TL;DR:
- Prognathia (progenia) is a congenital malocclusion caused by excessive mandibular development, leading to lower teeth overlapping upper teeth.
- Complications include chewing/eating difficulties, breathing issues, speech defects, periodontal diseases, tooth loss, facial changes (protruding chin, elongated face), and reduced oral hygiene.
- Causes: Genetic defect, prolonged bottle-feeding, pacifier use, soft diets, mouth breathing, or childhood habits.
- Diagnosis involves interviews, clinical exams, imaging (cephalometry, orthopantomogram), and plaster bite models.
- Treatment: Early orthodontic interventions (braces) for mild cases; surgery is required for advanced stages or unsuccessful orthodontics.
- Surgical procedures involve jaw repositioning using techniques like genioplasty, mandibular transection, and bicuspid osteotomy.
- Prevention: Proper oral hygiene, balanced diet, avoiding childhood habits (finger sucking), and vitamin D intake. Early detection is crucial for better outcomes.
Prognathia is a congenital malocclusion, which is classified as an anterior malocclusion. It occurs due to excessive anterior development of the mandible. As a result, there is an abnormal relationship of anatomical structures within the bite, as the lower teeth overlap the upper teeth. Although on the surface progenia appears to be an insignificant condition, it can lead to a number of serious complications. The improper relationship between the upper and lower jaw teeth causes problems with eating and chewing. Breathing is also significantly impaired, suffering especially at night, leading to dry mouth and throat, increased susceptibility to upper respiratory tract infection, or the occurrence of periodontitis and tooth decay. If left untreated, progenia can also cause health problems in the form of headaches, speech defects, enlarged tongue size, or cosmetic defects in the face. The hallmark of progenia is primarily a protruding chin and lower lip. Many patients are ashamed of the condition, especially since in its advanced stages the disease can alter facial features. Progenia also causes crooked teeth that overlap, which in turn makes it difficult to maintain proper oral hygiene. Untreated progenia also leads to inflammation and other periodontal diseases. In extreme cases, it can even cause tooth loss.
Progenia – causes
Progenia is a genetic defect, so it can be observed as early as early childhood. It can also develop as a result of prolonged bottle-feeding or the use of a pacifier. Eating too soft, mushy meals and various types of childhood habits, including breathing through the mouth too often, are also thought to be the cause of progenia. Noticing the symptom of progenia in a young child is not easy, but it helps improve the treatment process.
Progenia – symptoms
Progenia in children should be recognized and treated as soon as possible, because as the child grows older, many diseases intensify that can cause discomfort and difficulties in proper functioning. Symptoms that should prompt parents to consult an orthodontist are primarily a protruding lower lip overlapping the upper lip, or an excessively protruding chin. Prognathism also often occurs with prognathism, which is the overdevelopment of the mandible or the maxilla and mandible, forming the so-called Habsburg lip. In this situation, the mandible is significantly elongated and its angle is increased. Smoothing of the labial-chin furrow and facial elongation can also be observed. In addition, in an intraoral examination, the doctor may also find the alignment of the lower teeth over the upper teeth. Sometimes the condition is also accompanied by tilted teeth. The patient, meanwhile, struggles with impaired biting and chewing function, speech disorders, and in some people an enlarged tongue is also found.
Progenia – diagnosis
In order to properly diagnose progenia, the orthodontist will conduct a thorough interview with the patient. He will ask about the predisposition to inherit the disease from the patient's relatives and habits. The orthodontist also performs a clinical examination, a functional test that involves positioning the mandible in a normal bite, or raphiographic examinations – cephalometry and orthopantomogram. After analyzing the images and measuring the angles between the designated lines, the doctor can confirm whether the patient is struggling with progenia. Specialists also make plaster models of the bite. For this purpose, a prosthetic-like impression is taken during the visit. The model is also analyzed and helps determine any malocclusion.
Progenia – treatment
Progenia can be effectively treated, although the techniques depend on the stage of the condition and when it was detected. Complete removal of the defect is only possible through surgery. The treatment of progenia requires the involvement of a number of specialists from different fields. This usually includes an orthodontist, an oral and maxillofacial surgeon and a prosthodontist. If the condition is diagnosed at an early stage, when the changes are not yet advanced, treatment can only be based on the intervention of an orthodontist. For this purpose, special treatment braces are used to restore the correct anatomical relationship between the upper jaw and mandible. However, it is worth remembering that conservative treatment usually plays a preparatory role for subsequent surgery. It is much easier to cure progenia in children than in adults, which is why it is so important to detect the defect relatively early.
Progenia – is surgery necessary?
