Comprehensive Explanation from Orthodontic Specialist Dr. Begüm Ulaşan in Bursa

"Can I fix my jaw with just braces, or is surgery absolutely necessary?"

This is exactly one of the most frequent questions asked by adults and adolescents who come for an orthodontic examination.

Every day at Milim Dental in Bursa, orthodontic specialist Dr. Begüm Ulaşan meets with patients complaining about issues like:

1. "My lower jaw is too far forward / too far back."
2. "My face looks asymmetrical."
3. "My front teeth don't close; there's a gap."
4. "My lips don't close comfortably."

And she provides an answer to this fundamental question: Can my jaw structure be corrected with orthodontics, or is jaw surgery (orthognathic surgery) mandatory?

In this article, we will detail this question along the axis of "Bursa – orthodontics – jaw misalignment – is surgery needed?", primarily based on the clinical approach of Dr. Begüm Ulaşan.

1. Jaw Structure and Orthodontics: Understanding the Foundation First

When we say "my jaw structure is misaligned," we might actually be talking about two different things:

1. Dental Problems:
2. The teeth are misaligned (crowded, gapped, forward/backward).
3. But the upper and lower jaw bones are relatively compatible with each other.
4. Skeletal (Bone-related) Problems:
5. The lower jaw is too far forward or too far back.
6. The upper jaw is too narrow or too far forward/back.
7. Right-left asymmetry in the jaws.
8. A noticeable jaw misalignment in the facial profile, even if the teeth are straightened.

Orthodontics (braces, clear aligners, Invisalign, etc.) can affect both tooth alignment and, during the growth period, jaw development. However:

1. In an adult patient where growth is complete,
2. Fundamentally changing the bone relationship may not always be possible with orthodontics alone.

In some cases, orthognathic surgery (jaw surgery) must work in combination with orthodontics.

This is why, in the initial examination, Dr. Begüm Ulaşan, the orthodontic specialist in Bursa, always analyzes:

1. Is the problem solely dental?
2. Or is the core issue the relationship between the jaw bones?
3. What is the patient's age, and are the growth plates closed?
4. What are the chewing function, joint, muscles, and facial profile like?

This analysis forms the basis for the question, "Can it be corrected with just orthodontics, or might surgery be necessary?"

2. When Is Orthodontics Alone (Braces / Clear Aligners) Sufficient?

2.1. If the Problem is Predominantly Dental in Origin

If:

1. Your teeth are overlapping, crooked, or gapped,
2. Your upper and lower jaw bones are roughly compatible,
3. There is no noticeable "jaw too far forward/back" appearance in your facial profile,

then often, only orthodontics can significantly improve the "appearance" of your jaw structure.

Because:

1. When the teeth are aligned,
2. When the upper and lower teeth begin to close harmoniously,
3. When lip support is balanced,

your face looks more proportionate and your jaw appears straighter when you look in the mirror.

In this situation, a classic treatment with an orthodontic specialist in Bursa, rather than surgery, is usually enough.

2.2. Jaw Guidance (Orthopedic Treatment) in Growing Patients

If the patient:

1. Is in the childhood-adolescent period (generally around 10–13 for girls, 11–14 for boys),
2. Still has growth potential,
3. Has a mild-to-moderate degree of recession/protrusion in the upper or lower jaw,

then jaw guidance can be performed with orthopedic appliances.

Examples:

1. Expansion appliances for children with a narrow upper jaw.
2. Functional appliances for adolescents with a receding lower jaw.
3. Different combined devices for some cases where the upper jaw is recessed/lower jaw is forward.

In such cases, Dr. Begüm Ulaşan in Bursa uses the advantage of growth to:

1. Aim for both aligning the teeth,
2. And directing jaw development in the correct direction.

Thus, a problem that might require surgery later can be controlled without surgery during the growth period.

3. When Does Jaw Surgery (Orthognathic Surgery) Come into Question?

Surgery is not mandatory for every jaw misalignment, but in some cases, a solution with orthodontics alone may not be sufficient or healthy.

3.1. If Growth is Complete and Skeletal Misalignment is Severe

In an adult patient:

1. The lower jaw is very prominently forward (Class III, prognathism),
2. The lower jaw is very far back (Class II, retrognathism),
3. The upper jaw is excessively narrow and sunken,
4. There are severe size differences between the upper and lower jaws,
5. There is obvious facial asymmetry,

trying to simply "camouflage" the teeth with braces or clear aligners can:

1. Be insufficient from a facial aesthetic standpoint,
2. Further strain the jaw joint and muscles,
3. Cause the teeth to be angled excessively and unnaturally.

