SARPE Surgery

[katsface]

Have you guys seen that meem with pictures of occupations/hobbies/etc that say "What my friends think I do...What my Mom thinks I do...What I think I do...What I actually do"?

I was bored, so I made one for the SARPE Gap. Hope you get a kick out of it!

[MissMelissa]

The last couple of days my one front tooth has been sore. This is almost 4 weeks after my surgery. I had a one sided expansion and its the front tooth on the other side, it also feels a tiny bit loose, while the one on the side that was expanded doesn't hurt and isn't loose at all. Did anyone else has this problem?

[goofylook]

@katsface.. that's hilarious

@MissMelissa.. My jaw expanded more on my right side than my left side which is a good thing for me since the cross bite is on the right side. My left front tooth is looser than the other one too. It seems that it is trying to move and close the gap. Honestly I have not noticed that my right front tooth has moved at all!! Weird.. right? I was gonna ask my ortho about it but my appointment is not until next Wednesday.

[goofylook]

In an effort to reduce confusion between the SARPE and LeFort 1 surgeries, I created this new post that basically clears it up. Please post there any points or comments I might have missed. I think the new post is an easy(ier) way for new people to find it and avoid the confusion.

http://www.archwired.com/phpbb2/viewtop ... 15&t=44254

Special thanks to katsface as I used some information from her post in this thread

Cheers,
Goofy

[Vantwins]

Kat - that is really funny! Ugh...my first surgeon made such a mess of my surgery with my teeth ending up lopsided, that I'm actually jealous of the "what I actually look like" shot!

Goofy and Melissa - my best guess is that your tooth that feels loose has a lot of space and freedom right now and wants to find it's old pal on the other side of the gap!

I got my top braces back on yesterday! My teeth were so sore last night I took a percocet left over from my surgery! My gap had started to close up since my surgery in November and they front teeth touch at the bottom (so I've got a triangular gap between them), so the ortho said the gap could get a bit worse at first because he wants to correct the unevenness first and then correct the gaps (between two front teeth and then there's also new gaps on the side from the middle gap getting smaller. The ortho felt pretty strongly that metal braces are more effective/faster, etc, so I'm bummed to not have clear brackets in the front, but I'm super happy to be making progress on straightening the teeth!

Next step - I've got gum grafting on the bottom, both sides, on 4/12 and an ortho appt on 4/15.

V

[Anastasia8]

Oh Katsface, that's bloody brilliant!

[katsface]

Kat - that is really funny! Ugh...my first surgeon made such a mess of my surgery with my teeth ending up lopsided, that I'm actually jealous of the "what I actually look like" shot!

Goofy and Melissa - my best guess is that your tooth that feels loose has a lot of space and freedom right now and wants to find it's old pal on the other side of the gap!

I got my top braces back on yesterday! My teeth were so sore last night I took a percocet left over from my surgery! My gap had started to close up since my surgery in November and they front teeth touch at the bottom (so I've got a triangular gap between them), so the ortho said the gap could get a bit worse at first because he wants to correct the unevenness first and then correct the gaps (between two front teeth and then there's also new gaps on the side from the middle gap getting smaller. The ortho felt pretty strongly that metal braces are more effective/faster, etc, so I'm bummed to not have clear brackets in the front, but I'm super happy to be making progress on straightening the teeth!

Next step - I've got gum grafting on the bottom, both sides, on 4/12 and an ortho appt on 4/15.

V

Vanessa- So glad you're happy with your new ortho, and seeing some progress! I'm still really surprised that your previous ortho/surgeon went ahead with surgery if your gums weren't ready for it. Does your new team want to repeat your SARPE surgery, or are they going to go with the expansion you have? Or do I remember reading that your new team doesn't think you needed SARPE in the first place?

Updates:

Wednesday 03.20.13 - I finished expanding to 13mm Wed. morning, and went to the ortho that day to have impressions made for a lower expander (not an RPE but something else to upright my tipped in lower teeth). And they made an upper impression for a fake tooth to fill the gap, and were awesome enough to have it made and ready to go by Friday!

