Bear with me, but if someone could give me some guidance it would be much appreciated!
Here is my situation. I'm 40, have known that I would need braces for a while, and finally made the decision. I have had a Maryland bridge for 20 years (left of front tooth) and have a gap on the other side - result of baby teeth. Have one more baby molar (in the bone) that will need to be removed - leaving a significant hole. Have gum recession behind MB. Front teeth slightly misaligned and have a gap covered (nicely) with bonding. Good lower teeth, some crowding. Healthy mouth and gums, lots of jawbone for grafts. Type of smile one can live with, but functionally and aestetically could be much better.
So after some research, I looked into this "corticotomy" procedure. That, plus bone grafts, plus temp teeth on arch wire and braces, followed by three implants looks to be the regime.
I am having this done at BU Dental school, not so much because of cost, but because of one stop shopping convenience that I assume you get from ALL pros being at the same location.
Concerns/Questions
1) Corticotomy - looks legit, and can cut the brace time in half I am told (my teeth do not need to move far, I was told it could take as little as 6 months)
Risks, too good to be true?
2) Bone graft. One should be easy, the other will be significant bc of hole after baby molar is out. Does the size of a bone graft play into healing and thus overall time frame? Can braces work while graft heals?
3) Clear braces vs metal... I have heard mixed things - from the clear ones protruding more and being more fragile, to the metal ones working faster and not looking as bad (smaller?) than clear. Any concensus?
4) Finally, Dental school. Any good / bad experiences? Anything I should really stay on top of?
Sorry for the multiple questions. I have a full blown oral consult on Wed and wanted to be a bit more prepared.
Thanks!
Paul
new here - lots of questions
Moderator: bbsadmin
Re: new here - lots of questions
20 years on a Maryland bridge? That is impressive!!Bear with me, but if someone could give me some guidance it would be much appreciated!
Here is my situation. I'm 40, have known that I would need braces for a while, and finally made the decision. I have had a Maryland bridge for 20 years (left of front tooth) and have a gap on the other side - result of baby teeth. Have one more baby molar (in the bone) that will need to be removed - leaving a significant hole. Have gum recession behind MB. Front teeth slightly misaligned and have a gap covered (nicely) with bonding. Good lower teeth, some crowding. Healthy mouth and gums, lots of jawbone for grafts. Type of smile one can live with, but functionally and aestetically could be much better.
It can be legit. It is more invasive than traditional non-surgical orthodontics. But it can speed up treatment and offer better long term retention.So after some research, I looked into this "corticotomy" procedure. That, plus bone grafts, plus temp teeth on arch wire and braces, followed by three implants looks to be the regime.
I am having this done at BU Dental school, not so much because of cost, but because of one stop shopping convenience that I assume you get from ALL pros being at the same location.
Concerns/Questions
1) Corticotomy - looks legit, and can cut the brace time in half I am told (my teeth do not need to move far, I was told it could take as little as 6 months)
Risks, too good to be true?
You don't want to try and move teeth into "spongy" immature bone. So you can potentially do some orthodontics in other ways while the bone heals. But maybe not. Size does matter like anything in life2) Bone graft. One should be easy, the other will be significant bc of hole after baby molar is out. Does the size of a bone graft play into healing and thus overall time frame? Can braces work while graft heals?
The extra time for ceramics is negligable when you look at a typical treatment plan. Plus protruding is also not a big deal. Choose whichever will make you more comfortable.3) Clear braces vs metal... I have heard mixed things - from the clear ones protruding more and being more fragile, to the metal ones working faster and not looking as bad (smaller?) than clear. Any concensus?
No comment on BU4) Finally, Dental school. Any good / bad experiences? Anything I should really stay on top of?
Who are you meeting with on Wednesday? Dr. Ferguson? Or are you having a team meeting?Sorry for the multiple questions. I have a full blown oral consult on Wed and wanted to be a bit more prepared.
Thanks!
