Upper Jaw (Maxilla)
The upper jaw or maxilla is often the source of a malocclusion. The maxilla can overgrow vertically and create an ‘openbite’; or undergrow and create ‘underbites’; or not grow wide enough, resulting in ‘crossbites’. The smile is very much affected by the position of the maxilla such that showing too much teeth and a gummy smile; or not enough teeth with a narrow smile, are common. The orthodontist is able to align the teeth but sometimes the maxilla must be repositioned to achieve a proper bite and smile.
The surgery is accomplished from inside the mouth avoiding any outside incisions. Rigid fixation is utilized by Dr. Wittenberg to avoid jaw wiring and to accurately place the bite in the chosen position. Recovery is quick, with minimal discomfort and rapid return to function.
The upper jaw actually extends up towards the eyes and cheek bones (malar bones). It can be underdeveloped or ‘deficient’ in its growth not only at the level of the teeth/bite, but also under the eyes and adjacent to the cheekbones as well. Therefore, it is common to perform a bite correction with a surgery to the upper jaw; and combine it with any augmentation required near the cheekbones as well. Since augmentation of the cheekbones is primarily a cosmetic enhancement, the patient can decide to accomplish both procedures at the same time for a more efficient recovery.
Commonly, many patients present with the perception that their ‘lower jaw’ is too far forward or too ‘strong’ in profile. This is a common view. However, in very many of these situations, it is actually the ‘upper jaw’ which has failed to grow forward far enough and so ‘relatively, the lower jaw ‘appears’ stronger. Once the upper jaw is advanced to balance the lower jaw, it is easy to then understand the original growth issue with the upper jaw. Images in the photo gallery can illlustrate it quite well.
‘Gummy smiles’ are a common concern and represent an overgrowth of the upper jaw in a ‘downwards’ direction. Since a smile is critical to human emotional response, it is often requested of Dr. Wittenberg to alter the amount of ‘gum/tooth’ exposed as part of a treatment plan. As well, the width of the smile can be enhanced with careful coordination with an orthodontist.
Dr. Wittenberg is the very first facial surgeon to perform orthodontic surgery with INVISALIGN. This is a major advance since the normal requirement was to have braces put on for surgery in all cases, prior to his innovation. He is extremely successful in utilizing special techniques for combining surgery with Invisalign orthodontics and he has received extensive requests for his services in this arena. He would be pleased to discuss the procedures with you in consultation.
Dr. Wittenberg has performed thousands of maxillary procedures for functional and cosmetic purposes and can share his experience and recommendations with you.
Please View our Before & After Gallery for Maxillary Surgery (upper jaws)