SARPE Surgery

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luke88
Posts: 87
Joined: Wed Aug 08, 2007 9:22 am

#871 Post by luke88 »

crazybeautiful wrote:When your ortho thinks you've had enough expansion, he/she will either put some cement on the hole or wire or something, so you won't be able to carry on expanding! Sorry :wink:

Also, think that braces will make your arch more rounded, so your top jaw may still look too small, but you wouldn't have had the surgery if there wasn't going to be too much difference in your jaw, right?


Can you not chew because you're in pain? I was eating basically normally (if a little more tenetatively) by like, day 3, and I can't imagine SARPE causing someone to be on soups past the first few days (if that)....just saying for your own good, you know; I wasn't going to succumb to a liquid diet just for SARPE. I'll save that for my bimax. :wink:
Thanks for replying.

Next Wednesdy i think they're going to close it up for me so I can't do any more expanding. I just hope then that the braces help to align my upper jaw with my bottom one, probably that is the plan.

I can't chew because my top jaw is too fragile. My teeth on both sides are covered in some plastic stuff, my front two teeth are not coevered though. My orth said I should be able to start eating after I have stopped expanding. My current diet consists of th diet stuff the NHS gave me and very very soft stuff such as potatoes and soup which I just swollow. I really could do with a Maccy D's! haha Most of my selling has gone now but I'm still bruised.

Delag
Posts: 834
Joined: Sat Mar 25, 2006 4:46 pm

#872 Post by Delag »

Hi Guys!

Luke - listen to your doctor. If you over expand they will have to turn you back. There comes a point when you have to trust that your doctor knows what he is doing and has your best interest at heart. The last few days of expansion are tricky and you will see a lot of movement - more than you did in the first few days. I never got my expander tied off, but then again I suspect I might still have a turn or two in my future.

Saurekraut - it feels like one half of my maxilla is lower than the other and I can feel the difference in the two halves right there in the middle. It isn't huge , just new.

Crazy - how is that coil treating you? You were really eating normal food by day 3? I was told 'no chew' for 6 weeks. I still can't chew now because only one tip of one side of my molars touch.

I felt a weird thing happen the other day. I yawned and felt like my upper lip split in two. I touched it expecting to feel a bloody split lip, but it was fine. I had an appt with the OS the next day and he said I pulled something I shouldn't have (and internal stitch?), but he didn't look too stressed. I am happy to say that I have a bit more feeling and movement in my lip so even if I did a bad thing, it feels good :D

crazybeautiful
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Joined: Thu May 24, 2007 2:20 am
Location: Yorkshire, England

#873 Post by crazybeautiful »

Yep, I was staight back to normal foods. Ok, I didn't have anything majorly hard, but overall I was eating as I did before. I think also, because only my molars on my left side touch anyway (as in, all my life), I am used to eating that way, so it wasn't a big change for me at all. I think it will be harder for me to adapt when all my molars touch! :shock:


My coils aren't bothering my now, which is good. The extra wires at the back of each 4 molars keep catching my gums, but everyday it's a different wire- so the wax is moving round my mouth quite a bit :lol:
~SARME, Nov 2007. 10mm expansion

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My blog: http://crazybeautifulsurgery.blogspot.com/

sauerkraut
Posts: 573
Joined: Tue Sep 04, 2007 2:57 pm
Location: Germany

#874 Post by sauerkraut »

How's everyone doing?

I had my extraction today - I needed one lower molar (I think! 4/4 if that means anything to anyone) taken out. I think my dentist was quite pleased with herself that she managed to negotiate this heavily filled tooth with LONG bendy root out past all the metalwork in my mouth (I still had the archwire in) without causing any damage. And I was pleased that I didn't feel a thing, not even the needle going in at the beginning.

I have to go back in a couple of days to make sure all's healing up OK, and to check that the neighbouring teeth - which were scrunched up alongside the removed one - don't have any decay in them. She thought it looked ok from what she could see today, so - so far so good!

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badbite
Posts: 450
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Location: Pennsylvania

#875 Post by badbite »

sauerkraut, What will you do with the space? I am missing #30 and will probably go the implant route if I am a canidate (may as well go all the way).

I am doing well. Braces are three weeks old now and no problems. I can't wait to get my lowers and see movement. I can already see a difference in my uppers!

Still no TPA and still worried about relapse.
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RPE in on Jan 7, 2008
SARPE on Jan 11, 2008 expanded 7 mm
RPE out on May 14, 2008

crazybeautiful
Posts: 745
Joined: Thu May 24, 2007 2:20 am
Location: Yorkshire, England

#876 Post by crazybeautiful »

Hi guys- I'm doing ok still, and glad you all are too :)

Brushing is a pain because I have to hold up my top lip to brush my canines- so I found a litle mini-brush to get all the nooks and crannies that I can't really get to. Also, I physically cannot fit floss between some of my teeth (in fact, most of them now!) because they are so tight- it's bothering my because my gums are going to get so bad if I don't floss- but I just cannot get it between my teeth :?

