Clue 1: Orient yourself
Which method completes movement at once?
Use the labels and the picture's left-to-right, near-to-far, or before-and-after order. Name only what you can point to.
The question
Which method completes movement at once?
Why it matters: Structure affects feeding, breathing, hearing, speech, teeth, and surgical planning. Care teams need to connect the exact structure to the function a child is using every day. Today you practice the professional reasoning behind that work: Severe maxillary retrusion may require moving the upper jaw, but the choice between methods depends on severity, growth, stability, burden, airway, and speech.
On your WebXam
Choosing midface advancement method and timing for a Class III cleft patient
For life
One result can have many causes; the outcome alone never tells you which.
Principle: Many roads, one ending
Five principles we return to
Having it is not using it
Same instructions, different switches
Same look, different cause
Change one thing and watch
Boss or doorman?
Decides the result or only allows it
Held down, not gone
Remove the brake and it returns
Many roads, one ending
One result can begin many ways
Try the everyday version first
Reposition a heavy platform in one move or advance it in small steps
A heavy platform can be moved with one large shift or several controlled adjustments. Each method changes force, precision, time, and risk.
Do not jump to the biology yet. Treat the picture as a small system. Track its parts, follow one change at a time, and keep more than one explanation open until the picture supplies a way to separate them.
Clue 2: Trace one change
Which method spreads change over time?
Follow one object, stage, or path. Point to the first place where the situation changes instead of jumping to the ending.
Clue 3: Keep the cause open
What tradeoffs must be compared besides distance?
List more than one explanation that still fits. Name the extra observation that would help you separate those possibilities.
Now inspect the illustration
Work from the visible evidence. A useful answer names the part of the picture that supports it and leaves unknown causes open.
- 1Which method completes movement at once?
- 2Which method spreads change over time?
- 3What tradeoffs must be compared besides distance?
Tier 1 check
Finish with the everyday model
Use the everyday picture to answer today's question in plain words: Which method completes movement at once?
You can complete today's required check without opening the technical details below.
Ready for the real names? Optional tier 2
Technical rules and limits
Rule 1: Match method to severity and growth status.
Rule 2: Compare stability and patient burden.
Rule 3: Recheck airway and velopharyngeal speech before and after movement.
Where the analogy stops: Jaw surgery changes living bone and soft tissue and requires individualized planning, not generic platform mechanics.
Carry the previous idea forward
Cleft-related midface undergrowth can reflect both underlying anatomy and treatment history, so scar alone should not be treated as a proven single cause.
Today's technical takeaway
Severe maxillary retrusion may require moving the upper jaw, but the choice between methods depends on severity, growth, stability, burden, airway, and speech.
Now map the same rules onto biology
Compare Le Fort I advancement with distraction
Single crane move
Conventional Le Fort I advancement
Small repeated steps
Distraction osteogenesis
Platform alignment
Occlusion and midface position
Educational illustration, not a clinical photograph, scan, or surgical plan. Use the labeled evidence cards and claim ceiling.
Mateo's case file: evidence supplied in this lesson
ANA16-E1
Mateo's adolescent records show a significant anterior crossbite and maxillary retrusion not corrected by orthodontics alone.
Why it matters: A skeletal correction is a reasonable team discussion.
ANA16-E2
He is near skeletal maturity in the composite scenario.
Why it matters: Definitive jaw positioning can be considered after growth assessment.
ANA16-E3
Advancing the maxilla can change velopharyngeal relationships and hypernasality risk; comparative evidence does not establish one best method for every cleft patient.
Why it matters: Speech, airway, stability, and burden belong in method selection.
Make the clinical decision
You are the craniofacial surgery conference chair.
Mateo needs a 7 mm maxillary advancement, has stable airway testing, and has a history of repaired VPI that is currently controlled.
ACompare conventional advancement and distraction with orthodontic, speech, and airway input.
BChoose a method from distance alone and skip speech assessment.
CPerform definitive surgery before checking growth status.
Choose the conference process and cite skeletal plus speech-risk evidence.
Evidence required
ANA16-E1 + ANA16-E2 Claim ceiling
You may identify decision variables. You may not select a real operation without full imaging, examination, and shared decision-making.Go deeper Optional tier 3
Everything required for today is above. Open these only if you want the explainer, source trail, or download files.
The everyday model and Tier 1 check are the complete required path for this lesson.
Use these checks to keep your place. They are not turned in through the portal.
Check off as you finish
- Worked through the everyday picture and answered its three questions.
- Completed the Tier 1 check in plain words.
Turn in: Anatomical lesson 16: Correcting the Bite and the Midface
Go to Schoology to turn this in.
Submit one PDF. Put your first and last name in the document header. Name the file: FirstName LastName - Assignment Title - YYYY-MM-DD.pdf.
Open Schoology PDF upload helpIf you cannot get in, see Mr. Mendoza. Do not skip the work.
Optional legacy technical materials Open only if you want the original notes, vocabulary, artifact, and CER work
Before this page, you should know
- The is the upper jaw and the bone of the midface, the region under the eyes and around the upper lip.
- Two forces hold the midface back: an intrinsic tendency to grow poorly forward, plus a restraining scar from surgery.
If not, review
Today's new idea is only
Moving the set-back upper jaw forward fixes both the underbite and the flat profile, and it waits until so it will not relapse.
