Has anyone done jaw surgery to correct failed othodontics?

[Orome]

I had 4 bicuspid extractions and orthodontic headgear to "fix" a class II jaw when I was a kid. By the time I was 16 I had occlusion, but I had an extremely small jaw, a recessed maxilla in addition to my recessed mandible (obtuse nasolabial angle) and some signs of mid-face deficiency (bags under my eyes, laugh lines and a hollow looking area under my eyes).
Anyways I was just wondering if anyone has had jaw surgery to fix problems that were caused during growth modifying orthodontics? It seems to be an uphill battle to say the least.

[jimmyjackson]

I've had braces 3 times.

The first and second time were with the same orthodontist and they gave me a discount for the second visit (still not sure why I did this). On the second treatment plan, they did extractions. After the second round of braces, my teeth went back into an open bite after several years.

Now, I'm in my third set of braces and getting surgery to correct the 'curve' (as my surgeon calls it). I think surgery should have been my first and only option.

[jimmyjackson]

I can't figure out how to edit my previous post, but I wanted to add the following:

After this second set of braces, I was devastated with how narrow my teeth were AND the fact that they went back into an open bite.

My third orthodontist has done something maybe few others would do - but I'm happy with it. He has widened the arch slightly and brought the back teeth forward to make it all fit. It looks so much better now than it did... that first orthodontist was terrible. I had a long face and narrow teeth - very bad combo.

Anyway, your case sounded similar - so I thought I'd tell you what I went through and how I chose to deal with it.

[Orome]

Thanks for the reply. With regards to widening the arch and bringing the teeth forward (I'm assuming some kind of pallet expansion), can that really be done in adults? I have been given conflicting opinions from orthodontists on whether that sort of non-surgical movement is possible/stable.

Your teeth went back into an open bite, did you wear your retainer during this time? Just curious, I'm unhappy with my results, but I have worn my retainer all these years since my treatment and my bite is still in alignment, but my profile is completely pushed in and my arch very narrow. It just seems like my jaw/mouth stayed the same since I was 12 while the rest of my face has grown. I'm kind of regretting having worn my retainer. lol

[jimmyjackson]

Before I saw this orthodontist, I was reading about palette expansion in adults - looking for ways to reverse some of the narrowness. That isn't what this orthodontist did though. He simply changed the angle of the teeth (my teeth were angled in fairly substantially). Now they're much closer to straight up and down. I think this is a controversial technique though, as my surgeon noted some very slight gum recession on a couple of my teeth due to this. I am pleased with the outcome though, and wouldn't go back on it.

My original complaint to the third orthodontist was simply: "I don't have enough room in my mouth for my tongue" (both in depth and width). He really insists on having proper spacing for the tongue, so this might be the only reason this worked for me.

As for the retainer side of the story. As crazy as it sounds, my teeth started to go back to an open bite while still in braces! I was complaining about the angle and width of my teeth on the last few visits, so the appointments were a little further apart ( a few months - instead of the usual 4-6 weeks). During this time my teeth started to relapse while the braces were on - and required additional treatment. I wore my retainer for about 6 months afterwards - though I think everyday for the rest of my life might have been the only solution.


I think any case involving vertical/recessed facial growth should be a candidate for surgery. This wasn't presented as an option to me - so I spent years doing the wrong treatment plan.

[Orome]

Before I saw this orthodontist, I was reading about palette expansion in adults - looking for ways to reverse some of the narrowness. That isn't what this orthodontist did though. He simply changed the angle of the teeth (my teeth were angled in fairly substantially). Now they're much closer to straight up and down. I think this is a controversial technique though, as my surgeon noted some very slight gum recession on a couple of my teeth due to this. I am pleased with the outcome though, and wouldn't go back on it.

My original complaint to the third orthodontist was simply: "I don't have enough room in my mouth for my tongue" (both in depth and width). He really insists on having proper spacing for the tongue, so this might be the only reason this worked for me.

As for the retainer side of the story. As crazy as it sounds, my teeth started to go back to an open bite while still in braces! I was complaining about the angle and width of my teeth on the last few visits, so the appointments were a little further apart ( a few months - instead of the usual 4-6 weeks). During this time my teeth started to relapse while the braces were on - and required additional treatment. I wore my retainer for about 6 months afterwards - though I think everyday for the rest of my life might have been the only solution.


I think any case involving vertical/recessed facial growth should be a candidate for surgery. This wasn't presented as an option to me - so I spent years doing the wrong treatment plan.

Yea, I think I could have gotten away with lower jaw surgery had I gone to a a different orthodontist when I was a kid.
That's interesting, changing the angle of the teeth. I don't think it would work in my case as my teeth are pretty much straight up and down.

I hear you with not having enough room for your tongue, I have the same problem.

Your case sounds a lot like mine except my facial profile developed that way naturally. I'm currently in braces in preparation for a surgery to fix my underbite. I also have a midface deficiency that will be fixed by augmenting my bone own structure with hydroxiapatite. There are few surgeons in the world that I would consider qualified to deal with cases like this.

What is hydroxiapatite? Is that an implant you are referring to? Who are the few surgeons if you don't mind me asking.

[Orome]

I attached an x-ray to give a better idea what I'm talking about. My biggest problem right now is finding an orthodontist/surgeon that understands my issues. Most (well the orthodontists I have seen) won't recommend anything to be done because I have occlusion from my previous orthodontic work. It's not just esthetic, my lower jaw has some asymmetry (I think one side is longer than the other) so it dislocates and pops any time I open wide, and I get pain at the joint.

[jimmyjackson]

Gunson is actually the surgeon I'm lined up with right now. They do accept insurance, but usually insurance doesn't cover a lot through them as they are out of network.

[Orome]

I have heard good things about Arnett/Gunson. Do both of you live in the area, or are you flying out there for consolations/surgery?
Just about anywhere you go online looking at jaw surgery people talk about them. There's got to be other surgeons that have an appreciation for aesthetics as well as jaw alignment.

[jimmyjackson]

I've heard of several other good ones in different places.

I chose Gunson because I liked the plan a lot more than the other 2 surgeons I consulted with. In fact, he was the only one to give me a full 100% complete plan on the first visit.

Now, it's going to be very difficult to make the follow-ups. It's an 11 hour round trip drive for me (which I already made once for the initial consult). At $400 a pop for a plane ticket and a 4 hour flight (layover in LA), it just isn't worth doing. I'm still looking over other options, but driving each follow-up might be the only way to go on this.