Patient Case Studies Group 1

AC-PROBLEM LIST

  • Overbite caused by a small severely backward positioned lower jaw.
  • Chronic trauma to the roof of the mouth resulting from a Deep bite in which the lower front teeth chew on the palatal gum tissue.
  • Outwardly turned lower lip resulting from the chronic trauma when the upper front teeth repetitively hit against an abnormally positioned lower lip.
  • Twelve year old child not compliant with conventional orthodontic therapy.
July, 1988
Excellent demonstration of how teeth chew on the roof of the mouth with this type of mouth deformity
Sept, 1989

PRE AND POST-SURGICAL ORTHODONTICS BY DR. BRAD WATTERWORTH.

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.
  • Total treatment time including surgery and pre and post-operative orthodontics is less than 13 months.



DD-PROBLEM LIST


  1. Overbite caused by the backward positioned lower jaw and forward positioned upper jaw.

  2. Paranasal deficiency and narrow base of the nose.

  3. Gum inflammation of upper front gum tissue caused by chronic exposure to air.


The Problem

The Solution
Diagram of Procedure
Predictive Model Surgery

Pre-Op Post-Op

Final Bite After Braces and Surgery
PRE AND POST-ORTHODONTICS BY DR. RICHARD NAMEY.

SURGICAL TREATMENT PLAN

  • Significant superior repositioning of the upper jaw to correct the long facial appearance, lip incompetence, and gummy smile.
  • Upper jaw setback to help correct the overbite associated with a forward positioned upper jaw.
  • Surgically widen the upper jaw to eliminate the crossbite associated with inadequate upper jaw width.
  • Significant forward autorotation of the lower jaw to help eliminate the overbite and to bring chin point forward.
  • Surgically allowing nasal base to widen with the superior repositioning of the upper jaw .


AF-PROBLEM LIST

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Pre-Op Post-Op

Pre-Treatment Bite

Post-Treatment Bite
PRE AND POST-ORTHODONTICS BY DR. JAY RICHARD.

SURGICAL TREATMENT PLAN

  • Advancement of the upper jaw to eliminate underbite and paranasal deficiency associated with a backward positioned small upper jaw.
  • Surgically widen the upper jaw to eliminate the crossbite associated with the inadequate width of the upper jaw.


JH-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 palatal gum tissue.
Pre-Op Post-Op

Pre-Treatment Bite
Above photo shows how lower teeth can chew on the roof of the mouth with this type of jaw deformity

Post-Treatment Bite
PRE AND POST-SURGICAL ORTHODONTICS BY DR. TOM CHOU.

SURGICAL TREATMENT PLAN

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


PL-PROBLEM LIST

  • Underbite caused by a severely backward positioned small upper jaw.
  • Underbite caused by a severely forward positioned large lower jaw.
  • Open bite caused by the excessive vertical downward growth of the back portion of the upper jaw.
  • Crossbite due to the inadequate width of the upper jaw.
  • Upper jaw asymmetry with the upper jaw's dental midline shifted to the left.
  • A long facial appearance caused by the excessive vertical downward growth of the back portion of the upper jaw as well as a vertically long chin height.
  • Severe dental compensation.
  • Dental decay and abnormal tooth wear caused by an abnormal bite relationship.
  • Paranasal deficiency associated width a backward positioned small upper jaw.
  • An unsupported upper lip, lip strain, and lip incompetence.
Initial Presentation

Presurgical Orthodontic Decompensation

Predictive Model Surgery
 demonstrating the planned correction of malaligned jaws and bite disorder

Immediate Surgical Changes
demonstrated at time of surgery (patient shaved his mustache off on the morning of surgery)

Pre-Treatment Bite

Post-Treatment Bite
PRE AND POST-SURGICAL ORTHODONTICS BY DR. CHARLES CAPPETTA.

SURGICAL TREATMENT PLAN

  • Upper jaw advancement with a bone graft to help eliminate the underbite and paranasal deficiency associated with a backward positioned small upper jaw.
  • Surgically widen the upper jaw to eliminate the crossbite.
  • Rotation of the upper jaw's dental midline to the right to correct the asymmetry of the upper jaw.
  • Superiorly reposition the upper jaw and autorotate the lower jaw forward to close the open bite.
  • Lower jaw setback to correct a forward positioned lower jaw and the eliminate the underbite.
  • Genioplasty to reduce the chin's vertical facial length and reposition the chin point forward 1/2 the total distance of the amount of the lower jaw setback.

POST SURGICAL PROSTHETIC REHABILITATION OF SEVERELY CARIES AND ATTRITED TEETH BY DR. BILL LEWIS.

COMMENTS: FACIAL HAIR (MUSTACHE) CONVENIENTLY CAMOUFLAGED HOW MUCH THE UPPER JAW WAS BACKWARD POSITIONED AND HOW PROTRUSIVE THE LOWER JAW WAS. Please examine the two intraoperative photos. One photo was taken just at the start of the case after the patient had just shaved off his mustache. Without the mustache you can clearly see how deficient the upper jaw actually was well as how excessively large the lower jaw was. The second intraoperative picture was taken at the very end of the surgical procedure and it reveals the pleasing dramatic correction, with the two jaws now in their normal positions and a normally sized and shaped chin.