Patient Case Studies Group 3

JB-PROBLEM LIST

  • Underbite caused by a backward positioned small upper jaw.
  • Open bite caused by the excessive vertical downward growth of the upper jaw.
  • Crossbite caused by the inadequate width of the upper jaw.
  • Gummy smile caused by the excessive vertical downward growth of the upper jaw.
  • Unsupported upper lip caused by a backward positioned small upper jaw.
  • Lip incompetence.
  • Paranasal deficiency associated with a backward positioned small upper jaw.
Pre-Op

Post-Op

PRE-AND POST SURGICAL ORTHODONTICS BY DR. JOHN BURKE.

SURGICAL TREATMENT PLAN
  • Advance the upper jaw using rigid fixation to eliminate the underbite, treat the paranasal deficiency, and give support to the upper lip.
  • Superiorly reposition the upper jaw to eliminate the open bite and gummy smile as well as treat the lip incompetence.
  • Surgically widen the upper jaw to eliminate the crossbite.


JC-PROBLEM LIST

  • Overbite caused by a severely backward positioned small lower jaw.
  • Open bite caused by the excessive vertical downward growth of the upper jaw.
  • Crossbite caused by the inadequate width of the upper jaw.
  • Lip incompetence and constant lip strain.
  • Small chin.
  • Abnormal TMJs.
Pre-Op

Post-Op

PRE AND POST-SURGICAL ORTHODONTICS BY DR. TOM CHOU.

SURGICAL TREATMENT PLAN

Phase 1 surgical treatment involves the correction of the inadequate width of the upper jaw by surgical-orthodontic expansion to eliminate the crossbite.

Phase 2 surgical treatment consists of:

  • Superiorly repositioning the upper jaw to correct the excessive vertical downward growth of the upper jaw.
  • Forward autorotation of the lower jaw.
  • Lower jaw advancement to eliminate the overbite.
  • Genioplasty advancement of the chin to provide normal chin shape and reduce lip strain.

COMMENT: Stability of this large open bite has been problematic with relapse occurring one year later. Further surgical treatment was proposed to close the residual open bite, but because of the positive dramatic functional and cosmetic changes the patient has opted not to undergo additional treatment at this time.


CC-PROBLEM LIST

  • Overbite caused by a small backward positioned lower jaw.
  • Outwardly turned lower lip resulting from the chronic trauma when the upper front teeth repetitively hit against an abnormally positioned lower lip.
  • Chronic trauma to the roof of the mouth from a deep bite in which the lower front teeth chew on the roof of the mouth.
  • Lip incompetence caused by a small backward positioned lower jaw.
Pre-Op

Post-Op

PRE AND POST SURGICAL ORTHODONTICS BY DR. CHARLES CAPPETTA.
SURGICAL TREATMENT PLAN

  • Lower jaw advancement to eliminate both the overbite and deep bite as well as position the lower lip and chin in a more favorable forward position.


ED-PROBLEM LIST

  • Underbite caused by a backward positioned small upper jaw.
  • Underbite caused by a forward positioned large lower jaw.
  • Upper jaw asymmetry caused by an upper jaw cant.
  • Lower jaw asymmetry with deviation of both the facial and dental midlines to the right.
  • Crossbite caused by inadequate width of the upper jaw.
  • Open bite and long facial tendency caused by the excessive vertical downward growth of the upper jaw.
  • Vertically long chin appearance.
Pre-Op

Post-Op

PRE AND POST-SURGICAL ORTHODONTICS BY DR. BILL AKERMAN.

SURGICAL TREATMENT PLAN

  • Differential superior repositioning of the upper jaw to correct the maxillary cant and long facial appearance associated with maxillary vertical excess.
  • Upper jaw advancement to correct the underbite associated with a backward positioned small upper jaw.
  • Surgically widen the upper jaw to correct the crossbite associated with the inadequate width of the upper jaw.
  • Lower jaw autorotation to close the open bite.
  • Lower jaw rotation to the left to correct the lower jaw asymmetry and restore the facial and dental midlines.
  • Lower jaw setback to correct the forward positioned large lower jaw.
  • Genioplasty with vertical and horizontal reduction to treat the chin's vertical excess and create an esthetic chin appearance.


KD-PROBLEM LIST

  • Severe downward vertical growth of the upper jaw resulting in a long facial appearance, lip incompetence, and a gummy smile.
  • A lower jaw which is backward positioned as the result of the severe downward vertical growth of the upper jaw.
  • A backward positioned upper jaw.
  • Paranasal deficiency associated with a backward positioned upper jaw.
  • Gum inflammation of the upper front gum tissue caused by the chronic exposure to air.

Pre-Op Post-Op

SURGICAL TREATMENT PLAN

  • Superiorly reposition the upper jaw to correct the excessive downward vertical growth of the upper jaw to provide vertical facial shortening as well as correct the gummy smile appearance.
  • Upper jaw advancement to correct the paranasal deficiency.
  • Lower jaw autorotation in order to forwardly reposition the lower jaw to reduce lip incompetence.


ND-PROBLEM LIST

  • Overbite caused by a backward positioned lower jaw.
  • Outwardly turned lower lip resulting from the chronic trauma when the upper front teeth repetitively hit against an abnormally positioned lower lip.
Pre-Op

Post-Op

PRE-AND POST-SURGICAL ORTHODONTICS BY DR. TOM CHOU.

SURGICAL TREATMENT PLAN

  • Lower jaw advancement to eliminate the overbite as well as position the lower lip and chin in a more favorable forward position.