ideas on what i will need (pics)

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#1 Post by **jayye** » Mon Jun 22, 2009 4:01 pm

http://family.webshots.com/album/573178102aYlSVb

hope this link works.

As you can (hopefully) see, my face slopes inwards towards the bottom. My bite is is a bit open but this doesnt cause me any problems. The majority of my teeth meet. My teeth are by no means perfect, but its my profile / jaw that I hate, my teeth I could live with! Anyone know what procedures might be needed to correct my profile, anyone got similar? In reality its not quite as bad as these pics, they are showing my situation at its worst. Thanks

#2 Post by **ReoSity** » Mon Jun 22, 2009 11:30 pm

Your lower jaw is retrognathic( positioned back to far) so they'd definitely do a saggital split to move it forward.

#3 Post by **jayye** » Tue Jun 23, 2009 1:55 am

thanks. What do you think about my upper jaw? If I push my lower jaw forward it looks ok, but I cant believe that my upper teeth could be pushed out far enough to look right with my lower jaw brought forward.

#4 Post by **Twinjoy** » Tue Jun 23, 2009 2:43 am

If you look at my blog you will see our profiles *were* similar. Aside from the fact that my teeth were horribly crooked our bottom and top jaw positioning seems to be similar. I had a BSSO (Bilateral Sagital Split Osteotomy (sp?) ). The orthodontist was able to make it to where I didn't need upper surgery as had been recommended in the beginning. They originally thought during the surgery they would also widen my arch but the wonderful magician pulled it off. I hope you have the same awesome results!

#5 Post by **jayye** » Tue Jun 23, 2009 3:24 am

twinjoy your results are amazing! Looking at your before profile, I think my upper jaw may be further back than yours? Not sure, but hopefully I can avoid double jaw surgery. I just dont think there is room in my gums for my upper teeth to move out as far as needed though. I have an appt with an ortho soon so will see what he says. Its nice to get an idea of what I might need doing before I go.

#6 Post by **DrJasonKTam** » Tue Jun 23, 2009 6:02 am

The center bite picture may be a bit deceiving because it looks like you are posturing your jaw forward. That being said, the upper jaw may need to be widened as the lower jaw comes forward. Using a lateral cephalometric x-ray, as well as other clinical measurements, your orthodontist and surgeon will be able to put together a proper plan.

Good luck!

#7 Post by **AF104** » Tue Jun 23, 2009 8:39 am

Room in your gums? Your gums move with the bone.

#8 Post by **jayye** » Tue Jun 23, 2009 1:28 pm

Thanks Dr Tam

AF104 - I mean if my upper teeth were brought forward with braces to fit with my lower jaw being brought forward surgically. The upper gums dont have room for the teeth to be pushed out enough. Will post a pic later.

#9 Post by **jayye** » Tue Jun 23, 2009 2:31 pm

Ive added 2 more pics, 1 with my lower jaw pushed forwards and mouth closed,
1 with my lower jaw pushed forwards and mouth open to show my gums, what I mean is do you think there is enough room in my upper gums for my top teeth to be pushed forwards/outwards so that they fit correctly over my lower teeth after my lower jaw has been brought forwards?
Or might it be both jaws need bringing forwards? Thanks for your opinions.

http://family.webshots.com/album/573203067gqzmoC

#10 Post by **ReoSity** » Tue Jun 23, 2009 8:07 pm

I'm still not understanding your question but in your case if they move your lower jaw forward, they have to move your upper jaw so your teeth fit. Go to a oral surgeon, they'll be able to answer all your questions.

#11 Post by **AF104** » Tue Jun 23, 2009 8:19 pm

In regards to this comment: "The upper gums dont have room for the teeth to be pushed out enough." You seem to think that the gums are left intact when the bone is moved. The incision goes through the gums. So, the gums and bone move an equal distance and maintain the same relationship that they previously had.

#12 Post by **jayye** » Wed Jun 24, 2009 3:50 am

No I do not seem to think that the gums remain intact when the bone is moved. I am talking about the upper teeth being moved with braces if I do not need upper jaw surgery.

Im obviously not explaining myself very well. I will let you know what the ortho says in a few week time. Thanks

#13 Post by **AF104** » Wed Jun 24, 2009 5:14 am

I've never heard of a gum injury from braces aligning the teeth in an arch. I'm sure you'll be ok but let your Orthodontist alleviate your concerns as well.

#14 Post by **archangel689** » Wed Jun 24, 2009 11:59 am

None of us here are oral / maxillofacial surgeons, so really the value of our opinions isn't very much. You need to get the opinion of a very experienced maxillofacial surgeon.

You don't have braces with teeth ready for surgery, so it's really really hard to tell anything without a trained eye.

That being said it looks like your midline might be off, so a lot could be done with just a bsso advancement with a rotation, but to correct the flatness you'd need a lefort, this would also alter the look of your nose. It could be worth it.

But I had a bsso on monday and let me tell you, not being able to feel my chin sucks, staying at the hospital sucked, and most everything generally sucked. See a really good surgeon that works in a hospital and does accident victims too.

#15 Post by **TwitBerry** » Wed Jun 24, 2009 12:53 pm

Hey Jayye,

I'm not a doctor, but it does look like you'll need at least a BSSO (lower jaw surgery) and, perhaps, genioplasty. But, definitely consult w/ as many surgeons as possible before making any commitments. I consulted w/ 5 before opting for the surgical route.

I had just the BSSO. In my case, 2 lower teeth were removed and my lower arch was pulled back via orthodontics to achieve a 1 cm overjet pre-surgery. Without extractions, my surgeon would have only been able to move my lower jaw forward by 3 mm or so, not nearly enough to fix my deficient jaw/chin.

Removing 2 perfectly good teeth will seem radical to some orthos, but it worked in my case. Everybody is different, so expert opinions are necessary. At about 8 weeks post-surgery, not only do I love my new profile, but my jaw muscles are comfortable for the first time ever.

Hope this helps.