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Natan: Jaw surgery before and after. Randbite. Upper jaw too small, too narrow

Facial diagnosis

  • Receding upper jaw

Dental diagnosis

  • Class III
  • Randbite

Treatment jaw surgery

  • Advancement upper jaw (Le Fort I)
  • Widening upper jaw (Smile distractor)

About this case

Natan is a nice example for the need of a smile distractor (Titamed®) in an orthognatic treatment.
Since the lower jaw was in the middle, and only the left side of the upper jaw was too narrow, the surgery was only performed on the left side, where the bite was too narrow. (Surgery = SARPE = surgical assisted rapid palatal expansion). After the smile distractor installation on the palate, and the expansion realised, orthodontics were started. Finally, once the teeth aligned, a Le Fort I advancement achieved the task. Natan was very pleased with the realised symmetry in the face.The sunken area on the left was mastered through the orthognatic surgery, made possible with the aid of the smile distractor (Titamed®). Way of working of the smile distractor: after surgery we wait one week to relax the tissues. Then the distraction starts, turning the device with a swifel key. This is one turn in the morning, one turn in the evening. This gives every day a jaw widening that is purely bone based, of 0,5 mm. opening. So after 10 days of turning there is an distraction realised of 5 mm.