Protruding Lower Jaw: What are my options?

A protruding jaw can affect patients of all ages, including children and adults. In some cases, a protruding jaw may be the result of a congenital and developmental abnormality. When a malocclusion cannot be corrected by dental and orthodontic treatment, a jaw surgery expert, also known as an oral and maxillofacial surgeon, will work in conjunction with other dental professionals to address the problem. A jaw surgery expert’s objective is to help patients achieve facial symmetry, reduce speech impairments associated with the misalignment of the jaws, and correct the way that the upper and lower sets of teeth (bite) fit together. Oral surgeons provide a variety of services that include treatment for sleep apnea, TMJ disorder, and full-mouth rehabilitation.

Will a protruding jaw affect my oral health?

A protruding lower jaw can have far-reaching effects on your oral health. For example, if your jaw misalignment causes your teeth to scrape against each other unnecessarily, your teeth will eventually weaken. When teeth scrape and grind against each other, tooth enamel becomes damaged. This leaves teeth unprotected and susceptible to dental caries. Weak teeth are also vulnerable to chipping and cracking.

Are there other concerns associated with a protruding lower jaw?

Yes, other concerns associated with jaw misalignment include the development of TMJ dysfunction, which can cause facial pain, headaches, and difficulty opening and closing the mouth. Many patients with this problem also face difficulty speaking properly and eating food comfortably.

How will jaw surgery (orthognathic surgery) help?

Jaw surgery, also called orthognathic surgery, is corrective in nature. Our jaw surgery expert will develop a treatment plan specifically for each patient to address misaligned jawbones. Orthognathic (jaw) surgery may be required to restore a patient’s oral health. If your dentist or orthodontist has suggested that you visit an oral surgeon, we invite you to schedule a consultation with our doctor. At your appointment, a thorough oral examination will be conducted to determine how best to help you.

If you have questions or would like to schedule an appointment, please contact Dr. Larry Wolford’s office using our online contact form or call 214-828-9115

Condylar hyperplasia (CH) is a generic term describing enlargement of the condyle.  There are a number of different condylar pathologies that enlarge the mandibular condyle, with subsequent adverse effects on the morphology and function of the TMJ and mandible.  This may result in the development or worsening of a dentofacial deformity such as; mandibular prognathism (symmetric or asymmetric), and unilateral enlargement of the condyle, ramus, and body, facial asymmetry and malocclusion. 

Wolford has developed a simple, but encompassing classification that will allow the clinician to better understand the nature of the various CH pathologies, progression, and treatment options that have proven to eliminate the pathological process and provide optimal functional and esthetic outcomes.  The classification (Table 2 and Figure 29) also begins with the most common occurring form of CH and progresses to the least common occurring form.

CH Type 1:  This condition develops during puberty, is an accelerated and prolonged growth aberration of the normal condylar growth mechanism, is self-limiting but can grow into the 20’s, and can occur bilaterally (CH Type 1A) or unilaterally (CH Type 1B).

CH Type 2:  These condylar pathologies can develop at any age (although 2/3s develop in the 2nd decade), are unilateral condylar vertical and/or horizontal over-growth deformities, and are the most common occurring mandibular condylar tumors; osteochondroma (CH Type 2A) and less common osteoma (CH Type 2B).

CH Type 3:  These are other rare benign causing condylar enlargement. 

CH Type 4:  These are malignant conditions that can cause condylar enlargement.

The more common forms of CH (Types 1 and 2) will be presented relative to the clinical and radiographic findings, growth characteristics, effects on the jaws and facial structures, histology, and treatment considerations that are highly predictable in the elimination of the pathology and provide optimal treatment outcomes. 

FIGURE 29 Description

A-C) normal TMJ with balanced joint spaces.
D-F) CH Type 1 with relatively normal condylar shape, elongated condylar head and neck, and narrow joint space related to thin articular disc or displaced disc.  In the coronal view the condylar head is more rounded.
G-I) CH Type 2Av; an osteochondroma with a vertical growth vector without significant horizontal condylar enlargement or exophytic horizontal growth. This is a “young” osteochondroma with only about 3 years of growth.
J-L) CH Type 2Ah; an osteochondroma with horizontal (as well as vertical) enlargement of the condyle and exophytic outgrowth of the tumor. This tumor has been present for 6 years. Notice the significant increased vertical height of the mandibular body and ramus.

FIGURE 29