Bimaxillary advancement with complicating factors: A case study
Patricia Brinkman-Falter, RDH, MS, COM

Introduction

  • Bimaxillary surgery is gaining favor as first treatment for OSA
  • Posture is affected because of airway constriction
  • No protocol exists for soft tissue recovery
  • Often there are craniofacial dystrophies
  • TMD can accompany OSA because of parafunctional behaviors
  • Diabetes, high blood pressure and rapid breathing are common complicating health factors

Educational Goals

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Surgical Plan

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Surgical Plan

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Surgical Plan

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Orofacial Myofunctional therapy is an important adjunct to the successful recovery of bimaxillary surgery

Post Surgery

Post Surgery

Post Surgery

Post Surgery

Scientific Poster presented at the 2019 IAOM conference

Surgical Plan

Exercises Used

Week 1
Squirt liquids into mouth
Palatal tracing
Hyoid release
Wiggle jaw side to side
Move lips
Trigeminal trace (T-Touch)

Week 2
Add tongue points
Add tongue to spot exercises
Start use of small straws for thin liquids

Week 3
Point and trace combined
Started used of maroon spoon
Tongue on Spot words
Lip smacks

Month 2-3
Start opening jaw with tongue blades
Lymph drainage massage
Coherent breathing
Marshalla’s “Butterfly”
Soft palate/uvula pull
Surprised Turtle

Month 3-6
Soft chew diet
Tongue presses
Singing
Upper cheek toning

Sleep Studies