Paul
Good Luck,
Rory
The corticotomy is similar to that they do in Wilckodontics. You may want to read this article:
http://www.archwired.com/AOO1.htm
and be sure to also read the two patients' stories linked to the article.
Search this site for "corticotomy" and "Wilckodontics" and see if you can find others who have posted information about their treatment. You might also want to do a similar search on google. I do remember that a couple of the people on this board who had a similiar procedure weren't too happy with the amount of pain they were in afterward -- but I think that overall they were pleased with the results.
Good luck!
http://www.archwired.com/AOO1.htm
and be sure to also read the two patients' stories linked to the article.
Search this site for "corticotomy" and "Wilckodontics" and see if you can find others who have posted information about their treatment. You might also want to do a similar search on google. I do remember that a couple of the people on this board who had a similiar procedure weren't too happy with the amount of pain they were in afterward -- but I think that overall they were pleased with the results.
Good luck!
I'm the owner/admin of this site. Had ceramic uppers, metal lowers ~3 years in my early 40's. Now in Hawley retainers at night!
Thanks everyone! Very helpful.
Rory, thank you for the insight into the (larger) bone graft. I thinks this will be an issue, and my thought is that they could do a lot of ortho without actually pulling the tooth first, then pull later and put an implant in. You'd have to see the tooth of course, but the aesthetic issue is in front and on the other side, not where the molar is. The molar is a long-term functional issue, it will have to be removed mostly because it is situated in a way that makes it hard to clean between the other teeth, but I just think that it will represent a big chunk of the time/effort etc related to the braces. The resident and I are already sort of disagreeing about this issue, but they are the experts.
Not sure who I will be meeting with on Wed - sounds like you know those guys. So far, everyone has been very helpful and informative. I am not trying to play dentist, but I have tried to learn as much as I can and am not afraid to ask questions. For the most part, they seem to like that, which makes me much more comfortable. And like I said, I am happy that I can go to one spot for the complete treatment, rather than seeing 4 separate pros at four separate locations.
I expect the corticotomy to be painful, I think the extraction will also not be fun, the tooth seems to be part of the bone, but I'll be fine. I've read up on the wilckodontics site and I guess I am surprised that this procedure is not more common - it seems like a pretty small concession for a 50% reduction in time. But I also have lots of room for my teeth to move, I understand that a normal smile or crowded teeth do not respond as well to this procedure...
I have some other questions, but I think I'll wait until after thursday.
Rory, thank you for the insight into the (larger) bone graft. I thinks this will be an issue, and my thought is that they could do a lot of ortho without actually pulling the tooth first, then pull later and put an implant in. You'd have to see the tooth of course, but the aesthetic issue is in front and on the other side, not where the molar is. The molar is a long-term functional issue, it will have to be removed mostly because it is situated in a way that makes it hard to clean between the other teeth, but I just think that it will represent a big chunk of the time/effort etc related to the braces. The resident and I are already sort of disagreeing about this issue, but they are the experts.
Not sure who I will be meeting with on Wed - sounds like you know those guys. So far, everyone has been very helpful and informative. I am not trying to play dentist, but I have tried to learn as much as I can and am not afraid to ask questions. For the most part, they seem to like that, which makes me much more comfortable. And like I said, I am happy that I can go to one spot for the complete treatment, rather than seeing 4 separate pros at four separate locations.
I expect the corticotomy to be painful, I think the extraction will also not be fun, the tooth seems to be part of the bone, but I'll be fine. I've read up on the wilckodontics site and I guess I am surprised that this procedure is not more common - it seems like a pretty small concession for a 50% reduction in time. But I also have lots of room for my teeth to move, I understand that a normal smile or crowded teeth do not respond as well to this procedure...
I have some other questions, but I think I'll wait until after thursday.
Hi -- I'm new to the site, but hope my experience can help.
