Upper jaw retrusion (maxillary retrusion) is a condition often noticed when the lower front teeth bite in front of the upper front teeth because the upper jaw has not grown forward enough. One of the most important factors in the success of treatment for this problem is timing.
Why does timing matter?
The upper jaw continues to develop during growth, and in this period the joints between the jawbones (sutures) have not yet fully fused. Orthopaedic appliances can use this flexibility to support forward growth of the upper jaw. As age increases, the sutures fuse and the chance to guide growth decreases.
Factors that determine timing
Age and growth stage
Methods such as a face mask mostly show their clearest effect between ages 6 and 10. At older ages, bone-anchored methods (mini-plates or mini-screws) can be considered.
Eruption of the teeth
The teeth that the appliances will rest on need to have erupted. The mixed dentition stage is a suitable time window in this respect.
Source of the problem
Lower front teeth biting in front are not always due to upper jaw retrusion. The size of the lower jaw or simply the position of the teeth may also play a role. A correct diagnosis requires an examination and a cephalometric X-ray.
Similar facial structure in the family
In children with a family tendency, it is kept in mind that the problem may become more pronounced as growth continues, and monitoring is closer.
The child's cooperation
Appliances such as a face mask need to be worn for a set number of hours every day. The cooperation of the child and family directly affects the result.
Treatment methods
- Face mask: Applies a forward force to the upper jaw.
- Palatal expansion: Widens a narrow upper jaw and is often used together with a face mask.
- Bone-anchored methods: In older children, these transmit the force directly to the bone.
- In adults: Once growth is complete, orthodontic camouflage is considered for mild cases and orthognathic surgery for marked cases.
For more detailed information, see our upper jaw retrusion and upper jaw advancement and jaw expansion pages.
Follow-up after treatment
In children with upper jaw retrusion, growth of the lower jaw can continue throughout adolescence. So after early treatment, regular check-ups until growth is complete are important.
