Narrow upper jaw but no need for sarpe?

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#1 Post by **venom** » Wed May 26, 2010 2:29 pm

has anyone experienced this with their ortho or surgeon?.
this is what happened with me today at my 1st consultation with the oral surgeon. I have a classIII underbite and narrow upper jaw/palette so i had the idea in my mind that i would need lower jaw surgery and sarpe to fix my bite problems.

during our discussion the surgeon suggested double jaw surgery to fix the underbite with no mention of my narrow upper jaw.
when i moved on to discuss my upper jaw he replied saying he didnt feel the need to expand the upper jaw and said something along the lines of " the upper and lower movement would fix everything"

now i'm worried that this method i will still have a narrow smile even after surgery:(.

#2 Post by **Audra** » Wed May 26, 2010 2:55 pm

I had two pre-molars extracted from my upper jaw as a child and ended up with an underbite.

My braces expanded my palates somewhat and I had upper and lower jaw surgery. Both jaws fit together nicely - without the need for upper jaw expansion.

#3 Post by **suzyscientist** » Wed May 26, 2010 3:36 pm

I have the same thing - underbite with narrow upper jaw. My surgeon said he could give me a great bite with just lower jaw surgery, but that if I wanted the "Rolls Royce" treatment I could have upper jaw expansion too, for a better aesthetic result. I chose the Rolls Royce option (he said it would give me an Angelina pout! Awesome!

) but the surgeon then said they would try to expand my palate with braces first and it seems to be working ok so far (only been 2 months though) so I might not need sarpe/sarme at all.

Think everyone's case is different though. If you're really worried ask your surgeon again - questions are ok!

Good luck

Suzy

#4 Post by **boatsink** » Wed May 26, 2010 6:40 pm

Good question, I am in a similar situation. My upper jaw is narrower than my lower jaw, resulting in an underbite, crossbite. My oral surgeon did not mention SARPE. During my consultation, I did ask about whether or not I would need to expand it. He said he cannot predict anything until the orthodontist has completed moving my teeth for surgery. I just assumed they will expand it during the surgery if my jaw is too narrow to fit over my lower jaw. Is this possible? I most certainly do not want to be in braces for one year and have to find out that I need SARPE first. However, I have met someone who had their upper jaw surgery to correct an anterior open bite, and in the process, they expanded her upper jaw without the need for SARPE prior. Her immediate post-op pictures did show a gap between her teeth....

#5 Post by **BracketRacket** » Wed May 26, 2010 6:44 pm

I *think* when they do a Lefort I as part of double jaw surgery they can expand as well. It's funny -- right now I'm going "they're doing SARPE to expand and I hope they don't decide down the road that they should have moved the jaw at the same time!"

#6 Post by **Audra** » Wed May 26, 2010 7:37 pm

BracketRacket wrote:I *think* when they do a Lefort I as part of double jaw surgery they can expand as well. It's funny -- right now I'm going "they're doing SARPE to expand and I hope they don't decide down the road that they should have moved the jaw at the same time!"

Yes, they can. I knew of a few people who have had their upper arch expanded while having double jaw surgery.

#7 Post by **LAJaw** » Thu May 27, 2010 2:14 pm

They can widen your upper jaw through surgery using a multi-piece Lefort I. A normal Lefort I detaches and moves your upper jaw as one piece. A multi-piece Lefort I breaks that piece into 2 or more pieces, which can be repositioned by the surgeon for a wider upper jaw. Two- and three-piece Lefort Is are most common - I'm slated to get a three-piece done for my surgery.

I'm not entirely sure of how they choose between a SARPE and a multi-piece Lefort I. A multi-piece Lefort I can minimize the total number of surgeries - if your maxilla needs to be moved anyway, a multi-piece Lefort I can simultaneously move and expand your upper jaw. The SARPE route will require two procedures - a SARPE first and then a LeFort I later. However I believe that a multi-piece Lefort I can only be used for minor expansion - if you need major expansion, you'll need a SARPE. Also since a multi-piece Lefort I has more cuts involved, it has greater risk for complications and requires longer healing time.