Surgery to fix asymmetry

Message

#1 Post by **murrdock311** » Wed Jul 18, 2007 1:31 am

I've researched endless hours and still don't have a soled understanding of how uneven jaws are surgically fixed through orthognathic surgery. Can somebody please give me some direction on what types of orthognathic surgery would correct a condition where one condyle is longer than the other(condylar hyperplasia). Thanks

#2 Post by **dubnobass** » Wed Jul 18, 2007 4:12 am

I can't speak for everyone but I am having jaw assymetry corrected through surgery in 3 weeks and have had the steps involved described to me as follows:
Bilateral sagittal split osteotomy:
-left side of jaw lengthed by 3mm
-right side of jaw shortened by 5mm

I have a cant in my upper arch because of the lower jaw assymetry (and a slightly gummy smile), so this is also being corrected:
Lefort I osteotomy:
-upper right side of jaw impacted by 4mm
-upper left side of jaw impacted by 2mm

They will also be rotating my jaw round to the front by 2mm because my chin and lower midline are off-centre. And somewhere in the middle of all this, they have to lengthen my lower jaw and tilt the plane of my upper jaw to correct a 11mm overjet.

Man, I'm glad I'm not the guy who has to do the modelling for all this!

#3 Post by **phil** » Wed Jul 18, 2007 7:03 am

I believe that HighandLo had Condylar Hyperplasia, and the procedure that her surgeon used to correct this condition was the standard Bilateral Saggital Split Osteotomy, or BSSO.

I had a mandibular assymetry as well (due to growth patterns from having a prognathic jaw and crossbite), and my surgeon corrected it with the BSSO as well. When he did the BSSO, he set the mandible back 7mm, as well as rotating it 3mm to the left.

The best thing to do is have a consult with a surgeon to discuss your case.

#4 Post by **ohmyjaw** » Wed Jul 18, 2007 5:04 pm

I had uneven upper and lower jaws. I had an interesting procedure - I had a unilateral BSSO (the surgeon cut only one side of my lower jaw and lengthened it a bit). It was just a couple mm of movement.

For the upper, I had an expansion and as well as moving it forward. I believe the expansion was more on the right than the left, and they used a bone graft in there.

#5 Post by **HighandLo** » Thu Jul 19, 2007 8:08 am

murrdock,

I did have condylar hyperplasia - my left jaw had grown more than my right. Both side of my jaw were cut (about 5mm on each side) and a piece removed from the L side. The R side was also slid to the left and I have plates and screws. My jaw is prefectly aligned now! I just have work left to be done on my bite which still cants to the left a bit. To place my chin in the center, my OS had to work on both sides of my jaw.

Lo

#6 Post by **phil** » Thu Jul 19, 2007 8:25 am

Lo,

Thank you for correcting me. I thought I had read on a thread somehwere that you did, but I must have been misstaken.

How is healing going, BTW? I am progressing, with the aid of heat therapy.

Phil

#7 Post by **HighandLo** » Thu Jul 19, 2007 8:43 am

Hey Phil,

You are correct - I did have the BSSO. I am doing well. Still am using heating at night for when I talk or chew too much during the day.

The swelling is mostly gone, though. I'm just waiting for the numbness to go away. I can open my mouth to about 28mm. More than that and my R TMJ joint aches. I go to the OS today and will update with anything new or exciting.

I have been reading your posts and it looks like you're doing great!

Lo

#8 Post by **phil** » Thu Jul 19, 2007 9:37 am

Lo,

28MM!!!!!!!!!!!! Oh my goodness. I'm lucky to get to 20. I don't know if having both upper and lower makes a difference in ROM. I bet it does! Well, that's my story and I'm stickin' to it...

Phil