Featured Patient Experiences

Featured Case 05/20 – Corrective Face/Jaw Surgery

Patient: 

Joe

The problem: 

“I have an underbite and cannot chew my food. It is impossible to bite a sandwich!”

Patient history: 

  • Joe is a 17+-year-old with a developmental facial and jaw deformity
  • He has had progressive challenges eating and speaking
  • His mother relates that it is also very socially challenging as a teenager in school.
  • He looks forward to looking “normal and being able to eat anything he likes”.
  • He was referred by his orthodontists and primary physician for corrective jaw surgery (orthognathic surgery)

Pre Op Photos:

 
 
 
 
 
 

Pertinent information:

Developmental growth deformities of the face and jaws are fairly common. The 2 most concerning issues for patients are aesthetics and chewing function.

It is not uncommon where the upper jaw (maxilla) or lower jaw (mandible) to grow at different rates to each other. This may produce an underbite (lower jaw ahead of upper jaw/ prognathic),  overbite (lower jaw retrusion), or open bite (teeth not touching) mal-occlusion. A bad bite is referred to as a mal-occlusion.

Many cases can be treated by orthodontics (braces) alone but when the jawbones have too much of a discrepancy, corrective jaw surgery may be required.  Corrective jaw surgery (orthognathic surgery) almost always goes hand in hand with orthodontics.

  • The patient starts with braces, followed by surgery, and then a short period of orthodontic fine-tuning.
  • The braces correct the dental discrepancies (crooked teeth) and the surgery corrects the skeletal (jaws, cheeks, nose, etc.) and bite relationship components, to result in balance and harmonious function.
  • Surgery is typically planned after major facial growth ceases. (females >15, males >18 years of age).

This treatment approach addresses and optimizes:

  1. The bite (occlusion)
  2. The airway (breathing)
  3. Aesthetics (facial harmony, balance, proportions, and profile)
  4. Function (chewing/mastication)

All planning is performed using computer-aided diagnostics, design, and manufacturing before embarking on surgery. Surgery is typically performed in a hospital or surgery-center environment under general anesthesia.

Single jaw surgery patients go home the same day and double jaw surgery patients typically stay for about 48 hours before being discharged.

Planning process photos:

 
 
 
 
 
 
 
 

Treatment:

  • Computerized/digital facial analysis and treatment planning with the fabrication of computer-generated surgical guides.
  • Presurgical airway (nose and throat) analysis was performed by using a small guided camera while sedated (naso-pharyngoscopy).
  • Upper jaw surgery (Lefort osteotomy)
  • Lower jaw surgery (bilateral sagittal split osteotomy)
  • Chin augmentation (genioplasty)
  • Cheek implant augmentation
  • Nasal septoplasty

Post Op Photos:

 
 
 
 
 

Commentary:

Admittedly Joe was very self-conscious about his appearance before surgery. It was one of the major driving forces with his decision to have treatment. An interesting concern that may be raised among family members is that they do not want patients to look like a totally different person after surgery. While this surgery is truly transformational, every effort is made to preserve inherent family and patient identity features.

Joe was very pleased with his final aesthetics and functional result. He and his family expressed how much this helped his self-confidence the most, among all the other benefits of this treatment.

Seeing and hearing how much a procedure helps a patient is the best compliment we can receive.

Patient Video Testimonial thumbnail

Before & After Photos Photos:

BEFORE
AFTER
BEFORE
AFTER
BEFORE
AFTER
BEFORE
AFTER

 

Featured Case 04/20 – Aesthetic Dental Implant

Patient: 

John

The problem: 

“I am missing front teeth and want to replace with teeth that look natural”

Patient history: 

  • John is an active and robust 23-year-old gentleman who never developed his maxillary (upper jaw) lateral incisors.
  • He has been wearing a removable retainer to replace his missing teeth.
  • He is very concerned about his appearance and requested the best long-term solution to replace his missing teeth.
 
 

Pertinent information:

Maxillary incisors are among the most frequent developmentally missing teeth. As they are in the most visible location, aesthetics are a major concern for patients. When teeth are missing, the bone shrinks (atrophy) and the adjacent teeth drift into the spaces.

Patients have 4 options when missing teeth:

  1. do nothing,
  2. removable denture,
  3. fixed bridge and
  4. dental implants.

Dental implants are the ONLY option that is considered permanent AND preserve the bone. Dental implants are typically considered when the patient has finished growing (after age 18).

Treatment:

Final result 5 years after treatment:

 
 

Commentary:

  • As this patient experience illustrates, dental implants appear natural, aesthetic, and remain healthy well after 5 years.
  • We believe that if John maintains good dental hygiene and sees his dentist regularly, he can have these implant “teeth” for the rest of his life.
  • It is ultimately most important to us at Inland Institute that our patients have both aesthetic and long-term functional success.
  • We were so delighted John had such a remarkable experience with natural replacement of his missing front teeth.

Dr. Gilbert &  Team