Maxillary Hypoplasia: A Cosmetic Problem With Postural Physiologic Implications Including Sleep Apnea

Dr. Shapira Blog, Breathing problems can cause TMJ, Sleep, TMJ 0 Comments

Question from Jeff:

I was told I have maxillary hypoplasia. I cannot show any teeth when i smile. I don’t want to re-arrange my face and have it go numb. Pls tell me of all other options

Dr Shapira Reply:

Dear Jeff.
There are numerous methods to address your  cosmetic problem.  The first is to do nothing as you can function for a lifetime with maxillary hypoplasia.  There are some common medical concerns related to maxillary hypoplasia .  There is usually a nasopharyngeal airway restriction associated with Max Hypo.  During the day this can lead to forward head posture and over time lead to other problems including back pain, neck pain and numbness of the hands and arms.  This same airway restriction can lead to sleep  apnea and snoring at night.  RERAs or UARS are a milder form of apnea and all can lead to heart problems, endocrine problems increased weight, cognition problems etc.
Cosmetic approaches can vary based on examination and is based on several factors.  As you know maxilary advancement carries a risk and is a major surgical procedure.  It is possible to do a Rapid maxillary expansion and anteriorization with a surgical assist which is a much less invasive procedure and movement is done orthopdically.
The DNA Appliance utilizes Epigenetic Orthopedics to grow bone and AIRWAY orthopedically and pneumopedically.  There are limits to intraoral movement but 
use of headgear (reverse pull) can be incorporated.  I am in Illinois and do many DNA and RNA cases but if the condition is extreme Dr Martha Cortes in NYC is probably the premiere DNA practitioner in the world and I have sent he patients who commute to NY for treatment.
There is no reason that you can’t use an overlat denture on your maxilla to give and excellent look without actually correcting the problem.  Snap in Smile treatment can give you an instant makeover for minimal cost.   Depending on the degree of hypoplasia and the costs you want to incur it is possible to do a reconstruction with veneers, onlays and crowns to build the teeth out to a full smile.  There will be increased thickness and a tendency to have some food retention after eating, usually a minor problem but some patients find it annoying.
In my practice I offer cosmetic only solutions but my preference is to achieve ideal airway and physiology as an integral component of cosmetic reconstruction. A large portion of my patients have been treated for sleep disorders, TMJ disorders, chronic neck,back or head pain and the cosmetics are used as a finishing technique.  Most patients get the best cosmetic results when they are built on a platform of health.
The use of Physiologic Dentistry and the diagnostic aids they provide are essential in finding the best position regardless of the type of treatment decided on.

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