Metal Mouth Message Board

Hi all,

last week I posted this :

viewtopic.php?t=13407&start=0

Now, I did indeed have that famous appointment with my ortho and the oral
surgeon. What did I learn after a talk of again about 1,5 hour ?

First that my overjet is indeed larger than my ortho initially told me. Last
week he told me it was only 2 to 3 mm, maybe too little to have jaw surgery.
What I knew all the time, and what he now did admit, was that it is indeed
more like 5 to 6 mm. A part of it is kinda hidden because my uppers are
slanting inwards. So, it is a very good case to get jaw surgery (advance the
lower jaw, called a saggital split osteotomy). Before that I would need some
corrections on my upper incisors (flaring them) and then the surgery would
be possible next month.

Secondly, the Herbst appliance will not be possible. At least this kind of Herbst
my ortho uses (there are indeed several types of Herbsts). It would make
my open bite more open and would hurt my upper premolars more than they
can take. As I told earlier, due to all those elastics, they are slanting inwards
to that extent that their roots make white bumps at the outside, in the gums.
They can't have much anymore or I will loose them. So the Herbst option
is no longer an option for me.

Thirdly, my ortho gives the option to take all braces off and to let everything
settle. To increase this effect, he would not even do proper retention. So,
he would make all teeth free and let "nature play". There are so many little
details I so wanted to have corrected later. All that would now be impossible.
And I still would have an open bite and only 2 first molars that touch when
I bite down and with that I would need to go on. Not exactly a nice end of
wearing braces for 29 months. He would eventually place some brackets
back after 5 months to correct some minor issues. But the important things
like the open bite and bad occlusion would only be treated by luck if nature
will want to work with me.

So, I felt quite down after this appointment and I also told him that. I am
now put in a virtual corner and need to choose between surgery and kinda
stop here. Damn, damn, damn, damn .........
My ortho will phone me within some days to know what I decide. How on
earth will I do that ?

Hi Clo-

You popped into my mind Monday and I was wondering how it was going with your appointment. As Mereyten said there are many of us who had the BSSO and we can help out if you go that route. I know it's not your preference, but it is doable from a recovery standpoint. I have a question, how will the open bite be resolved with the lower jaw surgery alone????....just curious because as you know I dealt with correcting an open bite. I do wish you good luck and I hope you find the right solution for you. Let us know what the ortho ultimately says. Keep smiling

Clo!

I'm so sorry to hear about all of this! What a tough decision to make! Whatever decision you decide to make we're here to support you no matter what! THis has been such a long road for you! I wish your ortho had better news for you!

Remember you can come here anytime just to vent! You have a right to! lol Good luck with making your decision! And keep smiling! You do have a beautiful smile even if your bite isn't correct!

~hAnnah




[url=http://www.TickerFactory.com/]


Top braces: 4/28/04
Bottom braces: 11/16/05

I'm so sorry your having to go through with all this! I agree with Karen write every down, get questions answered, then make the best decision for you. We're here for you regardless of the decision!

Hi,

thanks for your replies !

It is now 24 h post-appointment. I did almost nothing but thinking what to do
next. Surgery would almost directly correct most issues I have with my bite.
But after surgery I certainly would need braces for some time to correct still
a lot. To create some kind of occlusion about everywhere.
I want to make something clear here. Whatever I say or do, I completely
understand the decision that was made by some of you to have jaw surgery.
All I say is only completely in perspective of if surgery is what I want or need.
Why do I say that ? Because I am not satisfied with what that appointment
gave me. There are so many orthodontic means that can be an alternative
to jaw surgery in borderline cases like mine is. There is the Mara, there is
the Jasper Jumper, there are lots of different types of Herbsts. I can not
imagine these are all rubbish. They must at least work a bit. So right now
I do not accept none of these are even considered.
One good thing though, I seem to be like promoted. My ortho emphasized
I could phone him or come in whenever I want. They would take me first.
So I indeed plan to have another appointment soon.
But what worries me more is that my premolars hurt at the place where the
roots make those white bumps in my gums. Their roots broke through the
corticoïde (or something like that) plate. I might loose them as of now.
Another thing I do not accept. My ortho is only trying to not hassle them much
anymore. I would do more. I would reverse the effect and try to get them
upright again. Like a car that sits partly over the cliff's edge like you see now
and then in movies. My ortho would only say not to move a lot in that car, to
prevent that it falls after all. I would let it secure at the safe side and after
that is done pull it again backwards. Sorry about my vivid imagination, but
you'll get my drift I think. Anyway, something will need to be done. Even
my ortho should know this, as he has another patient who indeed lost a tooth
that way.

@smile2006 : the surgeon said, once the jaw is split, he can not only move
it forward, but has also some possibility to make some inclination by lifting
the front of the jaw (so, at the chinside) a bit. It would, together with the
better occlusion I'll get, be enough to close my bite in a acceptable way.
He asked if I still have my 3th molars. Yes, I said, I have still all 4 of them.
Owwww, he said, this complicates things as normally they cut where the
3th molars were. It is still possible, but more difficult if they are still there.
Because then they start the cut behind the 3th molars. Or I could have them
removed before, but then I would need to wait 6 months after the extraction
to have the jaw surgery. Awwww, I thought, I did not even start yet and I
already hear about complications. And then I read things like out of 20, 1
looses the feeling in the lower lip or chin for the rest of his/her life. That is
a lot I think. Arggg, I am certainly not ready yet to have this surgery or to
even choose right now ...

wow...what a story...myself and I am sure everyone on this board feels for you! Hang in there!

Hi Clo, sorry to hear such drastic options for you. About the "bumps" where your roots are. I went to a periodontist because I had some bleeding around a couple of teeth at the gum line. They were ok, but said I had 7 teeth that need a skin graft over the roots because they were too close to the surface. This had to be done before I got braces, BTW. Anyway, neither the surgeon or the orthodontist even mentioned that you were a candidate to have extra tissue placed over your roots?

(The grafts came from the roof of my mouth and were done in two sessions. Probably all told I would have been ready for braces in three months, but because of finances, I had to delay longer - just so you know the time frame) I do believe as you, that your best option with the roots showing is straightening your teeth, though.

You have a most difficult decision to make, good luck to you.

Hi again-

I agree with Meryten, of those who have been active on the orthoganathic board, very few have mentioned long term numbness as an ongoing issue. As was said previously, an experienced surgeon is the way to go and your "nerves" are in his/her hands!!!! I'm doing well numbness-wise. My surgery was two months ago today and I finally beleive that I will regain all my feeling as all areas of the lower jaw (and finally chin) have feeling (and the sensation is increasing daily). The recovery is not speedy from the surgery and I was worried for awhile about the numbness issue too. Also, I can see how lower jaw surgery only could close the open bite as the jawline can be lifted some through autorotation. Also, if you decide to go the surgery route make sure the correction of moving the jaw is pleasing to your appearance (for example if tipping the chin up closes the bite, will it also sit well with your overall appearance/facial balance?). Most surgeons can do computerized before and after photos to help determine this. You do have a big decision and I feel for you because after 29 months you deserve some good results! Also, your teeth need a break!

Clo, if I may just infer from your posts and read a bit between the lines, I think deep down it is not just the surgery itself you question but the ability itself of these professionals who have steered you wrong so many times in the name of what is best for you. Anyone in your position whould question their recommendations. It almost has come down to self preservation, not just straight teeth.

I would take all the time in the world to think about it. Talk to as many people as you can, call the local dental university and present them with your case, etc. Do what you have to do to feel like you can make a decision.

Deep breaths. Hugs and let us know what happens.