Intro - And questions about BSSO and SARPE Timeline

[katsface]

Hi!

I'm brand new here, and I wanted to introduce myself quickly before I start bogging everyone down with a ton of questions

I'm Kat. I'm 28 years old, I've been married for three years, and I live in the US.

I've had three different orthodontists look at my teeth over the past 2 and a half years. The first two said my bite could be 'corrected' completely with three + years of braces . They both just looked inside my mouth to come to this conclusion. No x-rays, no nothin'. They also said that I had no jaw issues, even though I can feel problems.

The orthodontist I saw this past week did a much more thorough examination than the previous two, including digital photos, iCAT 3D imaging of my jaw and teeth, and of course, looking at/feeling my face. His conclusion made much more sense to me, given what I see in the mirror and feel in my mouth. He said I have a narrow palate, retruded lower jaw, crowding top and bottom, overbite, deep bite, cross bite, uneven jaw growth, my mid line is off, and some other things. The problems I have with my jaw have caused excessive ware on my jaw joints and it was scary to see how worn down the bone is, especially on one side.

Long story short, I trust this guy. He's made an appointment for me to see an oral surgeon in early December. He says I'll need braces, SARPE on top, and BSSO on the bottom. Didn't get a change to ask what order these procedures happen in. But, he did say the total time frame, including all of the surgeries, should be 19-20 months.

So, I guess my first question is, does 19-20 months seem realistic? He uses SureSmile in all of his cases, and he said this will speed up the process a lot. I'm also assuming that since some of the correction will be achieved (or assisted) surgically, that might speed up the process? Does that make sense? I just don't want to get my hopes up that it will be over that quickly if it tends to be a very drawn out process.

I would love to hear what others thought and what your own experience was with these sorts of procedures. Were your projected treatment times correct? Does 19-20 months seem possible for two surgeries and braces?

Thanks for your help and time!

[redwine]

In my particular case, I had lowers installed in the summer to straighten teeth, tip them back out to where they belonged and to add much needed space. Although my ortho would prefer be to wait to have SARPE for a couple more months, I hope (plan) to have it done on the 18th of December. Ortho is fine - says that he can anticipate what the lowers will do to plan for the expansion of the palate. I need to do it over the holidays because of work constraints. Then, next year (again, over the holidays) I'll be getting my lower jaw moved forward about a centimeter. A little fine tuning after that and I should be done. Total sentence: about 2 years for the whole process. Right now I'm fighting with the hospital (Johns Hopkins) for a confirmation on the date. You would think that a hospital of that size would have practically unlimited OR space, but that is definately not the case. I'm currently working with the oral surgeon, his scheduler and now a patient advocate to get this nailed down. Probably more than you wanted to know, right?

[katsface]

Congrats on having your surgery today (at least according to your ticker)!!

Your situation seems similar to mine. Only, I won't be in braces very long at all before they do the SARPE. I'm not even sure if he's going to put an archwire on the top arch until after the surgery.

So, your timeline doesn't sound too far off from mine. That's encouraging! I hope you're doing well, and I hope your recovery goes smoothly!

[e77]

I'm having Sarpe on Jan 15 - then braces will follow about 3-4 weeks later. I was given the timeframe of 18-21 months so yours seems to be about right.

[PaultheCanuck]

Hi Kat,

Your situation sounds very similar to mine - over bite, cross bite, narrow palate, crowding, midline off...

I had SARPE in June 2010, braces in Sept. 2010 (still on) and am having my BSSO and genioplasty Jan. 9/13. I am a bit older than you so your timeline sounds about right for someone your age. For me it looks like it will be approx 36-39 months total time from the start of the process to the end. I have to say that the palatal expander has been the worst part by far for me but the results were fantastic.

Good luck!

[Vantwins]

That timing sounds about right to me. I got my RPE in and had SARPE in November, got my braces on in December, should have my next jaw surgery next fall/winter and then 6 months or so to tweak with the braces and recover from surgery, so I'll probably be around 18 months as well. Can't wait to be done and hopefully have a beautiful smile!
Vanessa

[Dolphinbite]

I had my SARPE surgery back in May and my gap STILL isn't closed. Trying to be patient, but it's getting old. I am ready for the second surgery!

