What is the treatment for a hypoplastic mandible?

From the Guidelines

The treatment for a hypoplastic mandible should involve mandibular distraction osteogenesis (DOG) as a recommended approach, especially in cases of congenital micrognathia or midface hypoplasia, as indicated by recent studies 1. The use of DOG in treating hypoplastic mandible is supported by its application in similar conditions, where it has shown to be beneficial in improving the quality of life for patients. Key considerations in the treatment plan include:

• The severity of the condition, which dictates the extent of surgical and orthodontic intervention required
• The age of the patient, with growing patients potentially benefiting from functional appliances to stimulate mandibular growth
• The presence of associated conditions, such as obstructive sleep apnea, which may influence the timing and type of intervention According to the study published in the European Respiratory Journal 1, DOG can be particularly useful in selected adults or adolescents where other surgical options like MMA are challenging. The efficiency of distraction advancement in treating conditions related to hypoplastic mandible, such as OSAS, has been scored, indicating its potential benefits. Treatment outcomes are focused on improving not just the aesthetic appearance but also addressing functional issues such as breathing difficulties, speech problems, and temporomandibular joint disorders that can arise from the abnormal jaw relationship.

From the Research

Treatment Options for Hypoplastic Mandible

The treatment for a hypoplastic mandible typically involves a combination of surgical and orthodontic procedures. Some of the treatment options include:

• Mandibular distraction osteogenesis, which involves the use of internal or external devices to gradually lengthen the mandible 2, 3, 4, 5
• Orthognathic surgery, such as bilateral sagittal split ramus osteotomy and genioplasty, to correct the shape and position of the mandible 2, 4
• Orthodontic therapy to improve the alignment and positioning of the teeth 3, 6

Surgical Procedures

Surgical procedures for treating hypoplastic mandible include:

• Mandibular distraction osteogenesis, which can be performed using intraoral or extraoral devices 3, 4
• Corpus lengthening by bilateral sagittal split ramus osteotomy 4
• Genioplasty to correct the shape and position of the chin 2, 4
• Le Fort I osteotomy to correct the position of the maxilla 2

Outcomes and Results

The outcomes and results of treatment for hypoplastic mandible include:

• Improvement in facial symmetry and aesthetics 2, 3, 6
• Correction of occlusal cant and improvement in bite alignment 2, 3, 6
• Increase in mandibular length and improvement in ramus and condyle development 2, 5
• Low complication rates, including infection and facial nerve palsy 2, 3, 5