LONG FACE SYNDROME

DEFINITION

A malocclusion characterized by a long, narrow face; steep mandibular plane angle; and Class II Division 1 dental/skeletal relationship with anterior crowding lip incompetence and associated mouth breathing.

INCOMPETENT LIPSSTEEP MANDIBULAR PLANE ANGLE

Class II division 1 malocclusion

Typical forward angulation

of head of a person with

Long Face Syndrome with steep mandibular angle.

ETIOLOGY

OBSTRUTION OF AIRWAY due to… Enlarged tonsils Dysplasia and inflammation of nasal mucosa

Uncontrolled allergies Narrow nostrils Constantly open lips (mouth breathing)

Adenoid or localised benign tumour Narrow palate

POSTNATAL CAUSES… INFLUENCE NORMAL DEVELOMENT OF DENTO-FACIAL COMPLEX

CONTD… SLEEP APNEA –sleep disorder

characterised by pauses in breathing during sleep TONGUE THRUST THUMB SUCKING.

1. 1.IMPAIRED RESPIRATION

2.OPEN MOUTH BREATHING

3.DROOPING OF MANDIBLE

4.EXTRUSION OF MOLARS

5.OPEN BITE

6.INCREASED VERTICAL DIMENSION

7.LONG FACE SYNDROME

Gradual development of the syndrome…..

OROPHARYNX IN LONG FACE SYNDROME CAUSING OBSTRUCTION OF AIRWAYS.

ENLARGED TONSILS CAUSING OBSTRUCTION IN AIRWAY

TONGUE THRUST

ANTERIOR CROWDING DUE TO THUMB SUCKING

CLINICAL FEATURES

CLINICAL FEATURES Long face Gummy smile Incompetent lips Flattening of cheeks at the base of the

nose making the nose appear larger than normal

Short upper lip or drooping lower lip Any of the clinical features related to the

etiological factors mentioned previously Expressionless face due to severely

active facial muscles

GUMMY SMILE

INCOMPETENT LIPS

FLATTENING OF CHEEKS AT THE BASE OF THE NOSE

SLEEP APNEA AND SHORTER UPPER LIP

LARGE TONGUE OF THE SAME PATIENT (CAUSE OF SLEEP APNEA)

DIAGNOSIS BY CEPHALOMETRIC EXAMINATION….

Amount of nasopharyngeal space

Size of adenoids

Long face associated with breathing

TREATMENT

TREATMENT

PREVENTIVE

SURGICAL AND ORTHODONTIC CORRECTION

PREVENTIVE TREATMENT

Includes…Prevention of various etiological factors

Application of various orthodontic appliances for the same

ORTHODONTIC APPLIANCE FOR TONGUE THRUST AND THUMB SUCKING HABIT

MOUTH BREATHING HABIT

REMOVAL OF NASAL OR PHARYNGEAL OBSTRUCTION

INTERCEPTION OF THE HABIT- - adhesive tapes can be used to seal the lips while sleeping

RAPID PALATAL EXPANSION– for expansion of the pterygoid plates and to increase the nasal air flow and decrease the nasal air obstruction.

SURGICAL REMOVAL OF ENLARGED TONSILS

RAPID PALATAL EXPANSION ALSO EXPANDS THE PTERYGOID PLATES.

SURGICAL AND ORTHODONTIC TREATMENT Surgical reduction of facial height and

proper alignment of teeth by orthodontic means

By properly planned and executed Le Fort I maxillary osteotomies, the vertical dimensions of the face can be shortened to improve the esthetic balance between the nose, upper lip, teeth, and chin and achieve lip competency

 Variable open-bite and nonopen-bite maxillary deformities in forty adults with the long face syndrome were corrected by Le Fort I osteotomy and orthodontic treatment.

LE-FORT 1 OSTEOTOMY

THANK YOU

-PRESENTED BY-DISHA NIGHOT

-ROLL NO. 14