Goal: Explain how orthodontics, Le Fort I advancement, and correct a retruded midface, and why these are done near .
Know by the end
- Surgery that repositions the jaw bones is called ; it corrects the Class III bite and the flat profile together by moving the forward.
- The is a planned cut across the that frees the whole upper jaw so it can be moved forward and fixed with plates.
- cuts the bone and then slowly separates the ends so new bone grows in the gap, used for large forward moves.
- These corrections wait until , because moving a jaw that is still growing would relapse.
1
The bite to correct
Model start: The grows poorly forward and scar restrains it, leaving a small, set-back midface and a Class III underbite.
- In a the upper teeth close ____ (behind) the lower teeth, an underbite.
- Surgery that repositions the jaw bones is called ____ surgery.
2
Two ways to move the jaw
- The ____ osteotomy is a planned cut across the that lets the surgeon move the whole upper jaw forward and fix it with plates.
- When the jaw must move a long distance, pulls the cut ends apart slowly so the body grows ____ (new) bone in the gap.
3
Why wait
- These corrections wait until ____ () because moving a still-growing jaw would relapse.
Everything you need for today is on this page. These links are optional.
What to read
Read the short plain-language explanation written for this lesson. Plain-language explainer for this lesson
Why this source matters
This explanation gives you the background for today's idea without making you decode a research paper: Moving the set-back upper jaw forward fixes both the underbite and the flat profile, and it waits until so it will not relapse.
Words to unlock first
orthognathic surgeryLe Fort I osteotomydistraction osteogenesisClass III malocclusionskeletal maturity
Reading moves
- Skim the title and abstract first to get the gist.
- Circle the one sentence that states the main claim.
- Box the evidence the authors give for that claim.
- Mark one sentence that confuses you, and move on.
Stop point
Stop after the final 'Use it now' section. The research citations are available separately for advanced readers.
Your output
Write one claim-evidence sentence: state the main idea, then name the example or evidence that supports it.
Where this fits
Tested on (Ohio WebXam)
Genetics of Disease · 072130
PLTW lesson
MI · Anatomical domain · Skeletal system; form and function of the facial skeleton
WebXam domain
Molecular and Genetic Technology
Evidence to produce
Present Mateo's plan at the team meeting. In three or four sentences, recommend either Le Fort I advancement or distraction osteogenesis for him, and justify it using two facts: his Class III, set-back midface and the size of the forward move you expect. Add one sentence on why you are waiting until he is older to operate.
Lab / skill
Human Body Systems (HBS)
Everything required for today's decision is already in the case file and plain-language explainer. The links below are original papers and database records for teachers and advanced readers, not assigned student reading.
- American Cleft Palate Craniofacial Association. 2024 Parameters of Care.
- Powell et al. 2022, Does Early Secondary ABG Influence Need for Maxillary Advancement (Cleft Palate Craniofac J)
- Dissaux et al. 2016, Evaluation of 5-Year-Old Children With Complete CLP, Part 2 (J Craniomaxillofac Surg)
- Daskalogiannakis et al. 2009, Need for Orthognathic Surgery in Repaired Complete Unilateral CLP (Cleft Palate Craniofac J)
- Claim: Mateo's underbite and flat midface can be corrected by moving his upper jaw forward.
- Evidence: Cite the Class III, retruded- pattern and one surgical method from today.
- Reasoning: Explain why moving the forward fixes both the bite and the profile, and why the team waits for .
How this is graded (rubric)
For: Present Mateo's plan at the team meeting. In three or four sentences, recommend either Le Fort I advancement or distraction osteogenesis for him, and justify it using two facts: his Class III, set-back midface and the size of the forward move you expect. Add one sentence on why you are waiting until he is older to operate.
| Criterion | Proficient | Developing | Beginning |
|---|---|---|---|
| Complete | Every required part of the artifact is present and filled in. | Most parts are present, but one is missing or left blank. | Several parts are missing. |
| Accurate | The science and data are correct and match the evidence. | Mostly correct, with a small factual slip. | Key science or data is wrong. |
| Scientific reasoning (CER) | States a claim, backs it with specific evidence, and explains the reasoning. | Has a claim and evidence, but the reasoning is thin or missing. | Gives an answer with no evidence or reasoning. |
| Professional communication | Clear, organized, and labeled the way a clinician or scientist would write it. | Readable but disorganized or missing labels. | Hard to follow. |
| Submitted | Turned in through the route named under Submit here and confirmed. | Turned in, but in the wrong place or unconfirmed. | Not turned in. |
How the model answer scores against this rubric
- CompleteProficient: Nothing is left blank: the model fills every part of "Present Mateo's plan at the team meeting. In three or four sentences, recommend either Le Fort I advancement or distraction osteogenesis for him, and justify it using two facts: his Class III, set-back midface and the size of the forward move you expect. Add one sentence on why you are waiting until he is older to operate.".
- AccurateProficient: Every number and claim matches the case evidence.
- Scientific reasoning (CER)Proficient: It names a claim, cites the specific evidence, and explains the reasoning, not just the answer.
- Professional communicationProficient: It is organized and labeled like a real chart note.
- SubmittedProficient: It would be attached to your class form or handed in, and confirmed.
What's next: We answered how the bite and midface are corrected. But the nose sits on that midface, and even after the jaw moves forward, Mateo's nose is still asymmetric and partly blocked. How is the nose itself affected, and how is it repaired? We chase that next time.