Thursday 03.21.13 - Went to the surgeon for my second checkup the next day (Thursday). He said that I'm over expanded but I'm supposed to be a little over expanded. My lower teeth will 'expand' too, plus my ortho factored in some relapse since it's inevitable. Everything else looked good apparently. There is a small matter of the $28,000 hospital fee that my insurance has thus far denied according to their website. I haven't gotten anything in the mail tho, and since the surgery and hospital were pre-approved the surgeon told me not to worry about it. He said it was most likely a clerical error or the insurance company just needing more information from the hospital. So I'm going to TRY not to worry about it... but if I get a bill for $28,000 (for an OUTPATIENT procedure!) I'm not going to be a happy camper. I'll also note that that is just the hospital bit. Doesn't include the anesthesiologist or surgeon's fees (which have already been approved and paid).

Friday 03.22.13 - Got my fake tooth, upper archwire, and powerchain! Good golly, I wasn't expecting that to happen two days after I finished expanding! But since I expanded for almost a month, I'm not complaining. I have a Class 2 Division 2 bite... meaning my central incisors tip in a little, and my lateral incisors tip out and overlap the centrals. One lateral overlaps worse than the other so they couldn't put a bracket on it. My next appointment is in two weeks and they expect things will be moved enough to put a bracket on that tooth and pop the archwire in. I'm so excited! I really want to get that tooth fixed.

So I had the powerchain put on yesterday and my central incisors are already less flared out and are now much more parallel to each other. They were parallel to each other to begin with but at some point during the expansion they started flaring away from each other. I don't want to get too excited because undoing the flaring was probably easy work for the powerchain, but it has been really cool to see real movement in the 'right' direction in such a short period of time. Keep your fingers crossed that my teeth keep moving quickly!


I'm sorry my updated and posts are always so long! But I'm kind of using archwired as a diary so I can go back and read about my progress. If I'm boring you, please feel free to ignore me (though I REALLY appreciate your support and Camaraderie!)

[slb1982]

Kat ~ I really enjoy reading your updates I notice that you post on alot of the threads & I think that's so great because I'm online a lot lately & love reading new posts on here. Glad that everything is moving along quickly for you!

My update: I stopped expanding to my 7mm on March 12th, and in a few days (March 26) I will be one month post op from my SARPE surgery! My surgery was on Feb 26, I started cranking my expander that night, and I was done expanding 2 weeks later. Seems fast, but I'm glad that whole part of this process was done so quickly

My orthodontist put a continuous wire on both my upper and lower teeth the DAY I stopped expanding (March 12th) - talk about moving things along quickly! On that same day they also tied "Zing String" ("Elastomeric Thread - A stretchable plastic thread used to close spaces or pull teeth") around the brackets on my two upper front teeth to start bringing them back together. I went back a little over a week later (March 21st) to have the zing-string re-tied (they are going to re-tie it once a week for awhile) to keep pulling my front teeth back together. So far, it's been 1 1/2 weeks since I stopped expanding and my gap has closed by about 1 mm (maybe 1.5 mm, it's hard to say because my front teeth are crooked so my gap varies at the top and the bottom). (I'm actually jealous of that previous "What I actually look like photo" that kat posted!)

I'll try to attach a few photos here - One of my mouth the night BEFORE my Sarpe surgery, One of my Post Op Day 4 (when I was the most swollen & bruised), and one of my 7mm gap on March 12th (I had just finished expanding - photo was right before I got my continuous wires put on to pull the gap back together).

00 (2).JPG

04.JPG

7mm.jpg

[katsface]

You guys are awesome! Thank you Vanessa and slb1982! But I have to be honest... the "what I actually look like" picture in my SARPE Gap image was carefully taken to reduce how crazy my teeth look. In the interest of full disclosure, I'll show you what my teeth looked like when I was at around 5mm of expansion. The gap got much bigger and my teeth are still all over the place with all kinds of new gaps that I didn't expect! But I didn't take a picture at the end of expansion before they put the fake tooth in.



I think the detail in this picture shows a little better how uneven my teeth were (they're even worse now!). My gumline/teeth slopes down on one side, and my lateral incisors are, well, crazy, my central incisors are way over-erupted... I could go on. You can see how the central incisors started flaring away from each other, too. Normally my lip will curl up more and show a lot more gum, but I still didn't have full range of motion with my upper lip at the point this pic was taken. I'm also probably poking my bottom jaw out b/c I still need to have a BSSO to advance my lower jaw. So, it's still not 100% what I look like if you catch me unawares, but at least the teeth are more accurate.

[john123]

Hey guys. I'm getting sarpe surgery at the beginning of summer to correct an underbite/crossbite and I have a small concern.

