Diagnosis and Treatment of Mandibular Prognathism
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The orthodontist is faced primarily with the problem of permanently stabilizing unstable or easily unstabilized structures in the form of teeth. Fortunately, he is able to influence the growth pattern of the face and jaws to a degree. Among the many discrepancies in growth and development of the face and jaws, the mandibular prognathism presents a challenge in diagnosis and treatment for the interested health disciplines. Antero-posterior discrepancies of the maxilla to the mandible can be treated by orthodontic procedures, surgical procedures or by orthodontic- surgical methods. When one is confronted with treatment of a mandibular deformity problem a decision must be reached as to how the problem may be best corrected. A thorough diagnosis of the maxillomandibular discrepancy problem is most important prior to initiating any treatment. The multi-discipline approach, especially surgery, sometimes provides a dramatic response regarding the "immediate" result. In the borderline cases the orthodontist must be very convincing, tolerant and expect tolerance in the belief that a prolonged treatment period of guidance will result in a healthy foundation for a "scarless" future. Correction of true prognathism by orthodontic treatment alone is very limited although prolonged treatment is recommended in many borderline cases. Serial growth studies made possible by orientated radiographs 14, 15, 28, 41, improved methods for endocrine studies, comparative study cases reported in the literature, the advent of antibiotics, improved surgical and orthodontic treatment methods 56 and improved materials have contributed to a favorable prognosis in the vast majority of mandibular prognathism cases. The purpose of this discussion is to review mandibular prognathism and to present results achieved using certain diagnostic and treatment methods.