In such cases, with orthognathic surgery (jaw surgery):

1. The lower and/or upper jaw bones are moved into the correct position,
2. Followed by fine adjustments with orthodontics.

For patients with such severe skeletal misalignments, Dr. Begüm Ulaşan in Bursa typically:

1. First conducts detailed cephalometric analysis and 2D–3D planning,
2. Holds case discussions collaboratively with a maxillo-facial surgeon,
3. Transparently shares the pros and cons of both surgical and non-surgical options with the patient.

3.2. Open Bite and Severe Vertical Problems

In some patients:

1. A gap remains between the front teeth when closing,
2. The back teeth touch, but the front area remains open (Open Bite),
3. There is excessive vertical facial lengthening,
4. The lips cannot close comfortably.

Mild open bites can sometimes be corrected with orthodontics alone, but in severe cases:

1. If skeletal reasons such as the excessive eruption of back teeth or overdevelopment of the jaw bone in the vertical direction are involved,
2. This condition may not be fully and permanently corrected with only braces or clear aligners.

In this situation, too, a combined plan of Orthognathic Surgery + Orthodontics is created.

3.3. Jaw Asymmetries

If when looking in the mirror:

1. Your chin appears shifted to the right or left,
2. One side of the cheek looks fuller, and the other more sunken,
3. Your lower teeth are not perfectly centered with your upper teeth (midline shift),

the orthodontic specialist will definitely examine this from a skeletal perspective.

Slight asymmetries can be somewhat corrected by just moving the teeth. However, if the jaw bone itself is developed towards one side, especially in an adult patient, jaw surgery is often necessary.

4. Dr. Begüm Ulaşan's Approach in Bursa: "Analysis First, Then Orthodontics or Surgery?"

Imagine you are applying to orthodontic specialist Dr. Begüm Ulaşan in Bursa with complaints about your jaw structure.

The examination process typically proceeds as follows:

4.1. Detailed History and Clinical Examination

1. You are asked what bothers you the most: Chewing difficulty? Appearance? Pain?
2. Inquiry is made about previous tooth extractions, orthodontics, trauma, etc.
3. Your face is examined from the front and side, and the temporomandibular joints and muscles are checked.

4.2. X-ray and Cephalometric Analysis

1. A panoramic X-ray is used for a general assessment of the teeth and jaws.
2. A Cephalometric film (profile X-ray) is taken.
3. A 3D CBCT (tomography) may be requested if necessary.

On these films:

1. The position of the upper and lower jaw bones relative to each other,
2. Vertical and horizontal angles,
3. The positions of the teeth within the bone

are calculated.

4.3. Comparison of Orthodontic and Surgical Options

Dr. Begüm Ulaşan then generally follows this path:

1. She shows how far one can progress with orthodontics alone.
2. She explains the ideal result achievable with Orthognathic Surgery + Orthodontics.
3. She informs the patient about the:
4. Treatment duration,
5. Difficulties,
6. Risks,
7. Aesthetic and functional results,
8. Costs
9. of both options.

The goal here is not to tell the patient, "You must have surgery!" but rather: "The realistic outcomes for the surgical and non-surgical options in this situation are these; let's decide together."

5. Can Clear Aligners (Invisalign / Aligner) Fix Jaw Structure?

Many adult patients in Bursa come to Dr. Begüm Ulaşan with this question: "Can I correct my jaw misalignment with clear aligners (Invisalign, aligners), or is surgery necessary?"

It is important to remember the crucial distinction here:

1. Clear aligners are an orthodontic method that moves teeth.
2. They describe "how" the orthodontics is done (aligner instead of wire).
3. They do not unilaterally enlarge or shrink the jaw bone; they move the teeth within the bone.

Therefore:

1. If your problem is solely dental, orthodontics with clear aligners yields very good results.
2. In mild-to-moderate skeletal problems, the facial aesthetic can be improved somewhat with a "camouflage" approach.
3. However, if the difference between the jaw bones is severe, it is not possible to fundamentally solve this using only aligners; the same limits of "non-surgical solution with braces" apply here too.

