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Oral Surgery/Vertical maxilliary defficiency

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Question
Dear, I have short face syndrome and show no upper teeth when smiling. My maxilla should be downgrafted for 6-7mm to improve facial estetics. Could you give me more inf about new fabricated materials, new techniques and results? I saw some studies that major imorovements have been done for this rare case.

Answer
Miroslav - there are a few techniques, but the simple alignment of the upper and lower jaw models, along with appropriate xrays, define what the appropriate technique.  The key factor in any success for elongating the upper jaw is determining the appropriate graft to fill the space between the sectioned part of the upper jaw and the area above the cut. This could be a solid bone graft from the ribs or the hip.  It could be a section of lower jaw bone.  Along with the bone is determining the need for artificial bone to fill any gaps.  Using the correct bone plates to stabilize the upper jaw bone, the sectioned part and the graft is very important.  There are a number of types and the surgeon needs to review the different types and their attachments to the bone.  

Saying all that, the most important factor is the alignment of the upper and lower jaw teeth.  The aligned teeth allow a stable occlusion. The occlusion is like the foundation for the jaws.  So the doctor needs to take impressions of your upper and lower jaws and align them.  Then the doctor can determine the positions of the bone after the jaws are cut.

So there are so many factors that need to be determined for the proper positioning of the jaws.
Yes there are new materials, but the most important factor is the surgeon to plan the surgery correctly and align the upper and lower jaws.  Then the bone surgeries can be determined.

So the most important thing is for you to find a skilled surgeon, not only during the surgery, but before in the planning.  I wish you well and I hope you can find a knowledgeable surgeon.  

Oral Surgery

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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