Oral and Maxillofacial Surgery

Case of the Month


Subjective:

Patient was referred by her orthodontist for surgical correction of an anterior open bite. The patient had a chief complaint of inability to incise food. In addition, a past history of TMJ symptoms was noted.

Objective:

The patient is a healthy 21 y.o. female, dental hygiene student. Past medical history, family history, social history, and review of systems was unremarkable. Following bite guard therapy the patient was asymptomatic relative to her TMJs, however an anterior open bite developed. Tomograms and MRI of the TMJ were normal. Pertinent clinical findings included vertical maxillary excess with 8mm of incisor being exposed with the lips at rest (lip incompetence). Class II molar relationship with occlusion only on the molars. Anterior openbite of 7mm. Facial examination revealed a slightly obtuse nasolabial angle and increased lower 1/3 vertical facial height.

Assessment:

  1. Apertognathia
  2. Vertical Maxillary Excess
  3. TMD (Temporomandibular Disorder) / MPD (Myofascial Pain Dysfunction)

Plan:

  1. Pre-surgical Orthodontic Treatment
  2. Le Fort I Osteotomy (6mm posterior intrusion / 5mm anterior intrusion)

Results:

BeforeAfterBeforeAfter

BeforeAfter

BeforeAfter

Composite Tracing
Patient treated by:
  • Dr. Steven R. Tucker Oral and Maxillofacial Surgery
  • Dr. Dwaine Blakeman TMJ and Family Practice
  • Dr. Jon Fisher Orthodontics 


 Steven R. Tucker DMD, PSC
 Oral and Maxillofacial Surgery
 909 Scherm Road
 Owensboro, KY 42301
 phone: 1-502-926-4107
 fax: 1-502-926-4166
 url: http://www.srt-psc.com

steven@occ-uky.campus.mci.net

Last Modified: May 30, 1997

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