[awags]

The original time frame I was given was about two years, but it ended up being about three. My orthodontist had predicted my surgery would be in April of 2011, and it ended up being in December of 2011. He originally said I'd be in braces 6 months post-op, but they didn't come off for another 11 months! The prediction he gave, could be right, but just know that it's possible it could take a little longer. It all depends on how fast your teeth get aligned properly. Good luck!

[katsface]

Thanks for the info everyone! Seems like it might be possible to get this done in that time frame. I know it's possible that it goes much longer. I'll do everything I can to help the process along, though.

My estimate has changed to 20-22 months. Not really more time, just a little more precise, I think.

I still don't have a surgery date... but I'm really eager to get started! I was trying to get a date confirmed before everyone went on vacation, but it didn't happen. So, now I'm trying to get in touch with the surgeon to get a date ASAP.

There is a LOT going on in my mouth right now!


I just got (some of) my lingual braces placed on top (no archwire), and regular metal on the bottom with the archwire today, as well as having the expander installed. Its a 'bonded' expander, which means it covers my molars. Actually, it covers my bicuspids too. Because of that, I now have sort of an artificial open bight. I can't touch my incisors to each other anymore, after having an 80-90% deep bight. It's weird!

They couldn't place the lingual brackets on the teeth covered by the expander, and will place those after it's removed 6-7 months from now. Also, they couldn't place a lingual bracket on one of my lateral incisor because it partially overlaps the incisor next to it. He said they will have to move some teeth before they'll be able to put a bracket on there. But, I won't even have an archwire until after I'm done expanding, so it's going to be a while. That's the most obviously crooked tooth, so I'm really eager to get started straightening it out.


They are going to expand me to 13mm, maxing out the expander device. My mouth is pretty small so they had to install the expander lower in my mouth (further away from the roof of my mouth) than normal. It's REALLY hard to talk, and I can't imaging how I'm going to eat. I'm sure I'll figure it out

They also didn't remove a lot of the excess 'sealant' after bonding my braces. (They use indirect bonding, and I was told it was not 'glue' still stuck on my teeth, but 'sealant'. Not sure what the difference is.) Anyway, they said my teeth wouldn't move if it was still stuck between my teeth, and then the assistant proceeded to leave mote of it stuck to my teeth. She said the excess would come off when I brushed. So I brushed when I came home... twice... and it didn't come of. I ended us using plastic tooth picks, and I'm ashamed to say, a sewing needle to scrape enough of it off that I could get floss through. I figure if I can get floss all the way between my teeth, then they aren't stuck together anymore, and my teeth will be able to move like they're supposed to.

On the up side, I actually think the lower metal braces look kind of cute.

Well, that's all I have to report for now. Thanks for listening!

If you have ANY tips for getting used to swallowing/talking/chewing with the expander, please, I would love the hear them!!!

[redwine]

Hi Katsface!
Congrats on getting approved!
I'm still expanding - started with an estimate of about 8mm, now at 9.5mm, and the expander only goes to 11mm. It was the largest one that would fit. I'm hoping they won't have to change it out. Post-surgery, I'm okay, but tired of eating mush. And I still can't talk properly, although with my teeth moving, it seems like I have to re-learn how to talk each day. When I first got the expander, I sang along with radio a lot (alone, of course) and that seemed to help with the talking.
I have a follow-up with the surgeon today and it seems that he put a stitch in the bones in front to help stabilize them. That stitch may get removed today as the gap isn't as large as everyone (except me) wants it. I have a vision of him removing the stitch and the gap flying open like curtains in a theatre. Ortho tomorrow, and we'll see what happens then. I'm trying so hard to stay positive, but today it is difficult. I'm really sick of eating mush - although the weight loss has been welcome. I'll let you know what happens.

