Dealing with Hypoplastic Maxilla: Causes and Treatments

Underdevelopment of the upper jaw's bones is known as Hypoplastic Maxilla or maxillary deficiency. It has links to foetal alcohol syndrome, Crouzon syndrome, and Angelman syndrome.

Cleft lip and palate are other conditions that may be linked to it. Some individuals may have it as a result of subpar dental extractions.

A very uncommon genetic condition known as maxillofacial dysostosis is characterised by recognisable anomalies of the head and face (craniofacial) region.

An underdeveloped (hypoplastic) upper jaw, downward-slanting palpebral fissures (meaning that the opening between the eyelids slants downward), minor ear malformations, and abnormal speech are major symptoms.

Maxillofacial dysostosis is an autosomal dominant trait that is inherited. It is thought that a second (different) type of maxillofacial dysostosis is inherited as an X-linked recessive trait.

Maxilla's size is unusually small. usually causing an imbalance or misalignment of the upper and lower teeth, or leaving the base of the nose and lower midface with insufficient projection.

Signs and symptoms

the upper jaw's bones are underdeveloped, giving the middle of the face a sunken appearance.

Due to the patient's constant forward head posture, can make it difficult for them to eat and can lead to future issues for them, such as nasopharyngeal airway restriction, which can then cause back pain, neck pain, and numbness in their hands and arms.

Additionally, snoring and sleep apnea can result from this restriction. Among other problems, sleep apnea can cause heart problems, endocrine problems, weight gain, and cognitive problems

Causes of maxillary hypoplasia

Maxillofacial dysostosis is an autosomal dominant trait that is inherited. The interaction of the genes for a specific trait found on the chromosomes inherited from the mother and father determines the presence of genetic diseases.

When only one copy of an abnormal gene is required for the disease to manifest, dominant genetic disorders result. The abnormal gene may be brought on by a new mutation (gene change) in the affected person, or it may be inherited from either parent.

Regardless of the sex of the offspring, there is a 50% chance that the abnormal gene will be passed from the affected parent to their offspring during each pregnancy.

How is maxillary hypoplasia treated?

The most popular method of treating this disorder is corrective surgery. It entails realigning the upper jaw with the lower jaw in order to create symmetry.

If possible, it should be done in childhood to give the jaw time to grow and recover. An orthodontist who specialises in moving teeth around in the mouth may be consulted before the surgery.

The length of the surgery's recuperation depends on how extensive it was. For a few days or even weeks, patients are frequently instructed to only eat soft foods in order to give their jaws time to heal.

They also need routine doctor visits to track bone displacement, infections, or other problems.

Treatment Approach for Maxillary Hypoplasia in Cleft Patients

Patients with cleft lip and palate require a multidisciplinary approach to treatment. A hypoplastic maxilla is typically present in these patients as a result of previous surgical scars.

Orthopaedic interventions at a suitable age appear to be crucial because orthognathic surgery to advance the maxilla in these patients is not very effective.

One of the most frequent congenital deformities is cleft lip and palate. Its incidence in the USA and in Europe has been estimated to be 1:700. In the majority of cases, no etiologic factor has been identified for this multifactorial deformity.

Children who have cleft lip and palate, whether unilateral or bilateral, are typically at risk for poor facial development.

They are more likely to experience growth retardation as a result of excessive palatal scarring or midfacial retrusion caused by maxillary hypoplasia. Typically, this causes a tip-to-tip relationship between the mandibular incisors and the maxillary incisors as well as 3-Dimensional deficiencies, an anterior crossbite, or severely rotated maxillary incisors.

Some of these early issues can be resolved using midfacial or orthopaedic protraction forces, depending on the patient's age and the degree of their midfacial development. As the maxilla is moved anteriorly, these forces cause growth at the circummaxillary sutures to increase.

Treatment for young patients with maxillary hypoplasia typically involves a facemask. To encourage the maxilla's growth in a forward and downward direction and to reroute mandibular growth, a strong force is applied to it. Facemask therapy, however, causes the mandible to rotate posteriorly and the force's vertical dimension to increase.

Additionally, dental compensations were noticed as the forces were applied to the teeth. According to some, using a facemask along with skeletal anchorage decreased the aforementioned complications and increased its skeletal effectiveness.

According to Beak et al., a facemask attached to the skeletal anchorage can be a successful alternative treatment for maxillary hypoplasia in cleft patients with few negative side effects.

Is maxillary hypoplasia hereditary?

Maxillary hypoplasia in people with clefts is caused by a combination of genetic facial growth pattern inheritance, inherent deformity, and scarring from previous surgical procedures.

Orthodontic Conditions in maxillary hypoplasia

Maxillary hypoplasia, also known as a maxillary deficiency, is the underdevelopment of the upper jaw's skeletal structure. The lower jaw appears to protrude forward due to the midfacial retrusion caused by this condition.

Along with foetal alcohol syndrome, it is frequently linked to Crouzon syndrome and Angelman syndrome. Cleft lip and palate may also be connected to it. Poor tooth extraction techniques can also cause maxillary hypoplasia in some people.

Because of their smaller upper jaws, patients with maxillary hypoplasia appear to have a large chin.

The underbite that results from this condition can affect your ability to chew, breathe, speak, and maintain general long-term oral health. Children who need facial reconstruction are benefiting from contemporary advancements like virtual 3-D surgical planning and osteodistraction.

Conclusion:

Depending on the specific condition it is associated with, hypoplasia will have different treatment options. There is frequently no treatment for these conditions.

As a result, the main goals of treatment are to help patients feel better and to lessen their symptoms. The severity of the condition will also influence the course of treatment.