Maxillary retrognathism (small upper jaw) is mostly hereditary anomaly where the upper jaw remains small in all three dimensions compared to normal lower jaw resulting in anterior (front teeth) and posterior (back teeth) dental crossbite along with unesthetic dished in (concave) facial appearance.
This condition should be diagnosed as early as possible and growth modification treatment to stimulate maxillary growth should be initiated around the age 9 – 10 years when maxilla is growing rapidly.
This girl reported early, at age 7 yrs, with chief concern of upper teeth behind the lower teeth and abnormal facial appearance. Orthodontic diagnosis revealed that she had retrusive (small) upper jaw along with other dental malocclusion.
Treatment was started with a simple Catlan’s appliance to improve the front teeth crossbite. As the permanent teeth started erupting, she was put on Reverse Twin Block appliance to stimulate the growth of upper jaw.
As the phase 1 treatment ended, the maxillary retrognathism improved and front teeth crossbite was corrected. She was then on observation phase till other permanent teeth erupted. Once the crossbite was corrected, the jaws grew in proportionate manner.
As other permanent teeth erupted, phase 2 (comprehensive) orthodontic treatment was started with fixed braces.
In phase 2 treatment, other teeth were aligned along with achieving proper dental arch form and functional occlusion. Upper and lower jaws also stayed in good proportion.
