question for those who had 3-piece Lefort 1

[suetemi]

Did you have a gap between your teeth after the surgery the way one would with a SARPE?

From a recent thread, I think spartafan said a 3-piece Lefort was when the surgeon cut the upper palate into a Y-shape. With the palate being cut into 3 pieces with a Y-cut, if it's the anterior part of the palate that's the "top" of the Y, then since the anterior part of the palate isn't being cut all the way through and I shouldn't have a gap. If it's the other way around, I would have a gap. Does that make sense? From the descriptions I've read of 3-piece Lefort 1, I'm having a difficult time getting a visualisation of how it works. Thanks

[spartanfan72]

Did you have a gap between your teeth after the surgery the way one would with a SARPE?

From a recent thread, I think spartafan said a 3-piece Lefort was when the surgeon cut the upper palate into a Y-shape. With the palate being cut into 3 pieces with a Y-cut, if it's the anterior part of the palate that's the "top" of the Y, then since the anterior part of the palate isn't being cut all the way through and I shouldn't have a gap. If it's the other way around, I would have a gap. Does that make sense? From the descriptions I've read of 3-piece Lefort 1, I'm having a difficult time getting a visualisation of how it works. Thanks

I gotta admit, I don't know as much as I probably should about the procedure they did on me. It was like I wanted information before hand, but not too much. I didn't want to hear the gory details, just the results.

That being said, I don't have a gap between any of my teeth right now, but I do still have the splint on for 2-more weeks. Had my 4-week checkup on Wed. and the OS was VERY pleased. Said my bite is settled in perfectly and I have no problems. Still slight swelling and numbness but that is to be expected.

Before surgery, my orthodontist said down the road I might need veneers on my lateral incisors. He said they are undersized from being crowded for so long. With the surgery to widen my upper jaw, he said there would be small gaps on each side of the lateral incisors. Veneers would make them the size they should be and eliminate the gaps.

Hope this helps....

[spartanfan72]

Saved a pic off the web and did a crude paintshop drawing on what I "think" they did to me. It's what the OS showed me on a model before the surgery.

[suetemi]

Hi Spartanfan, thanks for your diagrams! And I'm relieved to hear that there's no gap involved between the front teeth. But there are two gaps on the side though...I wonder if they do the 3-piece Lefort just to not create a gap in the front, or if there's another (structural or functional) reason they do it this way (the Y-incision as opposed to just cut in half and expand). Does your upper palate feel stable despite it being separated in 3 pieces? I know you're still wearing the splint so maybe you can't tell til it comes off. Can't your ortho close your gaps with a powerchain instead of getting veneers?

[spartanfan72]

Hi Spartanfan, thanks for your diagrams! And I'm relieved to hear that there's no gap involved between the front teeth. But there are two gaps on the side though...I wonder if they do the 3-piece Lefort just to not create a gap in the front, or if there's another (structural or functional) reason they do it this way (the Y-incision as opposed to just cut in half and expand). Does your upper palate feel stable despite it being separated in 3 pieces? I know you're still wearing the splint so maybe you can't tell til it comes off. Can't your ortho close your gaps with a powerchain instead of getting veneers?

Everything feels tight, but again that may be due to the splint. My OS did say they widened my jaw as much as physically possible. He said it was more than he expected to have to widen it before surgery. I think that was the reason for a 3-piece over a 2-piece...the amount they had to move it.

I suppose the ortho could close the gaps with a powerchain, but that would be moving my teeth "in" and thus doing the opposite of what the surgery was for. The OS said the day my splint comes off, he made an appointment with the orthodontist for the same day. He will then put some kind of "wire expander" on my upper jaw, not to widen it, but to keep it from regressing back to it's orignal size.

He said this is temporary and nothing like the splint I have on now. I shouldn't have any chewing restrictions with it on.

I do find it weird and kind of hard to brush my back teeth now. Before I had so much room due to the jaw being so narrow. Now it seems like my teeth are so much closer to the inside of my cheek it's hard to get the brush back there.

[spartanfan72]

duplicate post

[Arvensis]

I had three piece lefort and I'm three months out from surgery (further than Spartan Fan, Splint has been off since Jan). I had a big gap on one side, no gap on other, of my front four teeth - this is because one side was smaller than other and needed to be expanded more. I did have a small gap in between my front teeth, but this is because the teeth were wired into the splint and weren't quite where they were supposed to be, and has since been corrected no problem.

We're not closing the gap on the left with powerchain - going to use bonding material instead (perhaps similar to veneers in concept?) - because it is too large and don't want to mess with the bite since the bite is almost perfect as it is right now. I had one powerchain, but now I'm currently wearing elastics to deepen my bite, IE moving upper teeth forward basically, over the lower. I'm probably getting braces off in April.

As for stability, I've been eating sandwiches and the like since immediately after getting my splint off, everything feels pretty good:) I can chew better than I've ever chewed before in my life! Also starting to get feeling back in my teeth now, just in time for most recent braces adjustment.

I didn't have my upper expanded as much as SpartanFan - about 1-2 mm expansion, and 6 mm forward. I can reach the back teeth much easier to brush than before - there's now space in the back.

[ohmyjaw]

I had a 3-piece lefort and I had only tiny gaps on the sides. I believe the reason for the 3 piece cut is so that the surgeon can manipulate the front and sides of the upper jaw independently.

My upper jaw felt pretty stable. I have a lot of screws and plates - you should see my x-ray. If I poke around my mouth, where my gums meet the inside of my cheeks, I can actually feel the ends of the plates. I was also wired shut for the first 10 days. I never had a splint.

The gaps were easily closed with powerchains. However, I have always felt that my laterals are too small, and I wonder if veneers would be a good option for me.

[suetemi]

After the 3piece Lefort does it feel OK to run or jump around and generally be active? Or do you feel physically limited in any way due to any strange post-surgical sensations or the rigid internal fixation? I can't imagine what it would feel like to have my upper palate and mandible full of plates and screws...I mean, I won't have to imagine it in a year or so. Can't wait, actually. Thanks for your replies!

[ohmyjaw]

Well, you feel physically limited by the fact that you've just had surgery and your're exhausted and can't eat properly.

But no, I didn't feel limited by any feelings in my jaw. I did have one strange sensation a couple times; it was like my face was being squeezed, but it only happened when I was lying down.

I don't actually "feel" the plates and screws in my face. But I can find them when I touch my face - with a bit of pressure - there are definitely hard bumps there.

[suetemi]

Well, you feel physically limited by the fact that you've just had surgery and your're exhausted and can't eat properly.

Hehe, I should have included that I meant well after surgery, like months or a year after.

[Emaciated]

I had a very minor gap, like 1mm on one side but its been fixed by the braces since.

I still feel slightly strange sensations when..

a) working out extra hard
b) sometimes when sneezing
c) sometimes when blowing my nose

I do gymnastics and can feel my upper jaw when I do a handstand. That's pretty much the only time I feel it. I assume that's because all the blood is rushing to my head.