Metal Mouth Message Board

Well, I've had my braces for nearly 18 months now, and here's the situation: Class II, 9mm overjet, open bite, crossbite on the left. Elastics are not doing the trick, so orthognathic surgery upper and lower was offered as an option. Surgeon says my lower jaw is small and under-developed, plus I have lower lip incompetency. I need to have the upper jaw moved upward due to a gummy smile, and the lower jaw advanced. When I heard about the recovery time, and the 30k cost...I was floored. The surgeon also mentioned something that could help the lower jaw only, but was much cheaper, and far less invasive. Micro-screw implants in the upper jaw to be used as anchors, along with a chin implant...my Ortho was on board with it, but emphasized that it was a very new procedure, and perhaps would give me SOME improvement in the lower only, but of course the big surgery is the gold standard. Then she and one of the other orthos called me in and said they would like to do a quad for the crossbite, and elastics again, and somehow (not sure how) it will also help some with my overjet. They said they wany to try this for at least 6 months, maybe more...before I decide if I want to go forward with either the screws or the full surgery.

I am so discouraged and confused...

I have pics here (sorry about the quality)...any thought Doctors? Suggestions or advice? Thanks for the time.

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Hi ladybug,

Just thought i'ld let you know that your situation sounds a little like mine. I started with a 15mm overjet and was given the options of braces on the top to bring my overjet back to 10mm, or braces top and bottom and upper and lower jaw surgery plus genioplasty to fully correct my functional problems of bad bite, wearing down teeth prematurely and helping with my recession and periodontal problems.

The genioplasty is to help my lip incompetence, the upper jaw surgery to help with my gummy smile and crossbite (I think), and the lower jaw coming forward to correct my remaining 10mm overjet.

I've had my braces on for nearly 18 months and was supposed to have had my surgery 9 months ago, but a tooth on the bottom has taken a long time to get into position so I still don't have a date. I could have gone just for the cosmetic improvement on the top, and i am really happy with the improvement of my overjet as it is a huge improvement on what it was, but my reasons for braces was to correct the functional problems I have and cosmetic improvements are a bonus.

Only YOU can decide if the cost is worth the benefits. I refinanced my mortgage to do my teeth, which will eventually cost about $20,000 Aus but this includes top hospital cover for 2 years (at $3000 per year), braces at $4975, surgery at $5 500, anaesthetist at $2000, and splints, x-rays etc at around $1500. Of this my top hospital cover and Medicare covers my 4 days in hospital, theatre costs, and about $3000 of my surgery and anaesthetist costs.

My advice is to take the costs and benefits of each into consideration and your likely outcomes and decide from there. Good luck with whatever you decide.

Chrisk

Thanks for the reply Chris. Sounds like our situtations are definitely a bit similar. I just don't have the financial ability to afford the orthognathic surgery, even though it is the best option for me. So I am really hoping that one of the other options will help, at least to improve things from where they are. Best of luck to you also with your treatment.

Good morning, Ladybug...

My daughter has the microscrew implants and has had the most amazing results!. Her open bite looked much worse than yours, but her teeth look fantastic now.

She had the implants put in July 2004. The braces went on a few weeks later. Now her bite is closed and the braces will come off in a month or two.

Here are a couple of very good articles that tells about the procedure:

http://www.angle.org/anglonline/?reques ... &page=0381

http://www.pcsortho.org/bulletin/bullet ... 20Anch.pdf

Thanks for the articles Mistake!! That is wonderful that your daughter has had such great results! Any chance you could post any progress pics of your daughter? I would be very interested to see what the implants can do, and how her teeth looked before...etc. Thanks so much!!

Unfortunately, I don't have any photos to share. I'm sure the ortho has some in her file, but I don't have any to show you. So just try to imagine an open bite with a front gap big enough to easily stick your pinky through...now imagine a really nice bite. That would be her "then" and "now."

Hi ladybug, just to say that I have the exact same problems as you although my openbite is a lot worse and I think my lower jaw is more recessive, although this is hard to tell because of the increased openbite.

I am going the full surgical route: maxillary impaction, mandibular advancement, genio and possible SARPE if orthodontic expansion doesn't work.

I'm only a few months into treatment so can't offer any advice at this stage but would just like to wish you the best with whichever route you decide to take