So how is asymmetry of the lower jaw corrected??

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#1 Post by **dvdrdiscs** » Wed Oct 20, 2010 5:29 pm

Long story short, I just had one of two pre-op appointments with my surgeon and I got nothing out of him in regards to what he is going to do. I have an underbite and asymmetry. From watching videos and reading up on it, I know the lower jaw can be pushed back and forward to correct under/over bites. But I'm curious as to how asymmetry is corrected by just moving the lower jaw? More specifically, my jaw is off centered and one side of my teeth touches the top while the other doesn't. Therefore it is also tilted vertically.

Anyone with a similar case can fill me in as to how it could be corrected since the only thing I can get from my surgeon is "I'm making a compound fracture and moving your jaw"?

#2 Post by **chicago29** » Wed Oct 20, 2010 6:09 pm

1) If the surgeon won't tell you exactly what they are going to do, run like hell. Find a new surgeon as that's a terrible sign.

2) I would say you're looking at a BSSO. They can move the lower jaw forward/backward and also rotate it clockwise or counter-clockwise. In addition, depending on the level of asymmetry, the surgeon may not even operate on both sides.

Good Luck!
Chicago29

#3 Post by **Marisama** » Wed Oct 20, 2010 6:19 pm

I have wondered the exact same thing for a long time. I have asymmetry as well and I don't understand how a BSSO can completely correct asymmetry. The length from my condyle (jaw joint area) to my gonial angle (corner of jawline, google it) is longer on one side than the other. The surgeon does not make any cuts between these two points. It just doesn't make much sense to me. I would love to hear other's thoughts on this.

#4 Post by **yvonner1991** » Wed Oct 20, 2010 6:24 pm

I have the exact same thing. My dentist said he has to put braces on my teeth and use rubber bands that slide your jaw to the center, i had them for a while but took them out because it pushed my jaw forward a lot. However, it's only temporary until you have your surgery.

#5 Post by **dvdrdiscs** » Wed Oct 20, 2010 6:44 pm

If I had options, I would run. But I don't and I don't think this surgeon is clueless per se. He has very good credentials and he is who my orthodontist works with 99% of the time when there is a surgical case. I just think he's done so many jaw surgery that it's very routine for him and he has forgotten that it is a new and scary thing for each patient.

From a pamphlet I read in his office (which I got more information out of than his own mouth), it seems like asymmetry can be corrected by a cut down the mandible behind the molars. The cut isn't a straight vertical cut but rather at an angle. For example, if you are to view the mandible from the top, the vertical cut would be diagonally straight down. From there, it can be moved left/right or forward/back. To correct the vertical alignment, it can also be moved up and down, one side more-so than the other to level them out. In a sense, I can understand how asymmetry can be corrected but every case is different and it is always nice to hear how your own particular case will be handled.

#6 Post by **rooney9995** » Wed Oct 20, 2010 7:46 pm

I'm planned for upper and lower jaw surgery to fix an underbite/asymmetry as well. This is what I was told in writing:

Bilateral Sagittal Ramusotomy: Moving the mandible 4mm back, 4mm up, and 2mm left, to correct the prognathism and laterognathia, complete correction of the apertognathia, and establish the framework for a functional occulsion

#7 Post by **boatsink** » Wed Oct 20, 2010 9:50 pm

That's interesting - I've been wondering about this question for sometime as well. I have asymmetry, crossbite that will require surgery. Thanks for the feedback. I'll be sure to ask my surgeon when I go in for my surgery consult, which is...who knows when. If I have any insight, I will definitely share.

#8 Post by **TwitBerry** » Thu Oct 21, 2010 2:57 am

Dvdrdiscs, Have you asked your ortho to sit down and explain the plan to you? If he doesn't know, ask him to find out and have him set aside time to go over the details.

#9 Post by **Marisama** » Thu Oct 21, 2010 12:19 pm

Usually, mandibular asymmetry is occompanied by upper jaw surgery as well. This is called an "occlusal cant", and needs double jaw surgery to correct.

#10 Post by **Marisama** » Thu Oct 21, 2010 12:26 pm

There needs to be an edit feature here. I meant to say... Usually, mandibular asymmetry is occompanied by upper jaw asymmetry as well.

#11 Post by **dvdrdiscs** » Thu Oct 21, 2010 4:00 pm

rooney9995 wrote:I'm planned for upper and lower jaw surgery to fix an underbite/asymmetry as well. This is what I was told in writing:

Bilateral Sagittal Ramusotomy: Moving the mandible 4mm back, 4mm up, and 2mm left, to correct the prognathism and laterognathia, complete correction of the apertognathia, and establish the framework for a functional occulsion

LOL. That may have been Japanese that I'm reading.

#12 Post by **dvdrdiscs** » Thu Oct 21, 2010 4:01 pm

TwitBerry wrote:Dvdrdiscs, Have you asked your ortho to sit down and explain the plan to you? If he doesn't know, ask him to find out and have him set aside time to go over the details.

According to him, he's already gone over the surgery with me. Quoting him directly "I'm making a compound fracture and moving your lower jaw." That's as detailed as he's been.

#13 Post by **dvdrdiscs** » Thu Oct 21, 2010 4:03 pm

RYANvaughn wrote:There needs to be an edit feature here. I meant to say... Usually, mandibular asymmetry is occompanied by upper jaw asymmetry as well.

My upper jaw doesn't appear to be asymmetric. The midline of my top teeth is lined up fine with the middle of my nose and lip. In terms of level, it doesn't appear unleveled either. I can tell it's my lower jaw because one side of my teeth doesn't touch and the midline is veered to the left.

#14 Post by **TwitBerry** » Thu Oct 21, 2010 9:26 pm

dvdrdiscs wrote:
TwitBerry wrote:Dvdrdiscs, Have you asked your ortho to sit down and explain the plan to you? If he doesn't know, ask him to find out and have him set aside time to go over the details.
According to him, he's already gone over the surgery with me. Quoting him directly "I'm making a compound fracture and moving your lower jaw." That's as detailed as he's been.

But, have you had your orthodontist explain the surgical plan? If not, I would recommend that you have this conversation with him.
Your surgeon sounds like mine did. I hope you get answers.