SURGERY FOLLOWING FAILED SPLINT THERAPY/OPEN BITE?

[lily101]

I'm a very complex patient who will eventually require ortho and corrective jaw surger for a bite that has totally collapsed. I've been in a splint (8 months) that has forced my jaw joints back creating a significant open bite. I've recently been told by other docs that the splint was a mistake which has caused irreversible changes and that the joints will never go back to their natural position. I'm still trying to get out of TMD pain caused by this appliance and am in PT. I know my jaw will settle somewhere but I'm very concerned about moving forward with ortho and surgery in this situation. Has anyone had a complicated situation such as this?

[2cd time round]

Hi. In my opinion I would say don't continue to ortho and surgery until you get the TMD pain sorted.

I'm in a pretty similar situation. I started splint therapy over a year ago to get my head, face and neck muscles relaxed and "where they want to be" and in turn to get my jaw into proper position. I am just starting to be phased into ortho as my neuromuscular dentist is getting a bit frustrated with my case (apparently I failed my botox injections but that's another story). So I understand frustrations about pain increasing or feeling a bit hopeless and just wanting to get things fix. when nothing is working

My bite is also now open and my jaw "twisted" into a strange (to me) position as well. My thinking on this is that this is a actually a good thing. In the past, my muscles had totally taken over the predominate role of the teeth in alignment as my jaws are in such a state. Muscles had forced my jaw to "fit together" - this means it was rotated and my bite completely closed. Sounds good, but if you see the cant of my lower jaw you'd realize how bad this actually was.

The lower splint I have has provided a "table" of sorts for my teeth to rest on and in turn given a chance for the muscles to relax into a "normal state". Heavy duty muscle relaxers have also helped a lot with the muscle pain and weird spasms I have in my facial muscles.

Now as for moving on to ortho. My ortho is working very closely with my neuromuscular dentist. He won't even touch my teeth until I am pain free for at least 6 months AND as long as the neromuscular dentist works along side him. I feel very comfortable with this as the ortho said he will not do anything with me if we can't get the muscles calmed down. If they aren't happy before surgery chances of "issues" arising post surgery are greater. So, I'm happy with the orth wanting to take things slow so as not to make things worse. My suggestion to you would be to talk to your ortho and find out how they can keep your tmj under control during treatment. Also, ask what he/she thinks about moving ahead while you still have these issue. Personally, if they said they would go ahead with it, I would seek another opinion

Now as for complicated here's my story - double jaw surgery and genioplasty when I was 17. My symptoms were headaches, shoulder pain, neck pain, "bruising" around my ear, tinnitus....all the symptoms of TMJD. In addition to this my jaws were a mess - didn't pay attention at the time though For the most part I thought things went very well but the muscular issues weren't dealt with. As a result, I am back here 20 years later with an open bite, narrow upper palate (will be getting SARPE) and some serious cants in my upper and lower jaw (double jaw surgery again at some point).

Hope this helps and you are feeling better since your post (which is a while ago I realize

[Marisama]

When will you be getting surgery? I have a cant also.

[2cd time round]

[quote="RYANvaughn"]When will you be getting surgery? I have a cant also.[/quote]

Hi. Not really sure when I'll be having surgery. I'm in a holding pattern right between ortho and my dentist. Having said that, I hope to get a referral to a surgeon next time I see the ortho (end of Oct.)

[overfortyish]

What is a "cant"??