Mandibular (lower jaw) Deficiency
Mandibular (lower jaw) Excess
Maxillary (upper jaw) Excess
Asymmetric Mandibular Prognathism
(lower jaw) excess
evaluating the problem of mandibular excess (prognathism), emphasis
should be given to the overall appearance of the face with less concern
about specific ceph-alometric (x-ray) measurements.
The orthodontist's goal will be to remove all dental compensations (poor
positioning of the teeth) while the surgeon's objective is to reposition
the jaws to achieve a functional occlusion and to enhance facial aesthetics.
The philosophy for management of the mandibular "prognathic" patient
is toward surgically moving the upper jaw forward to achieve normal
occlusal relations with enhancement of the skeletal volume. The lower
jaw generally requires surgical repositioning to achieve improved proportions
and symmetry. Reshaping of the chin is often necessary for ideal facial
These procedures stretch and align the facial skin. This results in
loss of unattractive folds, leveling of the lips, and lessening of the
deep skin creases that would worsen with aging.