Surgical Examples

Class II, Div 1, Lower Jaw Advancement Surgery

Some patient’s lower jaw is retrusive enough to require jaw surgery to correct their bite. Lower jaw retrusion is hard to diagnose when looking straight at a patient.

Diagnosis of lower jaw retrusion is easier to do from the side photo. This patient’s chin is retrusive although in this photo she is posturing forward, somewhat.

Intraorally, her upper teeth overlap the lower teeth more than they should. This is called a deep bite.

Intraorally from the side, her front teeth are well ahead of the lower teeth. This is called excess overjet, although many people call it “overbite.” You can see the upper molar is well ahead of the lower. Ideally, the arrows should be in line.

At the completion of treatment the front smile is similar to where we began.

From the side, you can notice an improvement in the chin position.

Intraorally, the deep bite has been corrected.

Also, the “excess overjet” and alignment of the molars have been corrected.

Class II, Div 1, Congenitally missing two lower, permanent premolars

This patient is similar to the previous case in that she has a retrusive lower jaw. Sometimes patients with this retrusion will show an extra fold of tissue under their chin on the front photo.

From the side you can see her chin is retrusive compared to the upper jaw.

Front dental view shows spacing between the upper teeth and malalignment of the upper and lower front teeth.

The upper teeth stick out well past the lower teeth. Also notice the lower silver tooth. This is a retained baby tooth that has a stainless steel crown placed on it.

The radiograph shows that our patient is missing both lower permanent second premolars (teeth under the stainless steel crowns).

After surgery the extra fold of tissue is not present primarily due to the advancement of the lower jaw and liposuction of this area.

Profile picture shows the advancement of the chin with the lower jaw surgery.

Intraoral photo shows well aligned upper and lower front teeth.

From the side photo the back bite is what is called a functional Class III occlusion since the lower space was closed and the lower molar brought forward.

Radiograph showing space closure in the lower arch. One problem with this type of bite is loss of contact to the upper second molars. In this patient contact was established with the lower first molars to prevent extrusion of the upper second molars.