In maxillary retrognathia, the upper jaw is underdeveloped and the normally developed lower jaw protrudes. The phenomenon is an anomaly of the jaw-cranium relationship and can occur as part of hereditary malformation syndromes or in an acquired form after trauma. The treatment of the patients corresponds to a special form of osteotomy.
What is maxillary retrognathia?
Prognathism is an orthodontic misalignment in which the upper jaw is too far forward in relation to the base of the skull. Malpositioned teeth with the front teeth of the upper jaw that are too far in front are also sometimes referred to as prognathism. Maxillary retrognathia is also known as false progeny and corresponds to hypoplasia of the upper jaw. Medicine understands hypoplasia as underdevelopment. For aht – arterial hypertension, please visit ablogtophone.com.
With this phenomenon, the underdeveloped upper jaw of the patient falsely leads to the impression of prognathism. The phenomenon is also known as opisthognathia, maxillary retrognathism, and maxillary retrognathia. The underdevelopment of the upper jaw usually corresponds to a shortening. For this reason, the normally developed lower jaw protrudes beyond the underdeveloped upper part of the jaw.
Maxillary retrognathia is one of the anomalies of the jaw-cranium relationship. The phenomenon often has a hereditary basis. However, under certain circumstances, maxillary retrognathia can also be acquired. The phenomenon is the second most common dysgnathia. Malformations of the teeth and the jaw are summarized as such.
Causes
In most cases, maxillary retrognathia is hereditary. In this context, the phenomenon can be present, for example, in the context of syndromes such as Crouzon syndrome and can be traced back to the primary cause of a genetic mutation. Hypoplasia of the maxilla in congenital cases corresponds to growth retardation.
Maxillary retrognathia occur, for example, in the context of dysostosis craniofacialis as craniofacial malformations or and associate the symptoms of acrocephalosyndactyly. However, rethrognathia can also be acquired and occur in this context, for example after operations. Sometimes the most common occurrence is after surgical interventions on a cleft lip and palate, which take place in childhood.
If a patient has teeth extracted during childhood or the patient irreversibly loses upper teeth in some other way, this loss can also promote acquired maxillary retrognathia. Except for those with an inherited condition, most patients with maxillary retrognathia are perfectly healthy apart from the maxillary abnormality.
Acquired forms may be preceded by trauma to the jaw or skull that has not been adequately treated. In this context, the phenomenon is a local complication.
Symptoms, Ailments & Signs
Patients with maxillary retrognathia have an abnormal jaw-to-cranial base ratio. In comparison to the upper jaw, the chin of the patient lies too far forward in significant parts. Because of this, patients have a concave facial profile. The maldevelopment makes the nose and the nasolabial fold extremely dominant.
Patients often complain that they have difficulty breathing through their nose, as nasal breathing is restricted by the misalignment of their jaws. The additional symptoms present depend on the cause of the maxillary retrognathia. In the context of malformation syndromes, there are usually many other malformations of the craniofacial system.
In acquired cases, the anomaly is usually an isolated phenomenon. Under certain circumstances, the maldevelopment can be associated with pain, especially in the case of traumatic causes. Problems with eating or drinking can set in from a certain level. In addition, all malpositions and incorrect loads on the jaw can cause complaints such as headaches or tension.
Diagnosis & disease progression
Within the framework of diagnostics, maxillary retrognathia must be differentiated from mandibular prognathism. These misdevelopments do not involve a shortened upper jaw, but rather an elongated lower jaw that protrudes beyond the upper jaw. The maxillary retrognathia at first glance appears to be a prognathism, but in no way corresponds to the same anomaly. The diagnosis is made by the dentist or oral surgeon. In most cases, the prognosis is excellent. This is at least true after early diagnoses of the anomaly.
Complications
Those affected by this disease usually suffer from various complaints in the jaw area. This leads to changes and deformations in the face, so that those affected primarily suffer from limited aesthetics. Children in particular can also suffer from bullying or teasing.
It is not uncommon for this to lead to a severely reduced sense of self-esteem or even to inferiority complexes. Sometimes the disease also leads to breathing difficulties, so that in the worst case the patients can also lose consciousness. The inner organs are also supplied with less oxygen.
Malformations can also occur on the face. The disease also leads to tension in the neck and jaw and often to headaches. Misalignments can also occur. Eating food and liquids can be difficult.
The treatment of this disease is carried out with the help of various interventions. Usually there are no special complications. Many malpositions and complaints can be corrected in this way. The patient’s life expectancy is also usually not reduced by the disease.
When should you go to the doctor?
