Jaw Surgery First Approach: 2 Years 8 Months Post-Op Review
- Dr. Park
- Oct 20, 2024
- 2 min read
By Dr. Park Jong-chul, Oral and Maxillofacial Surgeon
This post details the remarkable results of a patient who underwent jaw surgery first, followed by orthodontic treatment, including maxillary expansion surgery. We will examine the transformative journey of a patient with prognathism (mandibular protrusion), facial asymmetry, and protrusion of the mouth, showcasing their progress 2 years and 8 months after the initial jaw surgery.
Pre-operative Condition: Prognathism, Asymmetry, and Protrusion
Initially, the patient presented with a combination of prognathism, facial asymmetry, and protrusion of the mouth. To address these complexities, a "jaw surgery first" approach was chosen, prioritizing the correction of jaw position and alignment before initiating orthodontic treatment. This strategy was crucial to establish a proper foundation for subsequent dental alignment and achieve optimal facial harmony.
What is Maxillary Two-Piece Expansion Surgery?
Maxillary two-piece expansion surgery is a procedure that widens the upper jaw (maxilla) to ensure proper occlusion and enhance facial balance. This technique is particularly important in cases with a narrow maxilla, as it creates the necessary space for proper tooth alignment and contributes to improved facial aesthetics.
Post-operative Skeletal Changes at 2 Years 8 Months
Significant improvement in facial length, prognathism, and protrusion
Successful correction of facial asymmetry
Comparison of soft tissue pre-op and 2 years 8 months post-op
Reduction in chin length (6.47mm)
No development of a double chin (attributed to the upward movement of the tongue))
Changes in bone structure at the maxillary expansion site - 2 days post-op vs. 2 years 8 months post-op
Changes in anterior teeth axis resulting from post-surgical orthodontic treatment
Stable maintenance of posterior teeth width
Complete bone regeneration in the gap initially created by maxillary expansion surgery
Maxillary Expansion Surgery vs. MARPE (Miniscrew-Assisted Rapid Palatal Expansion)
Two primary methods are available for maxillary expansion: surgical (maxillary two-piece expansion) and orthodontic (MARPE).
Maxillary two-piece expansion surgery: Effective for widening the basal bone up to approximately 5mm.
MARPE: Recommended when expansion exceeding 5mm is required.
Conclusion
The "jaw surgery first" approach, combined with maxillary two-piece expansion, demonstrates remarkable effectiveness in correcting prognathism, facial asymmetry, and protrusion of the mouth. The widened maxillary arch achieved through this procedure remains stable even after the completion of orthodontic treatment.
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