9.  How do you treat long face syndrome?

Answer:
(From McCarthy page 1381:)

Willmar (1974) used the term “long face” (vertical maxillary excess) to describe the traits of  the long face deformity.  The principal physical finding is exaggerated anterior facial height due to maxillary vertical hyperplasia.  The nose is frequently narrowed in the alar base region and the nasolabial angle is often obtuse.  The so-called adenoid facies is associated with a propensity toward breathing through the mouth. The palate is high-arched and narrow.  The mandible is forced into a clockwise rotation and a Class II malocclusion may be present.  With the lips in propose there is a large inter-labial gap.  There is too much incisor show.  Patients have a gummy smile.  It is corrected by a LeForte I osteotomy.

Treatment:
1) LeForte I osteotomy with intrusion will shorten the vertical height of the maxilla and allow for autoraotation of the mandible into normal occlusion.
2) Sometimes saggital splits are necessary for mandible advancements also.
 

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