How to fix bimaxillary protrusion + maxillary excess?
Posted: Sat Aug 11, 2018 11:52 am
I'm a 28 year old male that has both bimaxillary protrusion and vertical maxillary excess. I believe the protrusion is both dentoalveolar (upper teeth slightly tipped forward) and skeletal (protruding jaw bones). The protrusion itself is likely a consequence of bad oral posture and mouth breathing during my childhood and teenage years. My side profile is somewhat similar to the person shown in Figure 1 on this article: http://www.redalyc.org/html/1530/153052 ... index.html
I'm trying to see if there are surgeries that can fix BOTH jaw protrusion and vertical maxillary exces simultaneously. The most common fix I've seen for bimaxillary protrusion is to simply do premolar extractions combined with elastics to pull back the teeth. Other solutions include pulling back both the upper and lower jaws using bimax. Both, however, seem to reduce available tongue space, which could result in functional problems later down the road. In addition, neither directly address the vertical length of the maxilla.
Are there any surgeries that can tackle both problems without removing teeth and/or tongue space reduction? Based on my readings, I think Posterior Maxillary Impaction (via Lefort I) might be an option. The movement produced in the maxilla by the impaction should reduce the tipping of the upper jaw/teeth. In addition, the impaction would also result in clockwise rotation of the mandible, which should reduce the perceived protrusion on the lower jaw (since the chin would naturally move forward with the rotation).
Would that be a possible fix? Are there any other options out there?
I'm trying to see if there are surgeries that can fix BOTH jaw protrusion and vertical maxillary exces simultaneously. The most common fix I've seen for bimaxillary protrusion is to simply do premolar extractions combined with elastics to pull back the teeth. Other solutions include pulling back both the upper and lower jaws using bimax. Both, however, seem to reduce available tongue space, which could result in functional problems later down the road. In addition, neither directly address the vertical length of the maxilla.
Are there any surgeries that can tackle both problems without removing teeth and/or tongue space reduction? Based on my readings, I think Posterior Maxillary Impaction (via Lefort I) might be an option. The movement produced in the maxilla by the impaction should reduce the tipping of the upper jaw/teeth. In addition, the impaction would also result in clockwise rotation of the mandible, which should reduce the perceived protrusion on the lower jaw (since the chin would naturally move forward with the rotation).
Would that be a possible fix? Are there any other options out there?