People who suffer from an optical change in the shape of the face should consult a doctor. In particular, if the maxilla and mandible are not superimposed, this is a cause for concern and could be indicative of maxillary retrognathia. If there is a significant overbite, it is advisable to see a doctor so that the jaw can be corrected. If problems with eating develop due to the misalignment, a doctor should be consulted. If food cannot be properly broken up by chewing because of the symptoms, it is advisable to consult a doctor. If you refuse to eat or eat only liquid or pulpy foods, you need to see a doctor.
Many patients experience impairments in their usual breathing activity due to the malformations. If breathing is difficult, this leads to sleep disturbances or if anxiety occurs due to the lack of breath, a doctor is needed. A doctor should be consulted if you have a headache, muscle problems or tension in the shoulder and neck area. If the person concerned also suffers from a mental disorder, a doctor should also be consulted. In the case of social withdrawal, depressive moods and behavioral problems, medical and therapeutic help is required. If you have low self-confidence, a reduced zest for life or a significant loss of well-being, you need to see a doctor.
Treatment & Therapy
Patients with maxillary retrognathia must be treated as early as possible. If left untreated, the anomaly of the jaw can cause serious damage to the teeth and supporting structures. These complications must be avoided by means of early treatment. The treatment is usually causal and takes place in orthodontic care. There are no conservative treatment options for the phenomenon.
Operational procedures are to be given priority. The oral surgeon usually resolves the malformation as part of a special osteotomy. Osteotomies are surgical procedures for the targeted cutting of bones that can correct misalignments. In this context, a so-called corrective osteotomy is often mentioned. An osteotomy is followed by internal fixation, in which the severed bones are brought into position and fixed.
In patients with maxillary retrognathia, osteotomy and osteosynthesis serve to advance the maxilla. In this case, the operation is preferably performed using the Le Fort I osteotomy technique. In most cases, the operation can correct the anomaly at least to the extent that complications such as tooth damage or damage to the supporting apparatus are excluded.
Outlook & Forecast
The positive prognosis for maxillary retrognathia applies in most cases. The prerequisite for this, however, is early diagnosis. The shortening of the lower jaw can be hereditary. However, it can also be caused by other circumstances, such as trauma in the facial area. Maxillary retrognathia is to be distinguished from a normal underbite. This is caused by the upper jaw protruding too far.
As a result of maxillary retrognathia, those affected suffer from an unusual appearance. They have head deformities and numerous complaints. Difficulty breathing may occur. Maxillary retrognathia has no impact on lifespan. However, it can reduce the quality of life. This is especially true when eating becomes difficult or breathing becomes difficult. Aesthetic issues are also affected by maxillary retrognathia.
Orthodontic treatment of maxillary retrognathia is essential. It can usually be completed with good results. The facial and jaw malformations that occur with maxillary retrognathia usually have to be corrected by oral surgery. The ability to chew, unhindered breathing and a more attractive appearance must be ensured.
Psychological consequences such as inferiority complexes or depression are common. If they receive psychotherapeutic treatment, the overall prognosis is good. This is especially true when there is a prospect of an improvement in the situation through oral surgery.
Prevention
Maxillary retrognathia in the context of malformation syndromes is difficult to prevent. However, acquired anomalies of this type can be ruled out by only carrying out interventions on the child’s jaw or the cleft palate from a certain age and with the necessary pre- and post-operative care.
Aftercare
The treatment of the misaligned jaw or misaligned teeth by the orthodontist can in some cases be supplemented with the help of special aftercare. This will be discussed with the treating orthodontist. This must be decided on an individual basis. The cause of the misaligned jaw and teeth is closely related to the type of aftercare.
In the case of teeth that have grown unevenly, it can sometimes be helpful to wear a stabilizer for a certain period of time after the classic treatment with braces. This is adjusted by the orthodontist and ensures the long-term result of the treatment.
You can do that yourself
If maxillary retrognathia is suspected, a doctor or orthodontist should be consulted immediately. Immediate treatment is necessary to avoid serious damage to the teeth and supporting structures and to ensure a speedy overall recovery.
The treatment itself can be supported by those affected by good dental and oral hygiene. Brushing your teeth more often and using a medicinal mouthwash reduces the risk of inflammation, especially in the case of existing damage to the periodontium. If no damage has yet occurred, the most important measure is to compensate for the difficulty in breathing through the nose by consciously breathing through the mouth. This is particularly important in the case of severe malformations of the jaw, because a pronounced misalignment can cause severe breathing difficulties and, as a result, a chronic lack of oxygen.
In addition, action must be taken against the individual symptoms. Headaches can be reduced by conscious relaxation and fresh air. Effective remedies from naturopathy include valerian and chamomile. A gentle massage helps against tension in the jaw area. Here, too, conscious relaxation can reduce the symptoms. However, if symptoms are severe, a doctor should be consulted.