First off, I really only need one side of my palate expanded. The top left side of my palate developed correctly but the right side did not, which is the reason for my underbite/crossbite. My question is, will this procedure and THE RPE cause my left side to expand too? Or will the ortho know only to expand the side that is underdeveloped?

Thanks.

[katsface]

Hey guys. I'm getting sarpe surgery at the beginning of summer to correct an underbite/crossbite and I have a small concern.

First off, I really only need one side of my palate expanded. The top left side of my palate developed correctly but the right side did not, which is the reason for my underbite/crossbite. My question is, will this procedure and THE RPE cause my left side to expand too? Or will the ortho know only to expand the side that is underdeveloped?

Thanks.

Did your surgeon tell you that you only need one side expanded? If so, this should be communicated to your Ortho long before the surgery so that they can plan your treatment appropriately.

The ortho doens't really have anything to do with the actual expansion process, other than installing the expander, and telling you when to stop. They can't control if you expand on one side or both, and the expander is designed to expand from the center to both sides. If your ortho/surgeon agree on the technique, you could be expanded on both sides, then have your braces bring the side that needed less expansion back in (or so my surgeon tells me- I didn't need uneven expansion btw.) But your ortho and surgeon need to be on the same page so they can plan your treatment accordingly.

As far as I know, there are ways to expand one side more than the other. It would be up to the surgeon to release one side of the jaw more than the other, or only release the side that needed expansion. If that's the case, your surgeon and ortho still need to be on the same page, because your ortho may have a treatment planned for you to have both sides expanded. He/she would need to know that you were having a one sided expansion to be able to plan your treatment properly.

If you're diagnosing yourself, and you think you only need expansion on one side, I would talk to both the ortho and the surgeon about it before hand. They may explain to you that they agree and they plan to proceed with a one sided expansion. Or, they may explain that you really need expansion on both sides for one reason or another. In either case, it will make you feel better to know before surgery that their plans are satisfactory to you.

[goofylook]

This is first time I heard about one sided expansion..!! I have a cross-bite on the right-side only and my left side has "no issues" but that doesn't mean I need a one-sided expansion. Teeth can moved around and slightly in-ward and out-ward to alight properly. However I want to clarify that "we" here or at least I am are no way experts. We have just been through this and done research and consulted professionals but mostly about our own cases which varies from one case to another even though they might "sound" similar.

Also, I might disagree here with katsface that the expansion is controlled by the ortho and not the surgeon. The surgeon job is only to loosen the bones and make sure no complication from the surgery, bleeding, recovery, etc. However the ortho decides what type of expander to use, how much to expand, and how frequent. other this detail I do agree with her on the other points that you need to consult an ortho and let him come up with a plan that work for you. Most of us have used an expander that do expand from the center out on both sides but I can imagine an appliance that pushes into one side only rather than both. Again, the ortho is the person who is knowledgeable of the different appliances available in the market and the techniques that can be used.

Don't try to diagnose yourself, I thought I have perfect lower teeth but I still got brackets put on them and they also need to move (darn it!! lol) because the ortho knows better. What you can do on the other hand is consult multiple othos, usually consultation is free, so consult as many as you can and then compare notes and analyze what they told you and don't be afraid to ask questions. Ask as many questions as you can. My 2 cents.


On another note, I had my 2nd ortho appointment and it was very exciting, lots of changes but I have to run to a meeting now so I will update maybe later tonight or tomorrow sometime.

Good luck,
Goofy

[john123]

You guys are right I shouldn't diagnose myself. I'm getting my braces and RPE on tomorrow, so I'll ask then.

Kinda off topic but...I'm getting the bonded RPE and was wondering how noticeable is that? Also, I'm in college and like I said, the ceramic braces come on tomorrow and I'm kinda nervous lol. Any words of encouragement?

[goofylook]

I was nervous too when I got my braces on, but surprisingly they don't like as bad as I thought.. I kinda like them The ceramic braces they are almost invisible, I had to point out to some people that I have braces on because they couldn't see them.

Plus, dude, you are in college, couple of beers and the gap/braces is magically gone! AND college chicks for the most part are easy if that is your concern. Just don't let your own self-conscious block you! Keep your confidence up..

My 2 cents (kinda like saying that a lot these days lol)

Good luck,
Goofy

[john123]

Wow thanks! I've been so excited for so long but now that it's actually happening it's pretty strange. The thing I'm really worried about is the rpe...speaking and looking wise haha