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Bimaxillary Dentoalveolar Protrusion (Facial Appearance (Profitt) (Lip…
Bimaxillary Dentoalveolar Protrusion
Facial Appearance (Profitt)
Lip incompetence (4mm or <)
Lip strain
Prominence of both upper & lower lips & dentoalveolar area
Etiology
Hereditary & familial
Tongue thrusting
Diagnosis
Case history
Clinical examination
Cephalometric analysis
Features
Extraoral
Convex profile
Decreased nasolabial angle
Incompetent lip
Lip strain
Everted lower lips
Deepened mentolabial sulcus
Hyperactive mentalis
Skeletal
Increased SNA & SNB
Increased ANB angle
mild divergent facial planes, slightly increased FMA angle, vertical growth pattern
Increased Y axis
Dental
Normal overjet & overbite, sometimes edge-to-edge
Decreased interincisal angle
Mild crowding/spacing
Normal class I molar & canine relationship
Treatment
Premolar extraction & retraction
FR-IV (mild cases, mixed dentition stage)
Surgical correction (sub-apical osteotomy) true skeletal proagnathism
"All :
3
characteristics must be present to make diagnosis of dental protrusion."
"Defer extraction until late mixed dentition/early permanent dentition."