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Vigor: Sleep apnea, too less teeth showing, overbite , lower jaw short, implants all on four

Facial diagnosis

  • Receding lower jaw
  • Receding upper jaw
  • Too short lower jaw

Dental diagnosis

  • Class II division 2
  • Deep bite

Treatment jaw surgery

  • Advancement lower jaw (BSSO)
  • Advancement upper jaw (Le Fort I)
  • Vertical lengthening upper jaw (extrusion upper jaw - Le Fort I)

Treatment dental implants

  • Implant supported bridge (fixed denture) upper jaw
  • Implant supported bridge (fixed denture) lower jaw
  • Zygomatic dental implants

Treatment aesthetic surgery

  • He refused the liposuction in the neck area


About this case

Vigor is a middle aged man, 45 yrs old. His main problem was his inability to chew, since too many teeth were lacking. Also, although he did not put too much attention to this, he was heavily snoring at night and his wive told about the periods of apnea when sleeping. Yes he felt continuously a bit tired. On physical exam, Vigor had clearly a desolate dentition, that needed to be replaced.  But clearly, he had a short face, showing no teeth what so ever. Above all he was retrognatic. Gradually during the following consultations we agreed that we would go for a facial makeover.  Extrusion of the upper jaw (vertical lengthening with also substantial advancement), advancement of the lower jaw, a bone graft from the anterior hip to fix the upper jaw, and implants in the upper and lower jaw. The goal was the restoration of a decent dentition on implants, but also to get rid of his sleep apnea, and to create, as an extra unexpected gift, a more balanced and more hansom face. One thing he refused by all means was a treatment for his heavy neck region with liposuction. He argued that he was not a women searching for perfection, and that is was a family characteristic. So during the one and only surgery, Vigor was treated with a substantial Le Fort I extrusion, a substantial BSSO = lower jaw advancement, total extraction of his rest dentition and placement of implants in upper and lower jaw. Two zygomatic implants were installed posteriorly and the new facial height. The teeth were placed as a supra structure on the implants in an Immediate loading way and after an aesthetic pass (all on four concept. After one week the teeth were screwed on the implants, and when I saw Vigor back 8 weeks later: what a transformation. He felt like new born, fit and relaxed. He was extremely happy with the surgical outcome. But he still did not regret that he refused the liposuction in the neck region.