When I had my 2 teeth out, the roots had fused together, so they came out really easily. They looked a bit strange with just one chunk of root, actually :lol:
~SARME, Nov 2007. 10mm expansion

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My blog: http://crazybeautifulsurgery.blogspot.com/

nesnob
Posts: 19
Joined: Wed Jun 04, 2008 11:08 pm

SARPE vs. Le Fort 1

#877 Post by nesnob »

Hi,

I have a question for the wise elders who have trod this path before ...

When my Ortho first described SARPE, he described the operation as "releasing" the jaw with a chisel, and there's a video on YouTube that appears to be the same thing.

However what my Oral Surgeon is now describing is apparently very similar to a Le Fort 1, in that he plans to section the bone all along my upper gum line, but leave something attached on each side at the back. And then there is some kind of chisel action below (or inside?) my nose. This all sounds a bit grim, however he also calls this SARPE. I get the feeling my Ortho is happy to leave the cabinetwork work up to the surgeon either way.

Are these just two methods of the same process? What is the difference between SARPE and Le Fort 1?

My primary concern is the recovery time. Any information or advice would be very much appreciated!

sauerkraut
Posts: 573
Joined: Tue Sep 04, 2007 2:57 pm
Location: Germany

#878 Post by sauerkraut »

Badbite, it was my ortho wanted the tooth extracted so I imagine he needs the space and in time it will be filled when the other teeth all move where they’re supposed to. My teeth really are super-overcrowded! Presumably you’ve got to wait until everything else is done before you can decide about an implant? Glad you’re getting on ok with the braces, still. Have you mentioned your concerns about relapse to your ortho? Try not to worry, I’m sure he knows what he’s doing!!

Crazyb, I know what you mean about the struggle to get at the obscure places to brush & floss. I’ve also had such problems for years and I’ve had periodontal disease and now have badly receding gums. All a bit of mess, really! The dentist and the ortho both think it’s quite likely more weak spots will come to light when new surfaces are exposed. I had my extraction site checked on today, and the newly revealed side of the tooth next to it is showing signs of demineralization, but no actual cavities, thank goodness. Oh and do you manage to floss the teeth where the molar bands are? I’ve almost given up on the teeth right at the back, what with having to thread through wires and past metal bits to try and find gaps that aren’t really there!!

Luke88, how’s it going? Have you finished expanding now?

Delag, any more problems with your upper lip thingie? (I said I wasn’t one for technical terms!) It sounds like your ridge is something a bit different from mine, so I shall just continue being weird on my own!!

Nesbob, hi and welcome! I can’t help out much with the technical terms I’m afraid, I just call the op I had SARPE because it sounds like what everyone else here had. It would be different in German anyway, but the surgeon did put something about LeFort on my notes as well. Before my op the OS showed me with pencil lines on a model all the places he would be making an incision – basically, like you say, all along the upper gum line – to release the bone. I ended up thinking it would have been simpler if he showed me where he intended NOT to make an incision :wink: . The hammer and chisel bit comes in, I think, when they crack open the suture line, along the top of the mouth where the two halves of the palate have fused together. Bit like cracking open a coconut, I suppose. Fun, eh?

As for recovery times, it’s hard to say, really, as everybody’s different. A lot of it depends on how you respond to general anaesthesia – assuming you’re having a general, and not being operated on under waking sedation, which some people do. I have a few other medical issues which mean it takes me a long time to get fit again after an operation, so I was exceptionally tired for many weeks afterwards. But I was still back looking after my 3 kids and doing some work from home within just a few days of the op. Make sure you get as nutritious a diet as possible, even if you have to liquidize everything, as that really helps. There’s a sticky at the top of the page with recipe ideas.

When is your op, do you have a date for it yet? Do you already have the expander in?

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badbite
Posts: 450
Joined: Fri Oct 12, 2007 10:11 am
Location: Pennsylvania

#879 Post by badbite »

nesnob, Many OS's use the terms Leforte 1 and SARPE as the same thing. My paper also said Leforte 1 though the surgeon kept saying SARPE. My recovery was a bit rougher than some on this board, but I felt better after about two weeks. I have a very demanding job with little childreen and babies and I went back to work after only thee days. Big Mistake!! Plan on taking a week off. It is beginning to feel like a distant memory now. I ate mashed potatoes and slim fast for the first week-two weeks, then started eating more solid foods gradually. It felt to me like I was trying to chew with marshmellow teeth. It didn't last long though.

sauerkraut, yes the implant is a long way away, and my ortho won't even let me bring it up. He said wait until EVERYTHING is done. He is leaving the space open though. Oh and he knows I am worried about relapse, he is not worried about it. I am wondering what he'll say at my first adjustment. I think I have relapsed some already.

