My story, crowding, SARPE, all the fun stuff!

[zeira]

Hi everyone!
I can't believe I finally get to post on this board instead of just lurking, jealous of all the cool treatment you guys are getting.

I had removable braces for the longest time starting when I was 12 who helped a bit to make space in my upper jaw, but then I moved to the US for college, and the treatment was stagnating, so I just stopped it. The plan was to save enough money and start a treatment here. So five years later, at 23, here I am, ready to start this!

I was a bit afraid to get this started since I new the first step would be to get out these nasty impacted wisdom teeth and an impacted premolar. I got that taken care of last year (sweet general anesthesia!), and mustered the courage to see some orthos.

I decided to see two orthos, one I was referred to by my OS and another one who had great reviews online. I found the ortho from online a bit too young, seemed a bit irritated when I asked about expansion rather than extractions, but the checkup was free. The plan was 16 months, three premolars out to match the one I was already missing and about $4800 for ceramics (a bargain!). I was very close to just calling in and getting started.

The second guy just did a very quick checkup, mentioned some problems, said that I might need surgery (even with the extractions), was a lot more worried about my jaw clicking, but wanted $450 for a full treatment plan. eeks! I decided to go through with it since I trusted my oral surgeon (coolest guy ever!) who referred me to this guy (who's supposed to be an adult expert). So here's the final diagnosis:
- skeletal class II division I malocclusion (huh?)
- moderate overjet
- moderate anterior overbite
- upper arch has severe crowding
- lower arch has moderate crowding
- maxilla is constricted (i guess that means it's narrow?)
Sounds pretty bad!

Treatment - start with fixed palatal expander and corticotomies (I think that the fancy term for SARPE?), move to full fixed appliances, decide on extractions (either three premolars, or one premolar to match the top and a lower incisor)
- should take about 24 months and costs $7800 (ouch!!) plus surgery (which might be covered by my health insurance)

They also asked if I was thinking about genioplasty. Huh? Way to raise my self-confidence, I guess I haven't noticed my chin until now. And my OS mentioned my gummy smile which I wasn't bothered by until now. I think I won't do anything about these, at least for now.

Anyway, for now I've just gotten this removable splint on the bottom to help fix my crossbite. I'm really excited to get this started. I'll post some pics soon.

Sorry for the long story!

zeira

[zeira]

Until I get the courage to post pics of my actual teeth, here is a bad photo of my lower "retainer" that's supposed to correct my crossbite. It's supposed to allow my upper teeth to move outside my lower ones when I start the expansion, but it already makes my midlines match. Crazy!
I love the color combo!

[zeira]

I was hoping to get some replies.

Anyway, here are some photos the ortho took for the initial evaluation. All those fillings look so terrible, but I've had most of them since I was 12, before I got the first set of braces. Bad genetics I suppose.

You can notice the major problems on these photos, midline is off, overbite, crowding on the top and bottom (those lower canines are at 90 degrees), lack of chin when mouth is closed (profile looks better when I keep my mouth slightly open, I've always wondered why my chin looked like that in photos, now I know), upper arch is pretty narrow, missing premolar on the left, and the flaring out of the molars to compensate the bite. Crazy stuff going on in there!

I can't wait to start seeing some movement, but it will be a while. First surgery, expansion, then stabilization, extractions, probably at least 4-5 months.

[starzz]

Welcome, Zeira
I'm happy for you that you can get braces now. Can't wait to see how your treatment progresses. I don't have experience with the appliances or surgery so can't comment much there. Do you wear the splint all the time except eating?

[zeira]

Thanks for the welcome!
Eeeks! "Interesting to follow" doesn't sound very good . Just kidding... I was actually disappointed when the first ortho I saw said I wasn't an interesting case.

I'm seeing my OS next Friday, so not much new until then. But I have a ton of questions for him. I've been reading a lot on the various types of surgeries. Based on what I've read I think I would be a candidate for gum reduction and chin advancement (I haven't gotten the technical terms down yet). I'll ask my surgeon what he thinks about it, but I don't think I'm prepared to go down that route.

I've been wearing the retainer since it makes my bite feel a lot better, but I'm still getting used to speaking with it. I wish I had regular braces, then I wouldn't have to explain to everyone I talk to what that thing is .

[zeira]

I still don't have a surgery date . I saw my OS on May 1st and I've been waiting for a call since then to see when they could fit me in. I'm hoping to get this done in the next month or so.

