braces.

If you want to straighten your teeth, I would visit an Orthodontist, and maybe even visit a couple to get a second opinion. Find out what the pros and cons are of doing treatment with or without orthognathic surgery.

M. Andrew Atwood, DDS
Bellevue Dentist
3.0 out of 5 stars 2 reviews

Invisalign not designed to correct jaw alignment

When someone is still growing and they have braces, then it is possible to use devices, such as headgear, to adjust how the jaws grow help the upper and lower jaws line up correctly.

When you get to be an adult and have stopped growing, then the size and relationship of the jaws are pretty much set where they will be at.

Invisalign and braces can help line up crooked teeth or help teeth not flare out as much, but cannot do anything correct the skeletal relationship between the two jaws. The option you are faced with at this point is orthognathic surgery to correct this problem.

If, after successful surgery, you still want your teeth to be straighter and would like to line them up better, then Invisalign would be something to look into.

Clinton Timmerman, DDS
West Des Moines Dentist

No other method but orthognathic surgery for skeletal issues

When there are skeletal issues, there really isn't much of a choice. Invisalign can tip teeth, but jaws and their relationships are really outside the scope of removable appliances and most bracket systems.

Lance Timmerman, DMD, MAGD
Seattle Dentist
4.3 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.