Metal Mouth Message Board

I took the first Cephalo at January 2009 (before I started orthodontic treatmet), and the second cephalo yesterday, after my orthodontist told me I'm ready for surgery (surgery date ~June).



I look at the "before" image and rub my head thinking my surgeon was right, my occlusion was not that bad... It's amazing what orthodontic treatment can do, the left image looks like the result of an underbite surgery...

On the right image, do you think that my bottom front teeth project too much forward, in comparison to the 2009 image it seems to project much more, no ?, I asked my ortho and he said it suppose to be this way, but I'm not convinced...

Wow...those two images look like they are in reverse order...your teeth looked fine before but with regards to your question...yes the bottom teeth look like they are tipping forward.

What are you actually having done? Sorry if you already mentioned this somewhere!!

Wow what a difference a year makes. I think the pictures are in the correct order as they have gotten the teeth where they need them now the surgeon has to re-position your lower jaw. My teeth were beautiful right before my surgery but none of them lined up properly. I needed the surgery to align the uppper and lower jaws. Wait till you compare your before to after your surgery-it is amazing. Good luck with your progress

ORTHO12 wrote:Wow...those two images look like they are in reverse order...your teeth looked fine before but with regards to your question...yes the bottom teeth look like they are tipping forward.

What are you actually having done? Sorry if you already mentioned this somewhere!!

I'm doing a double jaw surgery + genio to solve underbite.

Here is how I looked at January 2009:



You can see the underbite here too, but today it's much more pronounced because the upper teeth were brought backward.

I think the reason that today the bottom teeth protrude forward (as seen in the 2010 cephalo) is because of overcrowding. My bottom jaw is so overcrowded that the only way I can have straight teeth without extractions is if there is protrusion to allow more space.

This is how the teeth in my bottom jaw looked a year ago:

Looks like you'v emade good progress then...Results should be really good When is the surgery?

my teeth did the same thing, i just had surgery in december.
They probably gave you this explanation, too, but your bottom teeth are bending backwards and your upper teeth are extending forwards diagonally to meet them. They actually make your bite worse with braces but it makes your teeth more vertical.
WhenI saw my xrays that looked like this I got confused and angry for awhile about the whole thing but then I realized the corners of my bottom front teeth were starting to crumble away from being chewed on sideways.

Just a warning, you're probably in love with the way your jaw looks in the mirror and you're going to think you're ugly as hell and completely hate your reflection for six months, but in fact most other people with think you look better. Not having the scowl from an underbite like yours and having a slightly warmer smile makes such a huge difference with making you approachable to the opposite sex.

ORTHO12 wrote:Looks like you'v emade good progress then...Results should be really good When is the surgery?

Surgery suppose to be in June.

shutdownexploded wrote:my teeth did the same thing, i just had surgery in december.
They probably gave you this explanation, too, but your bottom teeth are bending backwards and your upper teeth are extending forwards diagonally to meet them. They actually make your bite worse with braces but it makes your teeth more vertical.

Actually, if you look at my January 2010 cephalo, you can see that my bottom teeth are bending forwards, not backwards. I'm not sure if this is normal...

I've tried to search the net for analyzed cephalometric images to see if the bottom front teeth should be bending forward or not, and found cases were indeed the bottom front teeth look to be bending forwards, even thought the bite seems to be normal (no overbite/underbite):





On the other hand, I can see images where the bottom front teeth are not bending forwards, like this one:



I'm really not sure what's right and what's wrong here...

The teeth are supposed to flange out a tiny bit rather than bend in towards eachother, but I see what you're saying. Maybe that other comment was right and it's just a crowding thing and they're compromising.

I went to see my surgeon today and told her about my concerns regarding the fact that my lower bottom teeth seem to be protruding forward (as seen in the cephalometric image in my first post).

She told me that indeed my bottom front teeth seem to be protruding forward, but not by too much, and that it's good for the surgery because it helps make the underbite malocclusion large enough to allow surgery on both jaws.

I asked her what she thinks about extracting two teeth in the bottom jaw, and then take the bottom front teeth backwards (orthodontically), so they won't protrude forward.

She answered that this is possible, but if the bottom front teeth will come backward orthodontically, then my underbite will reduce (currently it's ~9mm), and I won't have enough malocclusion to justify surgery of both jaws.

I told her I think it's a win/win situation then, since I'm solving the bottom teeth protrusion and will also have surgery just on my upper jaw.

She told me that aesthetically, the solution I'm offering is less attractive, because I'll look similar to what I looked at the beginning of the process. Not sure I understand why... I started this process with an underbite, and I won't have underbite after surgery, so why would I look the same ?

I'm not sure I understand her line of thought here, there are two options that I can see to solve my current 9mm underbite:

1. (this is what she wants to do) Surgically take the top jaw 3mm forward, and the bottom jaw 6mm backwards. To compensate for the bottom jaw (which is taken 6mm backwards) she wants to do genioplasty to take the chin forward. This option will cure my underbite, but still leaves me with protruding bottom teeth.

2. (this is what I offered to do) Extract 2 teeth at the bottom jaw, and take the bottom front teeth backwards (orthodontically), let's say by 3mm. Then do surgery just for the top jaw and move it forward ~6mm. I won't need genioplasty since I didn't move my jaw backwards.

There is one thing that might make option #1 better, she said that my malocclusion is caused because my lower jaw is too developed, and my upper jaw is not developed enough. But, she say that the overdevelopment of my bottom jaw is more dominant than the underdevelopment of my upper jaw. So, maybe option #2 will fix the underbite but not the correct symmetry of the jaws... not sure.

I will consult my orthodontist next time I see him, since this is confusing.