When the Lower Jaw Sits Behind the Upper Jaw
The most common skeletal condition includes the patient whose lower jaw and teeth sit behind the upper jaw. It is crucial that these types of cases be diagnosed and treatment planned properly to preserve or enhance facial esthetics as well as to provide proper function of the teeth, the jaws and the jaw joints. Since growth is completed and therefore can not be manipulated, surgery is necessary in addition to orthodontic treatment.
From the beginning, the case is methodically planned by the orthodontist and a maxillofacial surgeon.
The ideal treatment in these cases typically involves braces to be applied to the upper and lower teeth, and the teeth are aligned relative to each jaw. Then, with the braces still in place, jaw surgery (orthognathic surgery) is performed by the maxillofacial surgeon. This typically involves the advancement of the lower jaw and sometimes requires simultaneous surgical modification of the upper jaw.
Most commonly, the patient is hospitalized for one or two days and the jaws are "fixated" or "wired" together for as few as two or as many as six weeks, to promote healing. Soon after the fixation is removed, Dr. Wintner can resume his treatment to provide final detailing of the bite. Dr. Wintner's goal is to complete as much tooth movement as possible prior to the surgery to maximize the surgical results. Usually the braces can be removed within three months post-surgery.