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ADVICE NEEDED: TAD vs JAW SURGERY vs EXTRACTION

Posted: Mon Apr 17, 2017 11:32 am
by bach
Hi everyone.

I need your advice/experience to help me decide about options my orthodontist offered.
I'm in my early twenties and a few weeks ago I had my first appointment. Conclusion: a class 2 division 2 malocclusion and a deep bite.
My lower jaw is 8mm (0.31 inch) retracted in relation to my upper jaw.
As a bite naturally tends to close, my upper front teeth are tilted a little back, and my lower teeth are a little tilted forward.
If my teeth would only be aligned with braces, an artificial overjet would be created (tilting lower teeth back/front teeth forward).
This bad occlusion can be corrected in 3 ways.

JAW SURGERY:
-not really a fan of this because I am quite pleased with my facial profile (don't want to change that at all), and surgery seems a very unpleasant and far-reaching treatment option.
-It is also the most expensive option, since I would need to consult a separate jaw surgeon.
-Seen from an unbiased position, it might be the best option (creating more space in my mouth), but I am scared to death that the change in facial esthetics will be awful (protruded jaw).

EXTRACTION of 2 upper premolars, so all teeth in my upper jaw can be pulled backwards to get a normal occlusion:
-This seems not a good option at all. It seems so unnatural to have 2 perfectly healthy teeth extracted.
-I'm studying for a master of arts degree in singing and piano: this option would reduce the size of my mouth, so I can't imagine singing with proper technique with a smaller mouth (less space to move my tongue)

TEMPORARY ANCHORAGE DEVICES (hereafter referred to as TADs):

To me this seems to be the best option. By placing TADs on the upper and lower jaw, all upper teeth can be pulled back, all lower teeth pulled forward.
This seems rather painful as well, but this causes the least changes in facial profile because the movement to correct the malocclusion can be devided between the upper and lower jaw. I also dont have to abstain from contact sports for a long time which I certainly will when having jaw surgery (training martial arts 5 days a week).
My orthodontist couldn't say for sure that this would be an option. Therefor he awaits the extensive research appointment: x-rays from the side, molds of my teeth, pictures etc.
During this first appointment he only made one x-ray from the front and looked at my teeth.

Thank you far reading all of this, and I would be very happy to hear your advice/experiences/recommendations so I can ask the right questions and make good decisions!!!

Kind regards,

Bach

Re: ADVICE NEEDED: TAD vs JAW SURGERY vs EXTRACTION

Posted: Mon Apr 17, 2017 11:36 am
by bach
P.S. Next appointment for the extensive research is only within 3 weeks, so I still have plenty of time to gather information!

Re: ADVICE NEEDED: TAD vs JAW SURGERY vs EXTRACTION

Posted: Tue Apr 18, 2017 4:43 pm
by Heidirs
It looks to me like you already have a pretty good idea on what you'd prefer to do. And if it were me, I'd have the same order of preference.

Re: ADVICE NEEDED: TAD vs JAW SURGERY vs EXTRACTION

Posted: Thu Apr 20, 2017 5:58 am
by pcspinheiro
Not so dissimilar situation here, if I had ever been offered TADs would definitely choose them... As it turns out, only found out about them after killing a perfectly healthy tooth and my ortho doesn't even use them (hence not mentioning them to me). Be glad you got all the info and options BEFORE you make decisions that you may regret, like me...