Mandibular prognathism

Mandibular prognathism is what we call the condition when the lower teeth stick out further than the upper teeth and the mouth doesn’t close properly.
There are two main causes: lack of growth of the upper jaw (maxillary hypoplasia) or excess growth of the lower jaw (mandibular hyperplasia).
We often find a combination of both: lack of growth of the upper jaw and excess growth of the lower jaw. This is due to the fact that the lower jaw stimulates growth of the upper jaw bone and if there is some mandibular prognathism, during adolescence, the upper jaw doesn’t grow enough and ends up being too small.

Before the surgery

After the surgery

Treatment for mandibular prognathism

Prognathism can be treated with mandibular retrognathism, maxillary advancement or a combination of the two (bimaxillary surgery).

This normally requires preparation with orthodontics beforehand to make sure teeth align properly once the jawbones are put in the correct position.
When we apply the “Surgery First” protocol, this orthodontic preparation is reduced or even eliminated.

We’d like to introduce you to Dr Birbe, the man in charge of your mandibular prognathism treatment.

Dr Birbe is a world-renowned surgeon specialising in the field of orthognathic surgery, giving him full expertise in conditions like the common condition mandibular prognathism.

What is the process for treating mandibular prognathism?

First of all, we have to do a proper diagnosis of the prognathism in order to determine how we will treat it.

If it is a dental issue, we will only use orthodontics.
If it is a skeletal issue, we can use skeletal orthodontics (screws and plates) when possible.

If it is a skeletal issue and the prognathism is severe, we use orthodontics and orthognathic surgery so, if the patient desires, we can improve their facial proportions and lip position.

  • Diagnostic appointment. Bite registration and x-rays.

  • Assessment of treatment options.

  • Begin treatment. Orthodontics or surgery, depending on the case.
  • Stabilisation phase with oral stabilisers.

What results can we expect from the treatment?

The main goal we achieve is correcting the prognathism, correcting facial proportions and improving breathing, especially while sleeping for patients who snore.

Jordi’s case

Jordi tells us about his case of mandibular prognathism. The original solution proposed wasn’t appropriate in his case and Jordi decided to come to the Birbe Clinic, where Dr Birbe explained that he had better options and, in the end, Jordi underwent advanced treatment at the Birbe Clinic without orthodontics beforehand.

In this video, Jordi explains what the treatment and his surgery at the Birbe Clinic were like.

“When you need something done it should be done right, focusing on the results.  I’m very satisfied with how everything has gone,” says Jordi.

Frequently asked questions about mandibular prognathism

After the treatment, the patient will have to wear invisible stabilisers at night for a few months.

It is possible to treat mandibular prognathism with surgery from 12-14 years of age, especially if it is due to maxillary advancement.  It also depends on the gender of the patient.

When the direction of growth favours surgical movement, we can do the operation before the patient has finished growing. However if the direction of growth is opposite to the direction of surgery, we recommend waiting until the patient has finished growing. Meaning that if we have to do a maxillary advancement, when the jaw may grow a bit more forward or in either direction, the direction of surgery and that of growth are the same, and we can do the operation before the patient has finished growing. However, if we need to do a mandibular retrognathism on a jawbone with potential to grow forward, as the direction of surgery and that of growth are opposite, the surgical procedure should be done after the patient has finished growing.

The Birbe Clinic is a benchmark in treating this type of condition. We have done numerous surgeries, all with excellent results.

Sometimes in the case of mild skeletal prognathism and severe dental prognathism, we are right on the line of what can be done with orthodontics alone. If the patient doesn’t require facial changes and only wants to treat the occlusion, a novel solution combines corticomy and orthodontics. This allows us to achieve greater dental movements, in a stable manner, and in some cases avoid orthognathic surgery. This involves tiny cuts and perforations in the bone around the roots that we want to move with orthodontics. These corticomies change the metabolism of the bone on a local level, decreasing resistance to dental movement with orthodontics and allowing for greater orthodontic movement without damaging the gums.

The cost depends on the treatment used: between €3,000 (orthodontics) and €12,000 (orthognathic surgery). Remember, you will be in the hands of a prestigious clinic with a team of world-renowned professionals. You will undoubtedly receive the best service at the most competitive price on a treatment that is a lifelong investment.

Why should I have the operation at the Birbe Clinic?


We strive for excellence in care and service, all of which can be seen in our top-notch results


We are honest, when we recommend a treatment is always because we believe it is what is best for your health and wellbeing


Our facilities were designed for optimal hygiene and sterilisation, and to ensure our patients’ comfort. We have an on-site scanner and operating room, with sedation and out-patient treatments

Quality, trust and experience

Our professional team is led by the world-renowned Dr Birbe, who is the only Spanish maxillofacial surgeon certified by the American Board of Oral and Maxillofacial Surgery 2001

Personalised care

Dr Birbe will see you personally, you will have his mobile number before and after the operation

Dr. Joan Birbe
Equipo Clínica Birbe

Contact us: Ease and options

At your first appointment, we explain the different treatments available and the best option for your specific situation. You will deal directly with Dr Birbe, one of the most world-renowned maxillofacial surgeons in Barcelona. You will get:

  • Personal diagnosis after oral and facial exploration
  • Firm quote, along with different financing options
Sala Clínica Birbe

Why the Birbe Clinic?

What do our patients have to say about us?

Learn more about Dr Birbe