Am I still in crossbite after Lefort-1?

[Pheanix997]

Hey guys,

I had jaw surgery several weeks ago to fix crossbite, Open bite, and underbite. In terms of my progress, I just got a new top wire put in to begin the segmental step down of the front 4 teeth to close the remaining anterior open bite.

My smile at the present time: https://imgur.com/a/xIhKQCN

(SORRY I can’t figure out how to hyperlink on here)

My question is, does it look like my upper jaw could be have been made a bit wider?

I guess this is surely a “good enough” result, so I guess I’m wondering if IDEALLYmy surgeon could have expanded the upper jaw some more so as to not rely so heavily on post-surgery orthodontics to align the bite.

When I look at other before-afters the upper teeth seem to noticeably vertically and transversely overlap the lower teeth, which is what I was expecting with my bite.

[academiannut]

I'm just a lay person, but I agree it looks as if your top arch needed to be expanded a bit to fit over your under arch. Did they do any arch expansion?

I'm at 19 days post surgery and also dealing with the disappointment of less than ideal results. Seems like few people get exactly what they wanted.

[Pheanix997]

[quote=academiannut post_id=507485 time=1557581632 user_id=32776]
I'm just a lay person, but I agree it looks as if your top arch needed to be expanded a bit to fit over your under arch. Did they do any arch expansion?

I'm at 19 days post surgery and also dealing with the disappointment of less than ideal results. Seems like few people get exactly what they wanted.
[/quote]

My top arch was expanded that’s why I’m wondering why go through the trouble with a 3 piece lefort to widen it and then not even do it to its maximum.

[mattt]

I definitely think they could have expanded your jaw more so it would fit over, now it almost seems like you have edge to edge bite... Are you in any elastics? Also, do you have any other bit pics or before pics? just to get a better idea what the starting point was...

[Pheanix997]

Yes: https://imgur.com/a/xIhKQCN

You’ll see my postop, preop, and 4-6 month preop when I was being decompensated with Invisalign and my ortho was working with the surgeon he referred me to (but not the one I ended up choosing)

When I decided to go with a different surgeon, he wanted me in braces. He didn’t give specifics regarding how he would continue the decompensation. As the months went on and surgery approached, I noticed my open bite had all but closed. When I asked my ortho about this, he said something vague like won’t worry it won’t affect the outcome of the surgery. I also notice my crossbite was worse with my original decomp than my preop crossbite....

[mattt]

Interesting, I almost imagined a bigger difference for before and after, but there definitely is a difference! What is the treatment plan now? how will he fix the bite?

[Pheanix997]

Oh and yes I’m in elastics. I don’t think my orthodontist is worried about the remaining crossbite (and open bite), but that’s besides the point. The goal with surgery was to actually get a wider JAWBONE, which is beneficial for things like soft tissue support in the mid-face.

I’m sure Orthodontics can fix or camouflage the remaining discrepancies, but they probably could have “camouflaged” the crossbite without surgery... so I guess I had higher expectations.

The thing is, he did a fantastic job on my profile and chin, it’s just the upper jaw seems to leave something to be desired.

[Pheanix997]

I don’t know Matt, I really don’t see *much* of a difference.

[mattt]

Sorry for asking for so many pics, but I'm just trying to understand your case better, do you have any with your elastic configuration on?

And I understand what you mean, they can do a lot without surgery to change the way it looks now, but I would imagine if you went through with something as invasive as cutting your jaw, you'd probably want to avoid extensive ortho work afterwards... But I hope he will be a bit more informative about what the plan is and what he's doing in the future, hearing the detailed plan from him would probably make you much calmer

[Pheanix997]

Yep, with my elastics on: https://imgur.com/a/3YOnM4l

And yeah, I mean ideally you want the jaws in the best possible position and so it should have been obvious that my upper jaw fit over my lower after surgery, but like you said it’s more of an edge to edge bite currently.

[Pheanix997]

I’m thinking upper jaw widening was not even performed...

[Pheanix997]

Some very knowledgeable members over at jawsurgeryforums think I should sue: http://jawsurgeryforums.com/index.php/topic,7690.0.html