On the up side, I can fianally floss most of my teeth after 32 years of struggling to get between them. I actually have spaces now. Some teeth are still too tight, and the braces don't make it easy, but I can do it now. The SARPE has really made a lot more room in there.
Image

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RPE in on Jan 7, 2008
SARPE on Jan 11, 2008 expanded 7 mm
RPE out on May 14, 2008

kimblebee
Posts: 30
Joined: Fri Nov 30, 2007 5:19 pm

#880 Post by kimblebee »

I had SARPE / LeFort done this past Tuesday. I was told to start brushing my teeth yesterday and to make sure I get around my stitches. The hard part is that I'm so swollen that I can't see where I'm brushing and can't really feel it. There is a bit of blood when I do brush and I'm going very gentle. I'm worried I may not be cleaning it properly or enough. The last thing I want is infection. I am rinsing with saline wash regularly and peridex. I also have a little syringe I've been using to squirt saline water up around to keep it clean. I'm just worried. :(

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badbite
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Location: Pennsylvania

#881 Post by badbite »

kimblebee, You can also take a q-tip, dip it in the peridex, gently lift your upper lip and wipe it up there. That will help heal and get rid of plaque/bacteria. I thought I was cleaning well until I went for my first post-op. There was tons of plaque in my upper lip and that is what he told me to do. I also didn't realize I had been forcefully brushing my gums, but I didn't do any damage in that short amount of time.
Image

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RPE in on Jan 7, 2008
SARPE on Jan 11, 2008 expanded 7 mm
RPE out on May 14, 2008

kimblebee
Posts: 30
Joined: Fri Nov 30, 2007 5:19 pm

#882 Post by kimblebee »

Thank you so much for your reply and suggestion. I will definitely start doing this.

nesnob
Posts: 19
Joined: Wed Jun 04, 2008 11:08 pm

#883 Post by nesnob »

Thank you everyone for replying.

I feel a bit better about it now ... I guess I was just nervous, but have now swung round to feeling more positive about it again :-)

The width of my palate between my two pre-molars is now only about the width of a finger, and I think has got narrower over the last few years (I'm now 33), so something has to be done. Most photos of PEs have "legs" attached to the ratchet in the middle, but my mouth is so small the ratchet is effectively attached directly to the bands by a big lump of solder!

I've had both the PE and upper and lower braces cemented in for about a week now, and they don't really bother me too much at all (er ... apart from eating and speaking!). My ortho plans to keep them in for a month to ensure they fit, and allow me to adjust to them. Then hopefully one quick check-up, and surgery soon after.

There are a lot of interesting stories here. I wish everyone good luck and a speedy recovery!

luke88
Posts: 87
Joined: Wed Aug 08, 2007 9:22 am

#884 Post by luke88 »

sauerkraut wrote:
Luke88, how’s it going? Have you finished expanding now?
helps. There’s a sticky at the top of the page with recipe ideas.
I did two turns of expanding for ten days and I was initially worried that I didn't feel it was enough but I was wrong. I am very pleased with the results, my upper jaw now looks more real, it actually fits with my bottom jaw, although not perfectly but it's much more aligned now than it was before the operation. I still have some swelling on my cheeks and gums and this is despite me being 4 weeks post op. My gap has started to close a lot now, I don't notice the gap closing as much as my friends do, probably cause I look at it a lot but they all say it's closed a lot. There's around a 5mm gap now, I have no idea how big it was after the expansion had finished. I'm currently in the healing process now, the expander can be a right pain when eating as food gets stuck but I can eat absolutely anything I want, it just takes you a lot longer because my upper jaw isn't strong enough to be munching on really solid foods or on meat products.
I'm seeing my orthodontist in 10 weeks time, I gather this is to check my progress, make sure everything is healing going fine, by this time, the expander would of been in nearly 4 months! I'm hoping by this point there will be be a decision made to take the expander out and fit my braces, but who knows, but currently I'm happy with the progress and think the healing process has been quite rapid, especially for me as I swelled very badly.

Elspeth
Posts: 51
Joined: Mon Mar 24, 2008 3:17 am

#885 Post by Elspeth »

I was a bit worried that I'd have to have a SARPE, but talking to my ortho today, he said that I probably won't need to (and I jumped out of joy, sort of, because I really can't afford it) but I would need an expander thingy for my very narrow palate. Apparently I'm young enough or something for the expander to do the job without the surgery.

How does the expansion of the upper pallate affect the appearance of your face? I'm really curious if it does. :P

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