Jaw distraction is a relatively new technique in Oral & Maxillofacial surgery, and is set to revolutionise the management of mandibular retrognathia in adolescents.

Mandibular retrognathia is a description for a form of malocclusion related to an under-developed lower jaw. If the lower jaw has not kept a growth pace with the upper jaw, it leads to an almost total inability to normally chew, with associated jaw joint problems (such as pain), and over-developmental eruption of opposing teeth.

In the child with un-even forward growth of both jaws, there is over-eruption of teeth that are not properly "meshing" with their opposite partners. Sometimes a frank jaw asymmetry can develop as an habitual jaw posture develops to try to “get-the-teeth-together”. With a short lower jaw, upper front teeth and gums tend to over-grow, and a chin/neck roll develops.

In combination with the recessed chin, a “horsy smile” or "buck tooth" appearance develops, which in effect is an attempt by the growing middle face to compensate for the undergrown lower face.

The end result of solely relying on orthodontic braces and tooth extractions may not be perfect, with orthodontic treatment running into many years, with an end point facial result that may still look "abnormal".

Always seek the services of a specialist orthodontist, and who is familiar with surgical treatments to correct for jaw growth discrepancies. Be wary of orthodontic treatment offered by non-specialists. Tooth extractions are sometimes recommended for correction of some bite abnormalities, but should be considered the exception rather than the rule.

SURGICAL CORRECTION METHODS OF THE UNDERGROWN LOWER JAW

Traditional jaw surgery often requires braces to be placed first, and for growth to cease, before complex and difficult operations can be performed to correct for both the underdeveloped jaw, and for the “compensated” opposing jaw. Click here to find out more on Traditional Lower Jaw Correction Surgery

New jaw-distraction techniques are relatively less complex operations, with fewer side-effects & are quicker to perform. Importantly they can be done at a much younger age, whilst growth is still occurring. The most important revolution of jaw distraction surgery is that surgery can precede braces, and prevent damaging compensatory growth and over-eruption of teeth in the opposing normal jaw.

Most distraction operations only last a couple of hours, and overall treatment can be completed over six weeks. Orthodontic braces normally follow, and usually (and thus far in all our cases) can occur without the traditional removal of premolar or molar teeth. The braces close the gaps that distraction can cause, and generally straightens the teeth. The change in facial appearance can be dramatic, even over the short 6-8 week treatment periods demonstrated here.

Click on the following cases to understand the process of lower jaw distraction, and to understand the conditions which are correctable with this surgical technique...

Case 1 This 13 year old boy had a significant under development of the lower jaw. The lower jaw was so short, that his teeth did not meet at all, leaving almost no ability to chew or bite... Read more

Case 2 This 14 year old boy had a significant underset jaw, with upper teeth becoming unprotected by the recessed lower lip, and leading to increased rates of knocks and chipping... Read more

Case 3 This 12 year old boy had  a significantly retruded lower jaw, leading to his lower teeth biting into the palate and gums behind the upper front teeth.The upper teeth were significantly prominent or "bucky" and were a chief cause of schoolyard bullying. Surgery occurred just prior to school holiday break up... Read more

Case 4 This 14 year old boy has a significantly retruded lower jaw. Surgery to lengthen the jaw was gradual over ~10 days, and braces followed shortly after the distractors were removed. Braces were finally removed 12 months after initial jaw distraction surgery at age 15... Read more

Case 5   This 12 year old boy has a significantly retruded lower jaw. Normally braces would be required to both extract four premolar teeth, pull back the upper front teeth, and pull forward the lower molar teeth. Braces would be completed over the ages of 14-16 years (2 years in total), and still result in a significant underset jaw, collapsed upper lip, and a somewhat unusual facial appearance... Read more

Case 6  This 11 year old girl presented with a retruded lower jaw. The patient's lower and upper teeth did not meet, meaning she had difficulties chewing... Read more