What are some ways to manage bimaxillary protrusion?

Doctor's Answers (1)

Hi, 

Thank you for your question. Bimaxillary protrusion is quite common in Asians, it is characterised by protrusive or proclined upper and lower front teeth. This means that the upper and lower teeth appear to slant outwards and thus may result in lips that are difficult to close and appear to stick out. It may be accompanied by a gummy smile and lower lip strain, and an anterior open bite.

Bimaxillary protrusion can be limited to the teeth or may involve the underlying jaw bones. Management will depend on the patient's concerns, as well as the severity of bimaxillary protrusion which is determined clinically as well as from a lateral cephalogram xray. If the protrusion is limited to the teeth, orthodontic treatment with extractions of upper and lower teeth may be indicated. Extractions of teeth allows for the space required to retract or bring the front teeth inwards and improve the angulation of the teeth.The most common teeth that will be indicated for extractions are usually the premolars. Most patient with bimaxillary protrusion will often query the need for the extractions, however I will advise them that without creating the necessary space, there will be limited improvement in the angulation of the teeth.

If the bimaxillary protrusion involves the underlying jaw bones, orthodontic treatment combined with orthognathic/jaw surgery may be indicated especially if it is associated with a gummy smile. 

Thank you for sending a photo, however I am unable to assess your lip position due to the presence of the retractors. The upper and lower front teeth do appear proclined, but it appears limited to the teeth position and orthodontic treatment to upright the teeth is definitely feasible. I would definitely recommend a visit to an orthodontist to discuss your concerns, provide a clinical examination and recommend a treatment plan that best suits you. 

Hope this helps!

Best wishes,

Dr Priscilla Lu, Orthodontist

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