My long intro: Bimaxillary protrusion, jaw surgery, and more

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Udjat
Posts: 4
Joined: Fri Nov 12, 2010 6:59 pm

My long intro: Bimaxillary protrusion, jaw surgery, and more

#1 Post by Udjat »

Hey everyone, I’ve finally joined after a few weeks of lurking around for info. I’m really happy I found this place! I’ve gotten a lot of information about procedures I had no idea existed that might be able to help me.

(Warning! Long introduction ahead)

So here’s some background info about why I’m here:

I had braces way back in 1997 when I was in 5th grade to correct some teeth that were rotated out. I don’t remember what else was wrong as I was pretty young. I believe I only had them on for about 2-3 years. Fast forward 10 years later, My teeth are in decent condition but I have an overbite and teeth that are slanted out.

For the longest time I thought, okay, sure I’ll just get a chin implant but I felt like it just wasn’t my chin. Turns out with some Google-fu, I learned I have serious lip incompetency and possibly bi maxillary protrusion. I’m pretty sure I have the unlucky combination of both a very under developed lower jaw and bi-maxillary protrusion. I’ve seen quite a few pictures of people who have bi maxillary protrusion but it appears they still have a significant space between their lower jaw and neck. Whereas I do not. It literally looks like the lower half of my face melted into my neck. :/ I have to strain quite a bit to get my lower lip to meet my upper lip. If I let my jaw hang slack my mouth is open giving me a kind “duuuh” face. I kind of feel like I have to clench my teeth together to keep my mouth shut. I try an avoid that due to my TMJ. My mouth gets awfully dry at night because of my lips not resting together.

I have Kaiser Permanente and from what I’ve heard, they tend to cover orthognathic surgery. I don’t know if I qualify because Kaiser’s guidelines for jaw surgery specifically say that bi maxillary protrusion is aesthetic. I have tmj issues to the point where just a cleaning from my dentist can get my jaw very sore and it will start to lock up. I’m hoping that will get Kaiser to cover it.

I live Washington but I just flew in to CA to get my referral for an oral surgeon.
Kaiser wants me to do physical therapy first before I get surgery. I did manage to get an appointment with one of their TMJ specialist and then I get to see the oral surgeon I think. I know physical therapy may help my TMJ but I still want the surgery.

It will be a while but I’m very serious about getting this done. I’m going to have all four wisdom teeth taken out this December but unfortunately done at separate times due to the dental insurance. I don’t get to be knocked out either because of cost. Then I will get a consultation appointment for redoing my orthodontics which will be in Washington state. I don’t think there is a whole lot to do in terms of straightening my teeth since I went through that when I was younger. I will be paying out of pocket for my orthodontics because all my insurance will have been used up for my wisdom teeth.


Unfortunately, my oral surgeon for my wisdom teeth told me that because my wisdom teeth have been in so long, the roots have fully grown out into the bone and very close to a major nerve in my lower jaw. I asked him what the chances of damaging my nerves during the wisdom teeth extraction and he said about 3%. I’m hoping that is true and my nerves won’t be damaged in either surgery..

If all goes well, I will join the ranks of all those who’ve had successful jaw surgeries. :D

It’s going to be tough going back and forth between California and Washington but I think it’s worth it.

When I saw my OS for my wisdom teeth, I asked him what kind of orthognathic surgery I would most likely receive. He told me they would probably rotate my lower jaw so that it will push out my chin.(yay!) They might also move my top jaw forward too. I was hoping for just a Le Fort I for faster recovering but I’m all for a Lefort II if it’s going to improve my looks dramatically. ( I forgot to grab a copy of my panoramic xray but I will post it once I get it.)

I have a bunch of questions here, if anyone can relate or give me their experience. I would appreciate it.


Anyone get their surgery done with Kaiser in Sunnyvale, Santa Clara or in the Bay Area California ? What was your experience with Kaiser? Any recommendations for an OS ? I did some research and so far the two doctors that come up in that area are Dr.Desai and Dr.Bui. Also what type of surgery did you have?

If you had/have bimaxillary protrusion or retrognathic chin , did you have surgery and what were your results?

This is question for those who’ve had their bottom wisdom teeth erupt horizontally.

If you had lower jaw surgery and had your wisdom teeth taken out, did you have any complication with the bones in your jaw? Damaged nerves?

If you had geinoplasty done along side jaw surgery, how much did it cost out of pocket or was it covered?

Whew, I can’t think of anything else but I’d love to hear about your personal experience regarding any similar situation!

Rodney008
Posts: 90
Joined: Wed Jun 16, 2010 10:20 pm

#2 Post by Rodney008 »

As for the horizontal wisdom teeth I had them extracted before my surgery. I was told this had to be done because they were cutting the jaw bone in the location of the wisdom teeth and they needed the bone to heal for at least 6 months after the teeth were extracted.

Regarding the genio, my insurance covered everything except this. My out of pocket cost for this was $1,500.

Good luck!

Izzy1979
Posts: 77
Joined: Fri Oct 15, 2010 1:42 pm

#3 Post by Izzy1979 »

same here - had horizontal impacted wisdom teeth that needed to be removed 6 months before orthognatic surgery for the bone to heal. Ended up needed braces an additional 15 months so it sure was well healed! So far no problem with bone/healing
I had a chin reduction and lower jaw advancement (BSSO), and while my surgeon had warned me I could have permanent nerve damage after surgery he thought it would be unlikely and should return fully within 6months. I already feel a little bit on my chin/lower lip but far from normal.

Why would you need Lefort II?

Udjat
Posts: 4
Joined: Fri Nov 12, 2010 6:59 pm

#4 Post by Udjat »

Actually, I'm probably mistaken about the Le Fort II. I heard the OS mention it and I probably got confused. I meant I will probably get Lefort I done on my upper jaw and have my lower jaw moved down/rotated out. I'm actually not sure if they will set my upper jaw it back or forward but the OS did mention it's possible that I might have both jaws done.

I'm going in for my jaw surgery consultation next month and will have a more exact answer. The one I saw today was just for my wisdom teeth and I asked that OS for his brief opinion.

Glad to hear that the surgeries went well for the both of you!

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