CCW rotation

[Meefly]

Hello.

When there is CCW rotation of the maxilla does the mandible need to be advanced forward to maintain the bite as before? I'm trying to get my head around the mechanics of how that works.

Also has anyone who has had maxilla advancement notiice an improvement with midface sagging and perioral bulges by taking up some of the slack so to speak?  I have really bad midface sagging and perioral mounds and nothing seems to help so I'm really hopeful there may be an improvement in this area.

Thanks!

[kavan]

Depends. Some CCW rotations are done to affect an auto rotation of the mandible where it auto rotates up and out with the CCW to the maxilla. eg. anterior impaction single upper jaw surgery, in which case no separate BSSO is done.  A CCW rotation PLUS an advancement can be done to accommodate a BSSO or as single jaw surgery IF the maxilla has too much CW rotation and too backward, the lower jaw is where it should be and also if the teeth will meet for the bite to be right with those movements. There are a LOT of permutations as to the combinations of displacements that can be done to achieve what ever the goal is.

[Meefly]

Thanks for the reply.

I'm not sure which applies to me; I know my maxilla is under rotated but not sure if my mandible just wants to come up or up and slide forward-it definitely feels it may be more comfortable forward but this may be symptomatic of my subconscious tendency to push it forward for aesthetic reasons.

It seems the more I read about jaw surgery the more complicated it becomes!

Does maxillary advancement make the cheekbones less prominant? I see a lot of cases where people who have jaw surgery also have cheekbone enhancement at the same time.  I do have very flat cheekbones but I don't want any extra surgery I don't really need.

Cheers

[kavan]

Thanks for the reply.

I'm not sure which applies to me; I know my maxilla is under rotated but not sure if my mandible just wants to come up or up and slide forward-it definitely feels it may be more comfortable forward but this may be symptomatic of my subconscious tendency to push it forward for aesthetic reasons.

It seems the more I read about jaw surgery the more complicated it becomes!

Does maxillary advancement make the cheekbones less prominant? I see a lot of cases where people who have jaw surgery also have cheekbone enhancement at the same time.  I do have very flat cheekbones but I don't want any extra surgery I don't really need.

Cheers

It does not change the cheek bones at all. However, when the area below them is advanced in a Lefort 1, the cheekbones can look less prominent via relative comparison.