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Maxillary Protrusion Correction Before and After Surgery Photos

Homepage Star of September 2012
[ Author:Fushun Ma | Time:2012-10-26 09:46:24 |  Font Size: [Large Medium Small]
Tags: maxillary protrusion, underbite, bimaxillary protrusion, protrusion teeth

Maxillary protrusion, also know as overbite, indicates the protrusion facial figure caused by the over growth of the maxillary bone. In occasion of mandible(jaw) undergrowth the mandible retracts making the upper jaw relatively protruding. This condition is not a real maxillary protrusion. In rare occasion a real maxillary protrusion and mandible undergrowth may coexist. Under this circumstance the upper and lower jaw relationship is not reliable to judge if there is maxillary protrusion exist. Then the relationship between the base of the skull and the maxillary bone is used to make the diagnosis of maxillary protrusion.

Though this page is titled as Maxillary Protrusion Correction, in real life we barely can see pure maxillary protrusion. Almost all the maxillary protrusion is companied with mandible protrusion, to be more precisely we should call it as bimaxillary protrusion. During facial bone development if the maxilla bone is overgrowth the teeth on the mandible will reach forward to meet the protruded upper teeth. Once this reaching effect stimulate the growth of the mandible the mandible bone overgrowth will follow. In this instance the maxillary protrusion and mandible protrusion coexist. If only the lower set of teeth reaching forward without the mandible overgrowth been stimulated a lower set of teeth protrusion is formed. In terms of maxillary protrusion correction both maxillary bone and mandible bone correction are normally needed in order to prevent iatrogenic underbite deformity. Practically the so called maxillary protrusion only represent the facial figure. Structurally the maxillary and mandible bone protrusion coexist only the maxillary protrusion may look more obvious.

maxillary protrusion correction
After maxillary protrusion correction surgery the height of the philtrum and the height of the lower jaw are more proportional. The ratio between the middle and lower face is back to normal.

The above photos are the before and one month after surgery pictures of a bimaxillary protrusion candidate. Though at the time of one month post surgery the surgical swelling is till exist this girl's face looks already relatively normal and her changes caused by the surgery has already revealed. In the front view photo the protrusion of the maxilla can not be depict clearly. However we can still notice the influence of the protrusion. If dividing the face to upper and lower parts by the line between the two corners of the mouth we could notice that the upper part is too long for the giving lower part and the lower part is too short for the upper part in the before surgery picture. This arrangement make the face unbalanced. In the after surgery picture the upper and lower parts ratio is back to normal and the face looks prettier though there is swelling on the face.

maxillary protrusion correcton in profile
After surgery the mouth is not protruding, the lips and the middle face are not convexes.

 maxillary protrusion in profile
Post surgically the philtrum is shorter, the angle between the lower lip and the chin is shallower. The eversion look of the lower lip disappears.

For maxillary protrusion correction the improvement always show better in profile view. This case is the same. The above two sets of photos depict that after surgery this girl's face profile changed a lot. Using simple sketch method to mark the outline of this girl's face contour we could compare the changes between the photos of before and after surgery. As illustrated below line A-B starts at the glabella ends at the very tip of the upper lip, and line B-C starts from this point to the tip of the chin. The angle in between this two lines is ∠ABC, which represents the degree of maxillary protrusion.

maxillary protrusion analysismaxillary protrusion analysis
Simple sketch method to compare the before and after surgery changes in face profile.

By comparing the lines we could tell that the line a-b is shorter than A-B, meaning the length of the philtrum is shorter after the upward movement of the maxillary bone. The angle of ∠abc is wider than ∠ABC, meaning that the protrusion is corrected after the backward movement of the maxillary bone. The eversion look of the lips is also corrected by the setback of the maxillary bone and the mandible bone. The lower lip chin angle is shallower after surgery, as shown by the yellow arrows. The upper lip is not too overlap to the lower lip and their  relationship is back to normal.

maxillary protrusion correction before and after surgery photos
Post surgically the philtrum is shorter, the angle between lower lip and chin is shallower. The eversion look of the lower lip disappeared.

The changes of the 3/4 profile view are mainly shown on the lips and the chin. The degree of protrusion of the lips is smaller, so as the degree of the lip eversion. Though no surgery has been done on the chin it seemed been moved forward, that is because the setback of the lips made the chin stand out.

Facial contour problems like this girl are common among Asian descendant. It is characterized with a upper jaw protrusion and a dripping face look. So many of the candidates come to see a surgeon complaining for the upper jaw problem and believing an upper jaw surgery could solve the problem. In fact all these upper jaw protrusion candidates have lower jaw protrusion at the same time, either bony or teeth protrusion, minor or severe. If only a upper jaw setback surgery is done iatrogenic malocclusion may happens.

In order to change the dripping face for upper jaw protrusion dominated bimaxillary protrusion surgeons will move the maxillary bone upward as well at the time of maxillary bone setback to minimized the length of the philtrum. The scale of the upward movement is restricted not to cause uneven biting level of the upper set of the teeth.

whether a pre surgery orthodontic treatment is needed concerns a lot of the candidates. Traditionally before maxillary correction or underbite correction surgeries a pre surgery orthodontic treatment is needed to restore the occlusion relationship before the compensation.  This is helpful for a surgeon to determine the real degree and situation of the malocclusion. However nowadays the advanced medical imaging technology can precisely calculate the degree of the malocclusion and the relationship between the upper and lower jaw bone pre surgically. And the development of surgical technique also let the surgeons to be able predict the final occlusion status for a giving patient with thorough medical imaging information. So a lot of maxilla surgeons do not ask their patient to do the tedious pre surgery orthodontic treatment anymore.

As stated above the surgeons have already left room for the teeth to adjust themselves to restore normal occlusion after the bimaxillary correction surgery. Stimulated by the chewing and speaking movement the teeth will accomplish the self adjustment and occlusion restoring process in one to two years. After this period of self adjusting the malocclusion normally will be restored to normal. If the malocclusion still exist after two years a simple orthodontic treatment may be introduced.

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