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The maxilla is the upper jawbone. It fuses together two irregularly-shaped bones along the median palatine suture, located at the midline of the roof of the mouth.

Maxillary retrusion[edit | edit source]

Other terms associated with maxillary retrusion include:

  • Midface retrusion
  • Midface hypoplasia
  • Midfacial retrusion
  • Midfacial hypoplasia
  • Midfacial retrognathia (used rarely)

Maxillary retrusion, also called maxillary retrognathia or maxillary hypoplasia, is when the maxilla recedes with respect to the frontal plane of the forehead. A retruded maxilla can have detrimental effects on a person's aesthetics.

Maxillary retrusion can be prevented or reversed, during childhood, using an exercise conceived by the orthodontist Mike Mew. This exercise involves putting pressure on the roof of your mouth using your tongue, and should be done continuously throughout the day. This exercise not only protrudes the maxilla, but protrudes the zygomatic bones as well, because the zygomatic bones are connected to the maxilla.

Surgical procedures in correcting maxillary retrusion include LeFort I maxillary advancement, LeFort II maxillary advancement, or a LeFort III maxillary advancement.

Maxillary protrusion[edit | edit source]

The reverse of maxillary retrusion is called maxillary protrusion or maxillary prognathia. Maxillary protrusion should not be confused with dentoalveolar protrusion, also called bidental protrusion, bialveolar protrusion, bimaxillary protrusion or bimax. (However, John Mew explains that bimaxillary protrusion is a misnomer.) Bimaxillary protrusion is an ethnic variation that has little influence to physical attractiveness.

Note that it is possible for one to have a bimax yet a retruded maxilla.

Narrow maxilla[edit | edit source]

A narrow maxilla is a maxilla which does not have much lateral projection. It could be caused by poor oral posture. In narrow maxillas, the cheekbones do not project laterally much. Narrow dental arch.

Palate expansion is used to correct a narrow maxilla. It could broaden cheekbones as well.

Downward maxilla[edit | edit source]

A downward maxilla is a maxilla which falls downward or grows downward. It could be caused by poor oral posture. Those with a downward maxilla usually have downward orbital rims as well.

Maxillary impaction is a procedure which corrects a downward maxilla. A LeFort III could elevate the maxillozygomatic area, including the infraorbital rims, upward.

Causes of poor maxillary development[edit | edit source]

  • Poor oral posture
  • Acidic diet
  • Vitamin K insufficiency
  • Poor head and body posture - Caused by sitting too much.
  • Lack of hard foods
  • Stress - Effects tongue position and head posture.
  • Thumb sucking
  • Allergies
  • Sleep position
  • Bottlefeeding
  • Retractive orthodontic treatment (braces, headgear and extractions)
  • Inflammation - leads to mucus production
  • Poor diet - could lead to inflammation and allergies, leading to nasal blockage

Effects of poor maxillary development[edit | edit source]

Eye area[edit | edit source]

  • Darkness under the eyes due to infraorbital retrusion.

Paranasal area[edit | edit source]

Nose[edit | edit source]

The nose is more pronounced in an ideal occlusion (straight teeth) but in the various malocclusions (crooked teeth) where the maxilla (top jaw) is underdeveloped it appears larger, although in fact it is smaller.[1]

—John Mew

Dorsal hump ("hook nose") as the bottom cartilaginous part of the nose gets pulled inward by the retruded maxilla.[2]

Lower third[edit | edit source]

  • More pronounced nasolabial folds.
  • Marionette lines caused by unsupported soft tissue from the cheeks by retruded mandible.
  • Pronounced separation of soft tissue between chin and cheeks.
  • Unpronounced jawline caused by tucked-in soft tissue by retruded mandible.
  • Stuffy cheeks
  • Small teeth
  • Crowded teeth

Health effects[edit | edit source]

A retruded maxilla is maladaptive since it causes snoring, sleep apnea, insufficient oxygen intake and spinal imbalance.. So a retruded maxilla like all other facial deformities are selected against. A retruded maxilla pushes the tongue back thus obstructs the airway, causing snoring and sleep apnea. People with sleep apnea have 20% decreased life expectancy[3] and increased risk for cardiovascular disease.[4] Most stroke patients suffer from sleep apnea.

A retruded maxilla blocks the airway passage, which in turn makes people to move their heads forward to compensate. Forward head posture, however, places a load on the spine. It could increase spinal load by several pounds, inhibiting mobility and increasing needless effort to maintain balance.

Other effects[edit | edit source]

A protruded maxilla increases the volume of the resonance chamber, the mouth. This leads to richer vocalization. Singers have protruded maxilla and are more likely to be attractive. Example. Good looking actors like Johnny Depp[1] and Brad Pitt[2] have good voices.

Identification[edit | edit source]

The indicator line can tell you what your maxillary position is.

Photoshopping a protruded maxilla[edit | edit source]

See Also[edit | edit source]

References[edit | edit source]

  1. Mike Mew (1986). Mouth Breathing and Facial Development
  2. John Mew. The Cause and Cure of Malocclusion. "The Duke of Wellington (Fig IV/23) provides a good illustration of an increase in both the upper and Lower Indicator Line. It can be seen that in relation to the frontal bone, the nasal bones themselves remain relatively static causing the nose to become progressively hooked as the nasal cartilage drops back with the maxilla."



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