This had a good part to it though. Today I went to try in the expander, and gah! that thing is terrible. I can't imagine how I'll survive with it for 6 months. I imagined it would be similar to the removable expander I had in when I was younger, but it's so much worse! Anyway, I was wondering why it had to sit so low on my tongue, making it impossible to say words like "need". When the ortho checked it he wasn't pleased at all and he wants to have it redone so it's higher. yay! The fact that I don't have the surgery scheduled yet give us some time to work around this. Phew!

Thanks everyone for reading! It's nice to have a place to vent.
I wish I had more time to talk to my ortho about some other issues I've been thinking more about:
- do I have sleep apnea and should I do a more radical treatment plan if so?
- what problems can my condylar resorption cause? I'm not sure if that's exactly how it's called, but basically the ends of my jaw are very thin, and it may evolve over time causing more issues. I'm not sure if it's something I need to look more into, or if this treatment will stabilize it.

Basically these were issues that were brought up just when I started seeing him, so I had no idea what it was all about, and never had time to think about them and ask all the questions. So I'm getting all anxious about everything now. Argh!

[Calistamay]

Congratulations on getting started. I also think that I look better in pictures with my mouth slightly open. When my lips are closed it just looks like I'm trying too hard to stretch my lips over my teeth. But 5 months in and they've reigned them in far enough that it is getting a little more natural (even with the braces on top). So that will something else to look forward to. Keep us updated, and good look!

[zeira]

Hi calistamay! Thanks for stopping by!

I have some important exams next week, so I should stop thinking about my teeth and start studying already! I just wanted to mention that I've had spacers in for almost two weeks now, since I need to try in the new expander next week. They were very amused that one of them had fallen out last time and I put it back myself, so this time they gave me some spare ones in case they start falling out! I'm the perfect patient.

I'm really glad I have the waterpik to help me clean between my teeth where the spacers are. I can't imagine how gross they would be otherwise. So if anyone is considering a waterpik, I say go for it!

[zeira]

Hi! Finally things are moving. I had my surgery last week (6 months after seeing my ortho and starting the process!) and I'm starting to expand tomorrow. I'm very excited to finally get this whole process started.
I can't even imagine what my teeth will look like in two years, they're such a mess right now!

[zeira]

It's been a year since I've had the surgery, I got top braces in November, premolars extracted in January, and lower braces around March. I still don't have brackets on my lower canines, but that should happen on my next appointment. I just got the expander out a couple of weeks ago, I had it for almost a year, which was a huge bummer. But the whole surgery ordeal was so worth it! Here's a before and after of my top teeth, isn't the difference just unbelievable?

[BracketRacket]

Lookin' good -- your teeth look a little similar to mine before my surgery so you give me hope! My expander comes out in a few weeks and I should have be getting braces next month.

[zeira]

Thanks for posting! The braces are very exciting at the beginning, when things change really fast. Then you just get used to them and it's no big deal anymore . The gap will go away before you know it, mine was almost gone before I got the braces.
I think my treatment plan was a bit different. I had the expander in for about a year, but I think they did that to keep everything stable while correcting the cross-bite on the back molars.

Good luck!!

[BracketRacket]

Yup -- my expander/distractor is actually attached to the bone in the roof of my mouth, so it comes out after 3 months. Then I'll have a multitude of appliances from the ortho to maintain the space. Good times!

[zeira]

Things are looking great now. They are working on rotating the canines on the bottom and they've made a lot of progress. The top is straight, I think soon we'll start working on closing gaps and alignment. I have a class I on one side, but class II bite on the other, so that will still be some work.

There was a mess-up with my ortho and I lost a couple month . A young ortho bought out his practice that was close to where I live, and the new guy was responsible for letting all the old patients now where we could find the other ortho. But they lead me on for a couple months and made me think they were working together and my other ortho was supervising everything. Ugh! So now I'm back with my old ortho, and he's trying to undo some stuff, and things are again under control. I could feel that my teeth were just drifting around and there was no plan, I wish I said something sooner. Plus this other guy blamed me for some brackets that he didn't put on properly and fell off, not a good experience.

I'll try to post some pics soon.

[lissety]

Hello Zeira,
I have a horrible crossbite. I have frequent jaw pain and migraines. I was wondering where you got all your procedures done. thank you, lisset