[katsface]

Hi Katsface!
Congrats on getting approved!
I'm still expanding - started with an estimate of about 8mm, now at 9.5mm, and the expander only goes to 11mm. It was the largest one that would fit. I'm hoping they won't have to change it out. Post-surgery, I'm okay, but tired of eating mush. And I still can't talk properly, although with my teeth moving, it seems like I have to re-learn how to talk each day. When I first got the expander, I sang along with radio a lot (alone, of course) and that seemed to help with the talking.
I have a follow-up with the surgeon today and it seems that he put a stitch in the bones in front to help stabilize them. That stitch may get removed today as the gap isn't as large as everyone (except me) wants it. I have a vision of him removing the stitch and the gap flying open like curtains in a theatre. Ortho tomorrow, and we'll see what happens then. I'm trying so hard to stay positive, but today it is difficult. I'm really sick of eating mush - although the weight loss has been welcome. I'll let you know what happens.

Hi there, Redwine!

Thank you so much for the advice. I really do need to practice talking more. I'm a little bummed because I'm hungry and eating is so slow that I get bored/frustrated and give up before I can get full. I'm sure my blood sugar is whacked out from all of the carbs I'm eating too, so that's probably not helping. I'm also having a hard time swallowing supplements, but I want to stay on track so I'm ready for surgery.

Good luck with the ortho tomorrow. Do you know what kind of models/diagnostics your ortho used to decide on the amount of expansion? I wonder why they seem to flip flop on how much is actually needed. You would figure that they could tell with a model exactly how much expansion would be necessary, right? Anyway, I'm sorry they're being wishy washy about your case.

With my expander in, and after reading your and Vantwins SARPE experience lately, I'm all the more ready to get this over with. So far, the soonest I can have surgery is Feb. 18th and that seems Soooo far away. The woman who schedules surgeries with my surgeon said she would try to find a date that's sooner, but it will still probably be mid February. I'm bummed that I have to have this expander in, not doing anything until then.

All in all, I'm excited to get the show on the road, but this is a whole lot tougher than I imagined. I have so much respect for everyone who's gone through this!

[redwine]

So, had a follow-up with the surgeon yesterday. Turns out, I've healed much more quickly than expected so they had to re-break the bones above my front teeth to allow for more expansion. It was done under local and didn't hurt - until later (enough to need painkillers). I immediatly felt some expansion and when I went to the ortho today for follow-up, I found out my gap is nearly 3mm wider than it was yesterday! Now, only two more turns 'til I'm done expanding, bringing the total to 10mm (not the 8 originally estimated). Lower braces will get new wire on 2/12, and I'll get braced on top on 3/14. It is possible that the expander will come out as early as April, but I'm not counting my chickens just yet. Many more days of mush in my future, but there seems to be light at the end of the tunnel!
As far as the healing goes, I give the credit to: good genes and large bones, 4ever fit Fruit blast protein drink, combined with Propel Zero and Airborne, and lots of fruit, veggies and greek yogurt. And Arnica, of course.

[katsface]

So, had a follow-up with the surgeon yesterday. Turns out, I've healed much more quickly than expected so they had to re-break the bones above my front teeth to allow for more expansion. It was done under local and didn't hurt - until later (enough to need painkillers). I immediatly felt some expansion and when I went to the ortho today for follow-up, I found out my gap is nearly 3mm wider than it was yesterday! Now, only two more turns 'til I'm done expanding, bringing the total to 10mm (not the 8 originally estimated). Lower braces will get new wire on 2/12, and I'll get braced on top on 3/14. It is possible that the expander will come out as early as April, but I'm not counting my chickens just yet. Many more days of mush in my future, but there seems to be light at the end of the tunnel!
As far as the healing goes, I give the credit to: good genes and large bones, 4ever fit Fruit blast protein drink, combined with Propel Zero and Airborne, and lots of fruit, veggies and greek yogurt. And Arnica, of course.

That's awesome that you're healing so quickly (even though they did have to break you again). It's amazing that your palate did sort of snap open like those theater curtains overnight And I'm glad your expansion will be over soon. Then you can get back to healing again lol.

Do you think the Arnica helped with swelling at all? I've read good things, and I've purchased some, but I wonder what your first hand experience has been like?