Summary: Clear aligners (Align, Invisalign) are an orthodontic tool; the suitability of the jaw misalignment is evaluated by the orthodontic specialist. Even if the tool changes (wire/aligner), the skeletal limits are the same.

6. I Have a Jaw Misalignment Severe Enough to Require Surgery; Can I Still Just Have Orthodontics?

This question is asked very frequently, and the answer is sensitive.

Some patients might want to "manage" with just orthodontics because:

1. They are afraid of the idea of surgery,
2. They are anxious about the recovery process and needing time off work/school,
3. They insist, "I want a non-surgical solution no matter what."

Dr. Begüm Ulaşan in Bursa usually approaches a patient in this situation as follows:

1. Shows the realistic difference: She explains the maximum change achievable with non-surgical orthodontics and the ideal result achievable with surgical orthodontics, using photos and drawings.
2. Explains the risks: If only camouflage is performed, the tooth roots may be angled too much, the jaw joint may continue to be strained, and the skeletal misalignment in the facial profile will not be completely corrected.
3. Asks the patient's priority: "What is most important to you: Only appearance? Only function? Or a balance of both?"
4. Sometimes performs controlled camouflage: If the patient absolutely refuses surgery but has noticeable discomfort, a camouflage treatment aiming for a "reasonable improvement" with orthodontics can be planned. However, this is applied in selected cases, not every case, and the patient is informed about all the limitations.

So, the answer is: Yes, partial improvement can be made with non-surgical orthodontics even in some severe jaw misalignment cases, but this is not always the ideal solution. The decision should be made after a detailed evaluation with your orthodontic specialist in Bursa.

7. Frequently Asked Questions – Short Answers

1. Can my jaw structure be completely corrected with orthodontics?
2. If the majority of the problem is dental, yes, it can be largely corrected. However, if the position of the jaw bones is severely misaligned, orthodontics alone may be insufficient; orthognathic surgery may be needed.
3. At what age does jaw surgery become inevitable?
4. Age is not the sole determinant; surgery comes into question if the skeletal misalignment is severe after growth has finished. It may be necessary at age 20, or only orthodontics may be sufficient at age 35; it entirely depends on the severity of the case.
5. Who should I go to for orthodontics in Bursa?
6. You need to consult an orthodontic specialist for orthodontic and jaw-related problems. Dr. Begüm Ulaşan in Bursa, under the roof of Milim Dental, works intensively on braces, clear aligners (Aligner, Invisalign), and combined treatments with jaw surgery.
7. Can clear aligners (Invisalign) be used to straighten teeth after jaw surgery?
8. Yes, clear aligner systems can be used before and/or after surgery in some orthognathic surgery cases. However, this entirely depends on your orthodontic specialist's plan.
9. My appearance is poor, but my chewing is fine; should I still have surgery?
10. This is a very personal decision. Your orthodontic specialist will clearly explain the difference in aesthetics and function provided by the surgical and non-surgical options; the decision is yours.

8. Conclusion: The Question "Can My Jaw Structure Be Corrected with Orthodontics, or Is Surgery Necessary?" Is Patient-Specific

To summarize the essence of this long article in one sentence: In some patients, the jaw structure can be corrected with orthodontics alone; in others, orthognathic surgery + orthodontics is necessary for the ideal result.

1. If the problem is primarily dental: Braces or clear aligner treatments applied by an orthodontic specialist like Dr. Begüm Ulaşan in Bursa are often sufficient.
2. If the problem is skeletal and severe: The option of jaw surgery (orthognathic surgery) must be carefully evaluated.

The healthiest approach is to:

1. Make an appointment with an orthodontic specialist in Bursa,
2. Following a detailed examination, X-rays, and analyses,
3. Get a personalized answer to the question: "Just orthodontics, or orthodontics + surgery?"

Remember: No information you read online can replace the expertise of a specialist who sees and evaluates your face, jaw, and X-rays individually.

But this article should at least let you know:

1. It may be too early to say, "My jaw structure is bad; I definitely need surgery."
2. It may also be unrealistic to say, "Everything can be fixed with orthodontics; no surgery is needed at all."

The correct answer emerges from a detailed evaluation with an orthodontic specialist like Dr. Begüm Ulaşan in Bursa. And often, seeing that you have more options than you thought will make you feel better.