Lower Jaw Narrowing vs Multipiece Lefort I or SARPE

[cam123]

I was wondering if anyone could point me towards some posts or links with information about lower jaw narrowing?

I have a minor size discrepancy (lower wider than upper and mostly just in my back teeth) which could be fixed by either by doing SARPE, multi-piece lefort 1, or by narrowing the lower jaw. The lower jaw will be moved anyway due to asymmetry/cross-bite, so it is a question of whether to have double jaw surgery or just lower jaw surgery. Besides being a little on the narrow side, there is nothing wrong with my upper jaw, like tilting etc. It seems that the SARPE and multi-piece lefort 1 procedure is very common but I cannot much on the internet about narrowing the lower jaw. For the procedure, they would split my chin down the middle, and tilt the lower jaw bones in slightly so that my back lower teeth would come closer together. Has anyone on this message board had this done?

[chicago29]

A SARPE and 2 piece LeFort are really the same thing. The only difference is with a SARPE they do not downfracture the jaw (in other words, it isn't sawed off your face...it still keeps some bony contact during the procedure). Sorry for my use of "sawed off", but that's the reality of it

Anyway, I'd be very hesitant about "narrowing the lower jaw". I've personally never heard of that, and with jaws it always seems like we need MORE space and not LESS. I would think they could expand your upper arch to accommodate the size of your lower arch. That seems much more in line with the experiences of people on this message board.

If I were you I'd get 2 or 3 opinions from board-certified oral surgeons, and go from there.

Best of Luck!
Chicago29

[crookedsmile1]

If you are overall pleased by your appearance I would go for just the lower jaw surgery. Upper jaw surgery sometimes can make a dramatic change in your facial appearance...good or bad. But mostly good

But typically most people seek a wider smile and fuller upper face and would benefit from upper jaw surgery.

[Brant]

If the only reason they are considering upper jaw as well as lower is because of a pretty small difference in the widths of the jaws, then a midline osteotomy on the lower jaw avoids the need for surgery on both. It can be a good choice for some people.

It's not such a common procedure, but they've been doing it for years. Just Google for it. First hit I got was http://articulos.sld.cu/ortodoncia/file ... 502e11.pdf It's not exactly the same type of problem being treated, but it's the type of operation you're talking about and it gives lots of other references.

[breezy27]

Hi there!
I had the exact same problem - my lower jaw was slightly wider than my upper jaw, which was otherwise 'normal'.

My surgeon didn't even present me with options - while I had my lower jaw advanced forward 10mm to correct an overbite, he also narrowed it in the manner you describe. Apart from some lingering numbess on my chin and some residual swelling, I can't tell the difference from a "normal" BSSO.

there was no additional pain, complications or problems. I couldn't feel the 'split' from the inside of my mouth at all. I am very happy with the way my teeth fit together and with my appearance (I am 5.5 weeks post op).

I ended up with one plate, and 4 additional screws in the front to hold it all together.

I hope this information helps!