Retrognathia (formally known as mandibular retrognathia) is a condition where the lower jaw is further back than the upper jaw and it looks like you have a severe overbite.
Often, the difference in placement between the lower and milk jaws is only noticeable when viewed from the side.
Retrognathia can be a difficult condition to manage. Physically, it can affect your ability to sleep or eat properly. Because the condition is visually noticeable, you may find that the circumstances affect your self-esteem or confidence.
Retrognathia has several causes. Treatment usually includes orthodontic appliances, braces and hardware, or surgery. Mild cases may not require treatment.
What Causes Retrognathia?
Some people are born with retrognathia and others develop it later as their jaws grow. If the condition is mild, it may not be diagnosed until childhood or adolescence.
The most common causes of retrognathia are:
.Pierre-Robin Syndrome: This condition affects both the jaw and tongue and causes obstruction of the airways.
.Hemifacial Microsomia: In this case, one side of the lower face is not fully enlarged and is underdeveloped.
.Nager Syndrome: This rare condition affects the development of both the chin and cheeks, as well as the hands and arms.
.Teacher Collins Syndrome: This condition affects various bones in the face, including the jaw.
.Surgery to Remove Tumor: Removing a tumor in the mouth can change the lower jaw, causing retrognathia.
.Facial Trauma and Fractures: If a child experiences physical trauma or fracture, it can cause their jaw to not develop properly.
What Complications Can Retrognathia Cause?
If you have retrognathia, you likely have difficulty with jaw misalignment. This can affect your ability to eat or sleep without restriction. You may also experience severe jaw pain.
Babies with retrognathia may have trouble using a bottle or breastfeeding because they cannot lock onto the nipple. As they age, their teeth may become misaligned. The teeth may also be crowded together or positioned in an unusual way.
This irregular placement of the teeth can make it difficult to bite and chew food. You can also develop temporamandibular joint disorder (TMJ). This causes pain and muscle spasms.
Finally, you may have trouble breathing, especially while sleeping. Because your lower jaw is retracted (set further back), your tongue can restrict your airway, causing snoring or sleep apnea. Sleep apnea causes you to stop breathing many times during the night, often without realizing it.
How Is Retrognathia Treated?
Treatment depends on the severity of the retrognathia. You may not need surgery or any treatment.
In babies
When a baby is born with retrognathia, they will likely undergo a physical evaluation to help the doctor determine how best to treat the condition. First, the baby’s breathing ability is probably newborn baby intense. It will be monitored in the care unit.
They’ll likely take X-rays so the doctor can further determine what the condition looks like. The baby can then undergo a sleep study.
They’ll likely take X-rays so the doctor can further determine what the condition looks like. The baby can then undergo a sleep study.
If a baby is diagnosed with obstructive sleep apnea, the plastic surgery and lung departments will likely look to see if the baby meets the criteria for a good chin. If the criteria are met, the baby may have surgery to correct the situation, perhaps while in the hospital.
The most common surgeries are bilateral sagittal split ostomy (BSSO) and distraction osteogenesis.
During BSSO, the lower jaw is carefully cut from both sides and moved forward to an ideal position. It is held in place with metal plates.
For distraction osteogenesis surgery, a special hardware is placed inside the jawbone, with an extension placed inside or outside the mouth. The device is activated to stimulate new bone formation.
Once the baby has fully recovered from the procedure, they can eat and chew as they usually do without retrognathia.
Distraction osteogenesis surgery may be the preferred surgery because there is less blood loss and less nerve damage.
Children and Adolescents
When retrognathia is not severe, it may not be noticed until early childhood. When this is the case, the child can often be treated with dentofacial orthopedics or orthodontics to alter growth and improve tooth alignment.
Dentofacial orthopedics uses biomechanical treatment such as orthodontic appliances to change the relationship between the jaws and muscle activity to affect the growth of the face.
For example, the special head can make the upper jaw grow more slowly so that the upper and lower jaws are more equal. Functional appliances can also support mandibular growth by moving the mandible forward.
Such appliances, used to move the chin forward, have also been shown to help with sleep apnea.
Epigenetic orthopedics is an emerging field that looks at the role of genes regulating jaw and facial development and uses therapy during critical growth periods to turn genes on and off. Treatment typically includes dental instruments fitted to help reposition the jaws to replace growth. In adolescence or adulthood, if the person is still retrognatic after growth has stopped, they may still need to have a maxillomandibular advancement (MMA) surgery.
During the MMA procedure, both the upper and lower jaws are advanced (mandible with BSSO). Patients will most likely need orthodontics to align their teeth prior to this surgery.
In addition to the treatments above, people whose retrognathia contributes to sleep apnea may need to use a continuous positive airway pressure (CPAP) machine to help them sleep. CPAP does not cure sleep apnea, but improves breathing at night.
Finally;
If you have retrognathia, you will be treated by several doctors, usually at various stages of development. If your condition is mild, you may not need any treatment, while if your condition is severe, you may need dental orthopedic and orthodontic treatments and surgery.
Surgery, such as distraction osteogenesis, can grow more bone in the lower jaw and improve airway obstruction in babies born with retrognathia.
After the surgery, the chin may return to its original position slightly. But even if there is some recurrence, the procedure can greatly improve the situation.
Adolescents or adults with retrognathia may also benefit from surgeries such as MMA, which can improve their appearance and treat sleep apnea if present. Orthopedic appliances can also lengthen the lower jaw.
If you are seeking treatment for retrognathia, you should speak to a medical professional for more information. Because each case is unique, the doctor can assess, diagnose and treat your condition according to your needs.
