Dr. Achanta Krishna Swaroop
Dentistry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello,
I am a 28- year-old, female and I went through two surgeries to correct my gummy smile and receding chin. I also had lip incompetence before these two surgeries but my issue is that this lip incompetence is still present. I had SARPE (Surgery Assisted Rapid Palatal Expansion) performed last year where my surgeon expanded my maxilla by 6 mm and DJS performed on after that where he did a maxillary impaction, MMA (Maxillomandibular Advancement Surgery ) with genioplasty. My issue is, I still have lip incompetence, and when I smile big, there is still a lot of gum that shows, I do not know what is going on.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern. I am a maxillofacial surgeon and will be answering your query shortly. Please check your follow up messages. Thank you.
Patient's Query
Hello doctor,
I underwent sarpe surgery where he expanded my maxilla by 6 mm. He installed a KLS Martin RPE on my palate that I had to keep for one year. I started an Invisalign treatment after that but my orthodontist considered that I could be ready for my DJS. After my surgeon removed my palate expander (KLS Martin RPE), he did a maxillary impaction, a mandibular advancement, and a genioplasty. So I am now more than seven months post DJS, I thought that my lip incompetence was because of the swelling at first, but now that my face has healed a lot, it seems that I cannot shut my lips together without having some sort of mentalis strain on my chin.
Hello,
Welcome back to icliniq.com.
Yes, I have analyzed the X-ray (attachment removed to protect the patient's identity). It seems like your main problem is the mental strain right? I want to confirm from you one main thing, are all four of your premolars extracted? Or do you still have premolars? (the smaller tooth next to our big molars). I want to specifically know this as it can be a game changer for you to set the lip incompetence right. Whether the teeth are extracted or not. Also one more thing, my diagnosis and treatment suggestions for you will depend on your bite as well.do you feel any difficulty in biting food with your posterior or anterior teeth? Are you able to chew food correctly? These answers will determine certainly how you can proceed ahead to get rid of lip incompetence. Lips are soft tissue, so when the jaw bone is correctly set in simple terms, your lips will automatically have an esthetic closure with the correct VDO ( vertical dimension at occlusion). So I am waiting for these answers, my plan will be according to this. I hope I cleared all your doubts.
Thank you.
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