If the results of orthodontic treatment are not satisfactory or the lesion is detected at an advanced stage, then surgical intervention is necessary. Surgery is usually preceded by the orthodontist's action, which consists in preparing the best possible conditions for the bite. If the jaw is too narrow and there will be no way for the lower teeth to fit in, braces are designed to widen the upper row of teeth. Depending on which bones have become deformed, the treatment involves action on the jaw or on both jaws.
Progenia – surgery
The vast majority of progenies are treated surgically. Progenia surgery mainly involves shortening the jawbone and positioning it in the correct way in relation to the jaw. This allows the surgeon to create a proper bite. The operation is performed using various methods. Among the most important are the vertical method, bilateral mandibular transection, genioplasty and the Obwegeser-Dal Pont method. The results to be obtained after surgery are very promising, but it should be remembered that both lower and upper teeth are later placed in a splint for about 4 weeks. The splints are an impediment to speaking and eating, so be sure to eat mixed foods. After the operation is performed, the patient stays in the clinic for several days. It is very important to follow all post-operative instructions, including, for example, proper oral hygiene. This helps prevent the entry of possible inflammation, which impedes wound healing. The patient should also check in regularly with the doctor after the surgery is completed. Do you want to reduce the facial features and in the cheek and nose area? If so, zygomatic bone osteotomy will solve your problems. The procedure is a combination of plastic surgery and osteotomy and involves breaking the nasal bones, cutting out unnecessary parts and reassembling the nose. The surgery usually takes between 1.5 and 2.5 hours and is performed under general anesthesia. The vast majority of cuts are located inside the nose, but sometimes small incisions can be made in the natural folds on the sides of the nose or at the base of the nose.
Progenia – bicuspid surgery
Progenia bicuspid surgery is performed on patients who face more complex skeletal class III jaw deformities. It is an option for those who have a history of long-term orthodontic treatment. The surgery involves the surgeon breaking both jaws and moving them into a new position. The procedure requires about four hours, and all the doctor's actions help reduce skeletal defects, malocclusion caused by disordered development of the jawbone and aggravated lesions.
Thus, bicuspid surgery allows both to reduce the disproportion regarding the improper growth of the bones of the facial part of the skull, and to improve the aesthetic effect. The surgeon performs the cutting and repositioning of the upper and lower jaw bones.
Is it worth operating on progenies?
Malocclusion, including prognathia in children is caused from disorders of the physiognomic activities performed. Problems with biting, sucking and breathing can cause future abnormalities in the location of teeth in the jaw. This is why preventive measures are much more beneficial than treatment. It is therefore worth paying attention to possible malocclusion already in young children. A small degree of progenies can be easily treated conservatively. If, on the other hand, the team of doctors decides on surgery, it is also not worth delaying this action for a long time. Surgical treatment is often the only way to completely cure progenies. This is especially true when the lesions are growing and orthodontic treatment is unsuccessful. It is also worth remembering that untreated progenia can cause numerous complications in the form of more rapid development of caries and periodontitis. Disorders in the relationship of the anatomical structures of the oral cavity can be reflected in speech defects. In addition to significantly impeding pronunciation, prognathism can also cause seplenia. People struggling with such a condition often also have problems pronouncing the sounds f, p, b and w. Pronunciation defects require the help of an orthodontist and speech therapist. The sooner the malocclusion is diagnosed, the better the results to be achieved later.
How to prevent the development of progenies?
Progenia is a serious malocclusion that initially seems insignificant to many patients, but as time goes on it can significantly impede daily functioning and social interaction. The effects of the condition if left untreated include tooth loss and a change in the shape of the face. That is why it is worth taking care of your teeth from the early days of life. The basis, of course, is proper oral hygiene, daily cleaning with the right toothbrush, a well-balanced diet, or avoiding habits such as finger sucking and nail biting. It is also important to take vitamin D products or supplementation. It is widely believed that progenia is closely related to a deficiency of just this vitamin. Therefore, it is worthwhile to control any occlusal abnormalities and consult specialists who can help cure the problem of progenia. The effects of the procedure performed by the surgeon are visible practically immediately after the operation, but it is necessary to wait about a year for the final result. With the help of an experienced doctor, the patient is guaranteed safety and improved comfort in daily life.
Conclusion
Progenia may seem minor at first, but its impact is far-reaching. From eating and breathing difficulties to speech and aesthetic concerns, this condition significantly affects daily life. Early diagnosis and timely treatment, especially in children, yield the best outcomes. Whether through braces or surgery, addressing progenia can restore function and confidence. Don’t overlook early signs—proactive care is crucial to prevent complications like tooth loss and facial changes. With proper treatment, progenia can be managed effectively, ensuring long-term oral health and overall well-being.