I had a maxillary expansion via corticotomy and palatal expander last November. My problems were malocclusion/collapsing of the lower teeth/crowding. My orthodontist said he wouldn't even try to put on braces without expanding my upper jaw, it was so narrow. I found a really great oral/maxillofacial surgeon whom I really trust. Along with the corticotomy, he removed all four wisdom teeth.
As for the surgery, I was out completely, and stayed out for a number of hours afterwards. Then I was on pain meds, but gave them up the next day in favor of Tylenol. In my case, the surgery cut the nerves, so I couldn't feel anything. I had tenderness under my nose as that was the point of maximum expansion. There was swelling and bruising (mostly from the wisdom teeth) and slight dizziness which lasted a number of weeks. Numbness of the upper jaw means you cannot feel when you brush your teeth, but with a mirror, you will prevail. Might want to ask your surgeon about his take on the numbness.
In my case, the corticotomy was not intended to speed up the straightening, but rather to make room to form a healthy bite. In addition, breathing through my nose has become normal and I've regained a sense of smell I didn't realize I'd lost. So, it's been a really great thing for me.
As for braces, I have self ligating metal ones. I thought about ceramics, but figured I would probably find a way to stain them (as I have done with the clear ties... spaghetti sauce is a downfall). My orthodontist's experience is that the metal self ligating work faster -- probably due to the fact that they're harder to break or mess up
In any case, the metal ones are indeed visible, but I don't mind and they go well with silver jewelry!
I had a maxillary expansion via corticotomy and palatal expander last November. My problems were malocclusion/collapsing of the lower teeth/crowding. My orthodontist said he wouldn't even try to put on braces without expanding my upper jaw, it was so narrow. I found a really great oral/maxillofacial surgeon whom I really trust. Along with the corticotomy, he removed all four wisdom teeth.
As for the surgery, I was out completely, and stayed out for a number of hours afterwards. Then I was on pain meds, but gave them up the next day in favor of Tylenol. In my case, the surgery cut the nerves, so I couldn't feel anything. I had tenderness under my nose as that was the point of maximum expansion. There was swelling and bruising (mostly from the wisdom teeth) and slight dizziness which lasted a number of weeks. Numbness of the upper jaw means you cannot feel when you brush your teeth, but with a mirror, you will prevail. Might want to ask your surgeon about his take on the numbness.
In my case, the corticotomy was not intended to speed up the straightening, but rather to make room to form a healthy bite. In addition, breathing through my nose has become normal and I've regained a sense of smell I didn't realize I'd lost. So, it's been a really great thing for me.
As for braces, I have self ligating metal ones. I thought about ceramics, but figured I would probably find a way to stain them (as I have done with the clear ties... spaghetti sauce is a downfall). My orthodontist's experience is that the metal self ligating work faster -- probably due to the fact that they're harder to break or mess up
In any case, the metal ones are indeed visible, but I don't mind and they go well with silver jewelry!
thanks Wired1
Looks like corticotomy is a general term for any sort of induced trauma to the jawbone (or bone in general). In my case, the procedure will involve them making lots of little holes under my gums, which then puts my system into overdrive to repair the area, and allows for the teeth to move more freely and faster. I don't "need" the procedure - but the amount of time in braces is a major consideration for me. Even if I can save a few months, it is hopefully worth the discomfort and extra expense. We'll see.
I have heard that staining can be a major problem - I love coffee and darker beer. Do I have to give that stuff up?
I'll post again later - I might even figure out how to get pix up...
Looks like corticotomy is a general term for any sort of induced trauma to the jawbone (or bone in general). In my case, the procedure will involve them making lots of little holes under my gums, which then puts my system into overdrive to repair the area, and allows for the teeth to move more freely and faster. I don't "need" the procedure - but the amount of time in braces is a major consideration for me. Even if I can save a few months, it is hopefully worth the discomfort and extra expense. We'll see.
I have heard that staining can be a major problem - I love coffee and darker beer. Do I have to give that stuff up?
I'll post again later - I might even figure out how to get pix up...