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 doctor,
I am going to undergo a corrective jaw surgery for functional reasons, and I expect a positive aesthetic outcome and wish to minimize risks and detrimental effects on my appearance. I have a large nose and a drooping smile. Also,I have an overjet and TMJ aches. I have 16 teeth on the maxilla and 14 on the mandible (two missing premolars). I do not have sleep apnea. The presurgical orthodontic phase is yet to be completed. I have attached the pre-operative X-rays and photographs and also the pictures of how I might look after the surgery. Could you please advise about the precise surgical movements ideal for me and the specific parameters of the orthognathic corrective surgery, like millimeters and type of rotation? Also, I would like to know about alternative treatment plans.
Kindly advise.
Hello,
Welcome to icliniq.com.
I have reviewed the records you have enclosed (attachments removed to protect the patient's identity). As your mandible is already jutting out, the first step will be maxillary advancement or stabilization procedures, followed by a second step that includes genioplasty or chin modification surgery or malar implants for cheek adjustment and repositioning. The second step will be carried out depending on your expectations of profile post the surgery. I have studied the photograph and wish you all the best. I suggest you go ahead with the orthognathic surgery and mandibular therapy procedures I mentioned as the second step. However, you better consult any surgeon in person for cephalometric analysis and interpretation so that the same doctor will plan a strategy for you.
You will have a good prognosis; however, the treatment would be time consuming to give you the aesthetic outcome you desire.
I hope this helps.
All the very best.
Regards.
Patient's Query
Hello doctor,
Thank you for the response.
My mandible is not protruding out, and I do not have mandibular proganthia. Instead, I have retrognathia, and the photographs in which I am protruding my mandible are to mimic how mandibular advancement might look like. Could you please consider this and suggest the diagnosis and treatment plan accordingly?
Kindly suggest.
Hello,
Welcome back to icliniq.com.
In case of mandibular retrognathia, you will need a surgical procedure called distraction osteogenesis. Distraction osteogenesis is an accessory correction surgery like chin correction surgery or genioplasty along with maxillary advancement. Though it is complicated, it is safe, and you can go ahead.
I hope this helps.
Kindly revert in case of further queries.
Thank you.
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