Questioning having Lefort 1 Osteotomy in a couple weeks

[RyanND]

Hi all.

First off I'm new here so hello.

Secondly, I'm having major pre-surgery jitters/concerns with having an upper jaw surgery which is scheduled in a couple of weeks. My surgeon is Kyle Tidstrom in Edina, MN and is a family friend so I feel comfortable with the surgeon.

What I'm concerned about is if I really need to have it, and if it will be beneficial in the long run. I do have a minor open bite, but its never seemed to have bothered me before, and this all stemmed from my orthodontist saying I should be having surgery. I'm 22 so its either do it or not, and I was hoping some of you could tell me what helped with your decision, and if you have before/after pictures or info that would be great. I'm posting a couple of picture of my "bite" so people can comment on how my bite looks compared to yours if you had this surgery.

Also, he has talked about doing some chin work to help my lips seal naturally, but I'm leaning against that as I feel my lips do seal naturally.

Here are some pictures.

http://picasaweb.google.com/11015526825 ... directlink

[BaliGirl]

I have a big open bite and tried to avoid surgery for the longest time - pics here for reference: viewtopic.php?f=9&t=36907
I didn't want to believe that surgery was necessary, thought I would beat the odds of all the gloom and doom stories my dentist was telling me about destroying my teeth.

Well......I cracked (and lost) 1 molar and 1 pre-molar before I was willing to "hear" the message. Unfortunately had to happen that way because I was very against the idea of surgery and wouldn't have even considered it if there were any other options.

The open bite by itself never bothered me. Dentists were always making comments about "don't you want to be able to bite through a piece of pizza/sandwich/etc.?" Since I have NEVER been able to do those things, I didn't feel like I was missing anything. My open bite was (to me) the way I have always been and it didn't bother me.

Losing teeth and not being able to replace them, however, does bother me. The reason for not being able to replace them is the force placed on these teeth from my abnormal bite - if it caused natural teeth to fail, implants will also fail.

Everyone's situation is different and I can't say that the same things that happened to me will happen to you. Gathering information is good, and the more data points you get to make a decision and be comfortable with it, the better. If I could look into the future when I was 22, I would do the surgery in a heartbeat then to try to prevent some of the problems I have now. But on the other hand, I also have no way to know if the surgery will be successful or not, so I might be second guessing that decision in a few years. Sorry, I'm sure you were hoping for an absolute recommendation to do one thing or another, and the best I can do is share my story and let you know it's perfectly normal (to me, anyway) to guess and second guess your course of treatment. I wish you the best of luck in your decision!

[RyanND]

Thanks for your response! The more the better I guess... I'm not looking for one person to tell me do it or not, just sort of looking for their stories and pictures like yours to help me make an educated decision without the influence of the orthodontist or surgeon. So far I haven't had any issues with cracking teeth or anything, and CAN bite into a sandwich as my bite is not as open as yours, which makes it harder for me to decide.

The losing of teeth is a small concern, but I am also worried with the possibility of losing feeling in my mouth and I've heard you get really sensitive to the cold? which concerns me as I'm an avid winter sports person.

[nell]

Hi Ryan,

I have an anterior open bite and have just been bracketed today. I, like you, also really want to avoid surgery and would not have embarked on orthodontics if it meant I definitely had to have a Le Fort 1. My open bite is not really noticeable to others and although I can eat a sandwich I find it hard to bite through things that need good incisors (like a steak sandwich).

My orthodontist is not recommending surgery for me, instead he is going to intrude my molars so that the open bite closes without major surgery ( I still need minor surgery to install the bone anchors to do this). I guess you could ask your ortho if he/she is familiar with this technique and if it is an option for you?

good luck.

[I want to smile!]

Looking at your pictures your bite doesn't look too bad and my immediate thought was that surgery seemed a completely over the top option. But that said, my open bite wasn't too bad at 22 (though it was worse than yours) and now ten years later it's about the same as Baligirl's pictures. Can you ask your ortho what the long-term implications would be? I was too scared to have surgery in my twenties, but having waited I can see how my bite has worsened over the past decade and now I'm having treatment because I'm scared about how much worse it will become. If you have treatment now, will that 'worsening' process be halted, for example, or could you still have problems later in life? If you don't have treatment, does the ortho think your teeth will be stable where they are now, or could you be forced to have surgery when you are older? If you're happy with your bite being just slightly open, could some kind of retainer hold it where it is? The ortho told me teeth naturally move forward about 1mm a decade, which doesn't sound much but it can have a big impact. If it helps at all, I've not come across anyone on this board who regrets surgery but it is a pretty nerve wracking experience even before you have to deal with the physical impact of the operation. Good luck with it.