Acromegaly_Chad
Offical Surgery Consultant
- Joined
- Apr 16, 2020
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So after Dr T and Z talked shit about BSSO Ramus widening I have found this in one of Dr Obwegesers papers:
Case 2: retromaxillism, narrow maxilla,
mandibular retroalveolism
Clinical characteristics
Frontal view showing narrow facies with poor
gonial angle contour (Fig. 2A)
Concave profile
Flat midface: maxilla and malar
??Edentulous?? facial expression
The chin prominent but in normal position
Lack of dental support to the upper and lower lip
Prominence of nasolabial folds and crease
Narrow alar base
Class I molar and canine relation
Crowding in the maxillary and mandibular
dental arches
Incongruent curves of Spee
Protrusive maxillary incisors
Treatment plan
The treatment plan is a combined surgical and
orthodontic approach. The two-stage surgical
approach (Figs. 2B?D) is
1. Anterior mandibular alveolar segment distrac-
tion osteogenesis [4,5] and surgically assisted
rapid palatal expansion (see Fig. 2B).
2. Orthodontic alignment of two dental arches,
including full decompensation of the existing
skeletal anomalies. Now it becomes clear that
this case is a class III case (retro-/micromaxil-
lism). The occlusion before the second surgical
procedure shows class III molar relation and
a negative overjet. The opened space behind
the canines will be managed by dental implants
at the end of the treatment.
3. Bimaxillary surgery: 13 mm of maxillary
advancement at the LeFort I level, mild mandib-
ular set back through BSSO [6], and clockwise
rotation of both jaws. In addition, vertical chin
augmentation and, again, mandibular segmen-
tal osteotomy for widening of the mandible.
If he does, it must be safe. He's literally my last resort now to fix my FUCKED up narrow CUCK mandible
Case 2: retromaxillism, narrow maxilla,
mandibular retroalveolism
Clinical characteristics
Frontal view showing narrow facies with poor
gonial angle contour (Fig. 2A)
Concave profile
Flat midface: maxilla and malar
??Edentulous?? facial expression
The chin prominent but in normal position
Lack of dental support to the upper and lower lip
Prominence of nasolabial folds and crease
Narrow alar base
Class I molar and canine relation
Crowding in the maxillary and mandibular
dental arches
Incongruent curves of Spee
Protrusive maxillary incisors
Treatment plan
The treatment plan is a combined surgical and
orthodontic approach. The two-stage surgical
approach (Figs. 2B?D) is
1. Anterior mandibular alveolar segment distrac-
tion osteogenesis [4,5] and surgically assisted
rapid palatal expansion (see Fig. 2B).
2. Orthodontic alignment of two dental arches,
including full decompensation of the existing
skeletal anomalies. Now it becomes clear that
this case is a class III case (retro-/micromaxil-
lism). The occlusion before the second surgical
procedure shows class III molar relation and
a negative overjet. The opened space behind
the canines will be managed by dental implants
at the end of the treatment.
3. Bimaxillary surgery: 13 mm of maxillary
advancement at the LeFort I level, mild mandib-
ular set back through BSSO [6], and clockwise
rotation of both jaws. In addition, vertical chin
augmentation and, again, mandibular segmen-
tal osteotomy for widening of the mandible.
If he does, it must be safe. He's literally my last resort now to fix my FUCKED up narrow CUCK mandible
