Hi guys.I had read many topics in this forum,and came across many information on the internet,but still i remain confused about this prochedure (i have an extreme underbite).Furthermore,my dentist said that this is a very serious operation and he doesnt recommend it.An ortho said it is nothing,that there are performed many operations like these,always with success.And the surgeon made it sound like it is a very easy operation!I also must say that when i have to smile i am in a very diffcult position and i am embarassed about my extreme underbite .But,let me make some questions:
a)sometimes when i eat food,i have a bad headache.Is it from the underbite?
b)If,many months after surgery,you get your jaw hit,will there be damage from the inserted screws?
c)And,again months after surgery,can you talk and eat ABSOLUTELY normally,i mean like before the surgery,without problems?
thanks
Hello John21,
Just wanted to answer some of your questions. My fifteen year old daughter had this surgery 2 days ago. She had her upper jaw moved forward 9mm and her lower moved back 4mm. From what I have read, the bones do heal back completely so if you were hit in the head it should be as strong as before surgery. I will tell you, this is not what I would call an easy operation. My daugter's surgery lasted about 4 hours, but from comments from other's most everyone that has the surgery is happy they did and would do it again. My daughter's surgeon said most people say they would do it again after a few weeks.
According to our surgeon and orthodontist the correction in the alignment of the jaw will allow her to eat anything she wants. Before the surgery she had difficulty chewing and could not eat things like apples and other hard fruit unless it was cut into slices.
Thanks for the replies!Oh,Meryaten,believe me my underbite i much more serious than Nahky's!The ortho and the surgeon said about moving only the lower jaw back,because the upper jaw is normal.And something else that i saw yesterday while searching in the internet.Check what this guy tells: http://www.dentalforum.com.au/forum/viewtopic.php?t=285
Don't let your dentist influence your decision to have or not have jaw surgery! That decision should be based upon the opinions of orthodontists and surgeons. Have consultations with multiple orthodontists and surgeons and see what the consensus is between them. I've come to believe that dentists are either a) ignorant about these surgical procedures, b) are only familiar with these procedures by the horror stories of malpractice they've heard/seen or c) maybe they want patients to have malfunctioning jaws in order to hasten tooth wear and enamel loss, so they can administer more crowns/caps/fillings. Cha-ching! In any case, an orthodontist will give you an accurate idea of how much can be fixed with braces and if surgery is needed and a surgeon can give you an accurate idea of how well a surgery will remedy your underbite. Also, I don't for a second believe these surgeries only have a success rate of 50/50 in regards to total relapse. Very few people would take those odds if that were the case. A 50/50 rate of relapse seems especially false concerning underbites. From what I've read, patients with an underbite are candidates to receive a vertical ramus osteotomy (is that what it's called?), rather than the standard bilateral sagittal split osteotomy (BSSO), which is used for overbites/overjets. The vertical ramus osteotomy is supposedly far more stable than the BSSO, but may require the patient to be wired shut post-operatively. Keep up your research and grill those orthodontists and surgeons! You'll find some answers you're comfortable with or you may just find surgery isn't for you at this time in your life. However, many people have this operation and are very happy they've done it. I'm hopefully having upper and lower jaw surgery in August...hopefully.
Relapse is probably what worries me the most about having this done. My surgeon gave me 2 options, BSSO or vertical ramus osteotomy. He recommended BSSO.
He said the other option is usually used with patients with very bad TMJ. He also said if nerve damage occurred then it has a much higher chance of it being permanent. So that along with being wired shut I decided to go with his recommendation for BSSO.
I didn't even think to ask him about relapse, don't know why, guess I never thought it was a possibility once you are done growing..
In about a week and a half, I am having surgery to correct my Class III bite. Mine is probably about as severe as the surgeons see--at least on the high end of it (13 mm discrepancy). My treatment plan began last summer with SARPE, 24 days of maxillary expansion with a palatal expansion, and ortho. On the 26th, I will have a BSSO and a LeFort I. The reason for both surgeries is not just about aesthetics. Early on, actually at my first joint consultation with the orthodontist and the surgeon, I asked about stability and relapse. The surgeon said that by doing what he's doing, he minimizes the risk of relapse. Evidently, the less distance anything has to move, the more likely it is that it stays put (makes perfect sense to me!). So, they are achieving that by "splitting the distance" between my arches. The surgeon will also lengthen my face a bit by lowering the maxillary arch, and I believe the mandible will be rotated a little to address symmetry issues. Actually, I will know EXACTLY what he's going to do next Monday at my pre-surgical consult.
So, John, long story short is, it may put you at a greater risk for relapse just having the BSSO done, especially if the setback is great. I believe the recommended limit by most authorities on the subject is 10mm, but you should check out what the research says, and possibly get a second opionion about your case if you can (more information never hurts).
It is true that mandibular setback for correction of Class III does have a fairly high relapse rate. In the end, after gaining as much information as you can, you have to look at the hard facts, weigh your options, and make a decision based on what you think is best for you. Good luck!
p.s. I had a dentist with a SEVERELY retrognathic mandible that said she would NEVER have the surgery to correct it. What is it with these dentists, anyway? Sheesh!
for your question b) about getting hit after surgery, my surgeon told me that at 3 months post-op you should be able to take a solid hit to the face without damage if your bones are in normal condition.
I have to wait 3 months before I can get back on my horse, because he said if I fell off before then, things could shift or shatter --> but in the long term it won't be an issue.
I would think, John (remember, we're all laypeople--consult the professionals for the real scoop!) that the distance of movement is going to be a crucial factor. Quite honestly, I would be happy if my mandible were set back as little as possible, and the maxilla moved to match, but stability in the outcome is the most important factor to me, not aesthetics. I want to have a bite that functions in a healthy way for the rest of my life, and if that means having not so strong of a chin, then I can live with that.
And, of course, there is still the issue of genioplasty, which may come up in my consult tomorrow, but we'll cross that bridge when we come to it--and it appears that I can see it just a little bit in the distance now!
John, I'm not sure if it helps, but I agree there is way too much misinformation out there based on people who fear the surgery. I was told by several people over the years as I pondered having my lower jaw surgery and getting braces that the bone had a big chance of breaking again, and the surgery simply "didn't work." Which, I suspected then and know now, is just not true. Also, I don't think anyone has mentioned this yet in this thread, and I don't know how it would apply to you, but I've read in some instances on here of people having the screws taken out after you begin to heal. I think it has something to so with your body's reaction to the metal, though.
.But,let me make some questions:
