Jaw distraction (by inter-molar mandibular distraction ontogenesis, of IMDO) is a new, specialized surgical technique. It is aimed squarely at adolescents and older children for the surgical treatment of small lower jaws associated with dental overbite (or overjet).
What is Jaw Distraction Surgery?
Many people have smaller lower jaws. Often this is confused with having too big an upper jaw.
The protrusion of upper front teeth makes them appear bucky. It gives the impression that the child’s problems are purely orthodontic, or related entirely to an excessively big maxilla, or excessively big upper teeth.
Social teasing, lip incompetence, speech difficulties (especially with sibilants and fricatives) can all occur, and lead to a great deal of pressure to attend your orthodontist for correction…
And the entire treatment motivation then becomes pulling backwards the prominent upper front teeth.
The advice seems easy… almost effortless… the upper teeth are too forward… so why not pull them back?
This view is very simple… and very misleading…
The size of the upper front teeth, the size upper jaw, and the sense of an oversized upper lip… all of these things are for the most part… normal
The Real Problem
The real problem… the problem that has been there since birth, and before that, and forever onwards… is the proportionally smaller lower jaw…
It is the lower jaw, or mandible, that has always been too small… it is called mandibular hypoplasia
If your child is 12 or older, and have already lost all their baby teeth, then we can assess your child as to whether they are suitable for jaw distraction surgery by the IMDO technique.
Jaw distraction by IMDO goes hand in hand with the Changing Vector CV protocol. Both your orthodontist and surgeon must be trained and accredited in the CV protocol philosophy to make jaw distraction a success for your child.
Our surgeons and orthodontists have developed IMDO and the CV Protocol with international partners, and are world leaders in both the distraction technology and the principles of surgery and orthodontic treatment.
We are trained specialists
Using volumetric imaging provided by Cone Beam and CT, only Profilo has developed the diagnostic and treatment tools necessary for the successful combined maxillofacial and orthodontic treatment of your child who may have mandibular hypoplasia associated Class II malocclusion.
Mandibular Hypoplasia and Treatment of Overbite
Genetics of small jaws
As a baby, if it was detected, and maybe if it was leading to breathing difficulties as a neonate (neonatal upper airway obstruction), it may have been called Pierre Robin Sequence (or syndrome).
But many people escape this diagnosis… not because your child didn’t or doesn’t still have Pierre Robin… but because they were not “picked up” when they were first in hospital, as babies.
Sometimes your child can have a mild form of Pierre Robin Syndrome… and maybe it could be because of a mild form of bilateral cranio-facial microsomia ( bilateral hemifacial microsomia)… or even Treacher Collins Syndrome… There are a number of craniofacial syndromes that are associated with a small lower jaw (mandibular hypoplasia)…
But the most common reasons to have a small lower jaw… is because your parent had it, and their parent also had it… and it is just a part of what makes your child look cute. A small lower jaw, and a small lower face, makes anyone look cute… as a child… and it may even look cute as an adult… but it also means often years of orthodontics, dental extractions, orthodontic splints, and dental treatment in general… to get away from.
Bucky and crowded teeth
Overbite and overjet are almost always associated with a small lower jaw… And there are many effects of a small lower jaw, only one of which is producing bucky front teeth.
A small lower jaw is associated with crowded teeth… seems obvious right?… Normal sized teeth, trying to erupt into a small jaw… they get crowded… but the dental crowding is not because you have too many teeth, or that the teeth are too big…
Simply put… dental crowding occurs, because the space available for them to erupt, is too small.
Then the front teeth are prominent, and escape the natural protection of the lips. The teeth chip, or they easily dry out, or they are difficult to keep clean. The crowded teeth are more vulnerable to dental caries, or even gum disease (periodontitis)
Of course there is the malocclusion… The overbite, or the technically more correct term is overjet, is usually described by orthodontists as a Class II malocclusion.
A Class II malocclusion, is just a fancy way of saying… your lower jaw, and the teeth it contains, is shorter than the relatively normal position of your upper jaw…
Ergo… your lower jaw is too small, and you have dental crowding and a bad bite as a consequence of that.
