Metal Mouth Message Board

Hey guys

I just had a lefort 1 yesterday and this morning my surgeon tried to fit my upper jaw and lower jaw to the splint and they didn't fit.

He saying that my muscles are sore and are not adjusting to the splint or that I need surgery again.

Hes put the splint on me wired now in the hope that my teeth will lock in now if the swelling goes down.

Also, I'm getting air into my cheeks. Is this normal?

Man I don't wanna go through surgery again that was horrible!

Hello,


I had the splint put during the surgery so woke up after surgery with the splint on.
Also was wired shut with elastics for first 3 weeks.

I wish you all the best.

Lucian.

I am under the impression that the splint was made after your measurements pre surgery and that is where your teeth should fit in post surgery. As I said In a previous post, I didn't have to wear a splint at all just elastics.

I think it's best you have a thorough talk with your team regarding this as having another surgery so soon after your first is quite serious (but not unheard of) and you do not want to go into this uninformed. I wish you the best and hope that it is just a case of you being swollen.

Adz,

Any update? Thinking about ya! Hoping for good news!

I was supposed to have a splint after my first jaw surgery. I woke up without one and my mom said the doc came out of surgery and said "everything went great. Her bite came together so well we didn't even have to splint her." It was all a load of BS. They screwed up my surgery so bad and my teeth didn't even come close to fitting in the splint, so it was left out and they just sewed me up and hoped I wouldn't notice. So, I would think something did not quite go as planned here if you're not fitting in your splint. I ended up needing a whole revision, and this time I got splinted and fit PERFECTLY in the splint that was laser cut from my 3D scans, models, and molds to how my teeth were going to come together after all of the surgical movements were made. If you're not lining up in what that projection is on the splint, then something is off and it makes sense they are talking revision with you. Good news here is if they pull you right back in and do it, it's usually no big thing. Prior to that 6 week mark, you can do it before bony fusion and avoid a whole separate and lengthy recovery like I had to go through.

Best of luck! Let us know how it works out!

There must be multiple ways of using splints because I'm having a hard time conceiving of a splint attached after surgery. I thought the way they were used is that the splint was wired in place and only then was your jaw re-attached to your skull with the plates and screws. I could totally see a removable "splint" applied afterwards like a retainer not fitting.

sirwired - At least for my procedure, my surgeon had a couple different splints that were used at different points during the procedure. They were part of the VSP "package", which also included some stencils to make sure the cuts are in the right position, etc. My surgeon actually opened the box from the VSP company in front of me to try on one of the splints so I saw what was in it. The splints are thin and flat, not like retainers typically are. The splint that reflects your final bite is used during the procedure like you said: before doing the final attachments to make sure your bite will come together perfectly post-op. It can be left in (or re-inserted post-op) to make sure your bite stays in that position. Obviously, if you're not banded/wired shut post-op, the splint won't be in there. It's the same splint as was used in the operation (or rather one of them. Like I said, my surgeon used a couple for different parts of the procedure. I don't know if that's standard or if other surgeons only use one splint).

snapdresser wrote:sirwired - At least for my procedure, my surgeon had a couple different splints that were used at different points during the procedure. They were part of the VSP "package", which also included some stencils to make sure the cuts are in the right position, etc. My surgeon actually opened the box from the VSP company in front of me to try on one of the splints so I saw what was in it. The splints are thin and flat, not like retainers typically are. The splint that reflects your final bite is used during the procedure like you said: before doing the final attachments to make sure your bite will come together perfectly post-op. It can be left in (or re-inserted post-op) to make sure your bite stays in that position. Obviously, if you're not banded/wired shut post-op, the splint won't be in there. It's the same splint as was used in the operation (or rather one of them. Like I said, my surgeon used a couple for different parts of the procedure. I don't know if that's standard or if other surgeons only use one splint).

For my surgery (just a LeFort I), I don't know if there was more than one splint, but I do know that by the end of the operation my splint was wired to my upper archwire (for nine nasty weeks!) and I was not banded shut. (In fact, I had the lightest bands I ever had during my entire treatment were post-surgery.) My splint was broad and thin, and had a TPA-like wire to help prop things open I guess. After finally getting that thing out over two months later, I hated it so much I drove over it with my car. (It's impossible to clean properly, or at all really, so my mouth felt nasty. I brushed my teeth three times starting the minute it was out of my mouth.)

sirwired wrote:by the end of the operation my splint was wired to my upper archwire (for nine nasty weeks!) and I was not banded shut.

So it was just wired onto your upper teeth and your lower jaw was left free moving? Wow! Interesting. I guess there's more variation than I had thought.

snapdresser wrote:sirwired - At least for my procedure, my surgeon had a couple different splints that were used at different points during the procedure. They were part of the VSP "package", which also included some stencils to make sure the cuts are in the right position, etc. My surgeon actually opened the box from the VSP company in front of me to try on one of the splints so I saw what was in it. The splints are thin and flat, not like retainers typically are. The splint that reflects your final bite is used during the procedure like you said: before doing the final attachments to make sure your bite will come together perfectly post-op. It can be left in (or re-inserted post-op) to make sure your bite stays in that position. Obviously, if you're not banded/wired shut post-op, the splint won't be in there. It's the same splint as was used in the operation (or rather one of them. Like I said, my surgeon used a couple for different parts of the procedure. I don't know if that's standard or if other surgeons only use one splint).

Same here, snapdresser! My surgeon did all of my planning through VSP and I think I had the different splints made too.

snapdresser wrote:

sirwired wrote:by the end of the operation my splint was wired to my upper archwire (for nine nasty weeks!) and I was not banded shut.

So it was just wired onto your upper teeth and your lower jaw was left free moving? Wow! Interesting. I guess there's more variation than I had thought.

I only had upper-jaw surgery, so there was no need to confine my lower jaw. The mild bands were just to help "remind" my lower jaw to rest in it's slightly-different position in the splint (which had indentations for my lower teeth so I could close my mouth almost normal.)

My surgeon was a dental-school professor (who actually has written a textbook chapter on "model surgery") and the dental-school lab did all necessary fabrication in-house. (Which makes sense, since a state dental school is orders of magnitude larger than any private practice; they probably have a program to train dental lab techs too...) Maybe there was also a different splint during surgery; I have no idea... All I know is that I woke up with one wired to the upper wire with some light bands.

LyraM45 wrote:Same here, snapdresser! My surgeon did all of my planning through VSP and I think I had the different splints made too.

Yep, you can see the two different splints in red on the second page of your VSP printout:
http://www.archwired.com/phpbb2/viewtop ... 15&t=49120

snapdresser wrote:

LyraM45 wrote:Same here, snapdresser! My surgeon did all of my planning through VSP and I think I had the different splints made too.

Yep, you can see the two different splints in red on the second page of your VSP printout:
http://www.archwired.com/phpbb2/viewtop ... 15&t=49120

Me three! My docs used VSP as well. My mid-procedure splint was GIGANTIC and really showed how screwed up my bite must have been. Today I get my splint out after 5 weeks and change. I'm not sure I'll drive over it with my car, but I might not be above putting it in a bonfire