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17 мая 2021

How to correct a protruding jaw without surgery?

I have a slightly protruding lower jaw and my lower front teeth overlap my upper teeth. About five years ago I went to several orthodontists. All doctors answer said that surgery would be needed after wearing braces. I wondered if it was possible to do without it.

The doctor's answer

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Answer Petrova Elena Alexandrovna

Orthodontist, Team lead TMJ, experience 9 years

Based on the data provided, we can note that you are characterized by:

  • Mesial bite;
  • Cross bite in the lateral section on the left;
  • Moderate crowding of teeth in the upper jaw;
  • Slight crowding on the lower jaw;
  • Absence of teeth 46, 37;
  • Narrowing of the smile and shifting of the center of the upper and lower dentition to the left.

Preliminary description of your clinical situation: The profile is quite harmonious and does not require moving the mandible backwards, but there is reverse incisor overlap and crossbite in the lateral region, i.e. maxillary narrowing. You could say you have a borderline case.

This means that in order to make a final decision about the need for surgery or the possibility of correcting the bite only by moving the teeth, we need additional diagnostic data (3D X-rays - CT scan of the face, plaster diagnostic models and a few more photos, which we take at the clinical appointment). Once all the data has been analyzed, a decision can be made.

Such a situation can be solved in the following ways:

  1. Bite correction by moving the lower teeth backwards - this requires the space in the tooth row that we can get as a result:
    • extraction of teeth on the right and left (in your case there are already missing teeth on the bottom right and left) and distalization – when the entire tooth row is moved backwards: support with micro-implants is necessary;
    • separation – grinding the teeth in a safe volume, as a result of which they are reduced in size and free the necessary space (up to 2-3 mm on each side).

    Limitation: the tilt of the lower anterior teeth and the bone volume in which the teeth will be moved – it is necessary to evaluate the initial tilt and bone volume on a 3D x-ray (part of the diagnosis).

  2. Bite correction by moving the upper teeth forward – increasing the inclination of the incisors. In this case, we are limited by the bone volume in the area of the anterior teeth, as well as aesthetic parameters. It can only be assessed on a 3D image.
  3. Combining 1 and 2 methods.

Alignment of the dentition with or without tooth extraction and surgical movement of the lower jaw backward and/or the upper jaw forward.

Also, a surgical operation may consist in the expansion of the upper jaw, if the volume of bone tissue does not allow the dentition to expand due to the movement / tilt of the teeth.

Possible treatment options:

We can offer you several possible solutions. From the point of view of efficiency, price/invisibility compromise and taking into account your situation, we would recommend treatment with a combined bracket system: Damon Clear ceramic braces on the upper jaw and Damon Q metal braces on the lower jaw.

Progress and timing of treatment:

  • Consultation with an orthodontist
  • Diagnostics (CBCT, TRG, casts, photo protocol)
  • Patient's choice of treatment plan
  • Oral sanitation or a certificate of sanitation
  • Installing braces
  • Alignment of the dentition (5-7 months)
  • Bite correction (4-10 months)
  • Details of orthodontic treatment (1-3 months)
  • Installing retainers and removing braces
  • Retention period

Please note that these recommendations are for informational purposes only.  You can get a detailed consultation only at the appointment of an orthodontist after examination and diagnosis. 

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