Snoring in adults, is commonly associated with small lower jaws… but they don’t often occur in children… because they are not yet adults. Snoring is also associated with obesity… as we put on weight around our waists, we do it around our necks too… in cross-section, our necks are like donuts, and as the donut gets bigger on the outside, the hole in the middle (your airway behind your tongue) gets smaller.
If the hole was already small because of a small lower jaw, then you can see why there is a link between having a small jaw in childhood, and development of snoring or even frank OSA (obstructive sleep apnoea) in adults.
Is that rocket science?
So your child is 12 or 13. They are just about to start puberty. And they are just about to start high school.
They look incredibly cute, and they are nice kids, and you hope they will grow into nice, kids. They have lots of friends through primary school, and that is likely to continue.
But you have been worried for a long time about their big front teeth… but that’s okay, because they are kids… they are about to hit their “growth spurt”. They’ll grow into their teeth. You’ve seen the dentist, or maybe even the orthodontist… and the advice is the same… let’s wait and see how they’ll grow… maybe that lower jaw does look a little small… but that’s normal… right?
They are starting high school now. They want to play netball, or rugby… or maybe it’s in the playground that the big unprotected front tooth gets it’s first knock. Maybe it’s already chipped.
Kids are starting to tease your child… poking fun… calling him bucky beaver… or rabbit teeth… or whatever… The taunts are cruel… your child is upset… Your friends, teachers, even parents of the other kids, suggest you see an orthodontist.
The advice is always the same… they need braces… they need pulling back… they’re too big… it’s not normal…
The problem has always been, and now it is agreed by everyone… Your kid’s front teeth are too big for their mouth…
There is a lot of social pressure to have braces now… because universally, braces, and orthodontists fix crooked teeth…
But when was the problem ever because of having big front teeth? Isn’t the problem now social pressure, or school bullying, or just the process of socialisation and sexualisation… of the insecure question of “am I attractive or am I ugly”… Of can I afford braces, or can’t I?... of the rough and tumble of the school yard, and the pressure to conform and be the same in everything.
The problem still remains… your child has a small lower jaw… And treating everything else but the problem, doesn’t fix the problem.
Is there an easier way?
If you want your child to keep all of their teeth…
If you want your child to have a very limited course of orthodontics (or potentially no orthodontics at all)…
If you want your child to avoid orthodontic splints, which treatment has almost no science, but a lot of expense.
If you want your child to have their condition cured… fixed… over… before they start high school.
If you want your child to have a normal airway… a normal facial proportion… a normal occlusion… to avoid dental crowding developing… to have normal lip balance.
Then consider IMDO as an alternative.
Jaw distraction works. There is science behind it. There are incredibly smart people behind it. It is performed by probably the brightest people on the planet…
How do you know jaw distraction is right for you?
Jaw distraction is not however for everyone.
You need to consult with your maxillofacial or craniofacial surgeon, and who is trained in jaw distraction techniques, and with your orthodontist who also understands, first hand, how jaw distraction works.
It is a procedure best performed between orthodontists and surgeons… working together to produce the best outcome for your child.
Surgery is not onerous, or difficult… you are not placing your child in jeopardy…
If you are concerned about the development of your child’s face, and the way their teeth are erupting, seek a specialist surgical consultation with your Maxfax (oral and maxillofacial) or Craniofacial Surgeon.
Your dentist, GP, orthodontist, surgeon, speech pathologist, school councillor, or chiropractor can refer you.
Jaw distraction is part of the orthognathic surgery armamentarium.
All forms of orthognathic surgery is performed at Profilo, in centres located in both Sydney and Newcastle, Australia. If your local surgeon or orthodontist is not already familiar with the technique, they can be trained by our practitioners.
It may be that distraction by itself is not right for you… everyone is different… everyone is unique… only one teratment process is ideal for you, and that has to be discovered, so that your child can achieve one surgical outcome… perfection.
Welcome to Profilo… where everyone’s treatment is specifically tailored and titrated…. Where everyone is treated as unique… Where no-one is treated in an assembly line.
Surgery to correct the size and shape of the jaws is a relatively common procedure, often done in conjunction with orthodontics which is required to align the teeth. The maxilla (upper jaw), the mandible (lower jaw) or both jaws may require surgical correction to treat jaw deformities resulting from either developmental problems or following severe trauma. Orthognathic surgery not only improves facial appearance, but also ensures the teeth meet correctly and function properly.