Dysgnathia (from the Greek dys-: mis- and gnathos: jaw) refers to a series of malformations in the area of the jaw, teeth and chin. Misaligned jaws are usually perceived by those affected as a considerable blemish and have a negative impact on their self-confidence. For this reason, measures are usually taken at an early stage to counteract dysgnathia.
Below you will find further information and selected dysgnathia specialists.
A basic distinction is made between prognathism and retrognathism.
In prognathism, the lower jaw is so prominent that it protrudes above the upper jaw and stands out from the face. In special cases, the lower row of teeth is so prominent (pronounced) that it is positioned in front of the upper row of teeth when closing the mouth. The chin and lower lip assume an exposed position.
In the case of retrognathia, the chin recedes backwards because the lower jaw recedes behind the upper jaw. The upper lip and upper jaw protrude, which is why the rows of teeth do not fit together when the mouth closes. The upper row of teeth protrudes far beyond the lower row.
Dysgnathia affects both the mental and physical well-being of those affected. The most common complaints are problems with the jaw's ability to chew. It is difficult to chew solid food. Many sufferers also experience pain when chewing. The upper and lower rows of teeth often do not fit together, so that the jaw has to be dislocated to achieve satisfactory chewing performance. This results in strains and strain pain in the facial area, which often also leads to headaches.
An even greater problem, especially in adolescence, is the impact of dysgnathia on self-esteem. Those affected often feel ugly and inferior to their fellow human beings. They are ashamed of their displaced chin and smile. In many cases, this leads to social isolation, which is often self-induced out of shame. In general, those affected suffer from actual or suspected social ostracism from their fellow human beings. The psychological distress caused by dysgnathia is therefore very high.
In the long term, however, malocclusions can also have serious physical consequences. Progressive adhesion is possible, so that the pain gets worse and worse over time. In addition, the great effort involved in chewing and speaking creates excessive pressure on the periodontium. For this reason, premature tooth loss cannot be ruled out.
First and foremost, those affected should consult an orthodontist. During an initial examination, the orthodontist will obtain an overview of the situation by taking jaw impressions and, if necessary, an X-ray of the head.
Normally, the orthodontist treats jaw misalignments with braces to bring the jaw and teeth into a more favorable shape. However, true dysgnathia is a deviation in the position of the bones, which means that orthodontic treatment is often not enough. In many cases, a referral to an oral surgeon is therefore advisable.
Maxillofacial surgery deals with the surgical correction of malocclusions. This is preceded by further professional examinations such as the DVT X-ray (three-dimensional imaging procedure). Based on this, the oral surgeon develops a plan for the surgical correction of the malocclusion, in which the jaw is brought into a functional and aesthetic state as part of an adjustment.
If the misalignment of the jaw is solely related to the position of the teeth, orthodontic treatment is sufficient in most cases. The orthodontist uses braces and brackets (fixing element for fixed appliances) to bring the teeth into the correct position. However, if the dysgnathia is caused by an anomaly in the skeletal structure, surgical intervention is often unavoidable. A combination of orthodontic and maxillofacial surgery, which usually follows a fixed schedule, has proven successful.
During pre-treatment by the orthodontist, the teeth are moved into their intended position using braces so that a normal position is achieved within six months to a year. During this time, the discrepancy (gap) between the two jaws usually becomes even greater at first. Once a normal position has been achieved, a surgical plan is developed on the basis of current jaw impressions, plastic bite impressions and x-rays. The subsequent operation is performed under general anesthesia and leaves no externally visible scars.
As part of the operation, the repositioning osteotomy, the upper and lower jaws are separated from each other in order to be moved into the correct position. Titanium plates are inserted and fixed with screws so that the positioning can be maintained in the long term. In addition, rubber bands between the jaws control the freedom of movement after the operation so that no counterproductive overloading can occur. The plates are removed again in a follow-up operation, usually after nine months. After the patient has been discharged within a week, it takes six weeks before soft food can be eaten again.
This is followed by a further six months of fine orthodontic adjustment until the fixed brackets are removed. The total duration of treatment depends on the severity of the dysgnathia (around 2 to 3 years).
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