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James a young adult, James had a situation where he has had what we call an underbite.
His lower jaw and lower teeth were in front of the upper teeth. In James particular situation,
and actually it’s what we probably see most often in these type of growth and bite patterns,
is where initially to the eye it may look like the lower jaw is just disproportionally
large, and sometimes it is, often times and maybe even most often it is the under development
of the upper jaw and it’s more retrusive position within the mid-face that contributes
to that concave look, that concavity sense to the face and the and what looks like just
a disproportionately large lower jaw. So in James’ situation we used, there are a couple
of components to the treatment, he was what we call an orthognathic surgery patient and
there were two steps to his treatment. The first step was using an expander in the upper
arch (palate expander) to help widen the upper arch, to help widen the upper jaw. But with
an adult the expansion has to be accompanied with a somewhat minor surgical procedure where
which results in what we call a surgically assisted maxillary expansion, where they go
in and it’s an outpatient procedure they go in and the basically free up the upper
jaw to allow the upper expander to work. So he had that done first and we used some braces
(traditional metal braces) on the top teeth and the lower teeth and then he had another
surgical procedure that actually moved the whole upper jaw forward to complete his treatment
and to help ultimately to correct the bite. When you move that upper jaw forward like
in James’ situation it typically results in dramatic changes. Dramatic changes to the
bite, also facially dramatic changes that lends itself to a lot more support to the
mid-face, more support for the nose, more support for the upper lip, more balance to
the face, and in James situations he’s a good looking young man and had a stunning
result.