Surgery for Moderate to Severe Class II?

[alyssabunny]

I am hoping to hear from some class two people

I have been seeking treatment for a class II overbite. I originally chose an ortho that would treat me without surgery (other orthos have tried to push me into surgery)but I am not sure i am going to get the desired result.

When I look at my profile, I have no chin and it really bothers me. I was wondering, if you get teeth removed to correct the overjet, does it make your chin look larger/smaller? My ortho seemed concerned that it would make my nose look larger.

Has anyone considered either a chin implant or a "nose job" in addition to jaw surgery (or in its place)?

To sum this all up, I think my case is borderline for surgery and I was wondering if plastic surgery is an ok alternative if my ortho can make my bite functional and I just want to improve my profile (of course if he cant I would be getting jaw surgery)

[nvcarissa]

I'm a class II maloclussion (overjet) and it will require surgery. To pull my top teeth BACK would make my chin recede even more. So, if all goes well with my treatment, in about a year I'll be getting surgery to move my jaw forward. This should also help my headaches.

Ask your ortho if a chin implant would help.

[chrisk]

Hi alyssabunny,

I will be having a genioplasty (chin surgery) in addition to my upper and lower jaw surgery. I was told by my maxillofacial surgeon that the genioplasty was to ensure that my lips would meet without stress post-surgery. My braces have been moving my top teeth back 5mm, and the lower jaw surgery will be moving my bottom jaw forward 10mm. (I had a 15mm overbite pre-braces). The upper jaw surgery will help correct my mid-line and gummy smile.

I have noticed since my overbite has been reduced that my bottom lip seems to be bigger, and my top lip thinner (as i'm not having to stretch everything over my teeth anymore) so possibly this is what he means by getting my lips to meet without stress.

I don't know if my chin looks smaller but i do feel that my lips have changed. Having said that, i am going into this for functional reasons not cosmetic, and my surgeon said that my profile will be much better. I guess i'm just trusting in his judgement and keeping everything crossed for a good cosmetic (and functional) outcome.

Either way, so far i am happy with the improvements that i have had so far, and comments from friends and family have all been positive, even to the point of suggesting that i don't need the surgery now. But my plan has always been to fix my functional problems so i will be seeing this thing through to the end.

Only you can tell whether jaw surgery will be worth the expense and recovery time involved, so either way may be you should see what your ortho or a surgeon (plastic or maxillo-facial) says in regards to your profile, teeth and jaws.

Chrisk

[alyssabunny]

Thank you both for your replies

I had some more x-rays and some computer modeling done so I will have plenty to chat about with my ortho in two weeks (my next adjustment).

I think I am going to seriously consider the surgery since things arent going as well as planned. I have also been having more headaches and TMJ issues than I have ever had (I need to take muscle relxants to sleep at night).

Please let me know how your surgeries go

Thanks so much,

Alyssa

[buffaloborn69]

Hi, I have a 17mm overjet. I haven't met anybody with anything larger than that. Right now I have an removable expander for my upper jaw. I need to wear this for 5 months, possibly more. On June 27, I get my braces on my bottom teeth. I too will need surgery, only on my lower jaw to move it forward. My ortho said he will try to do as much as he can with braces so the OS doesn't need to do a lot with the surgery. At my ortho's office, one of the techs had a 16mm overjet and she said the ortho moved her teeth with braces alone, no surgery! I would love if he could do this for me but I'm not holding my breath.

I got this overjet from sucking my thumb until I was about 12. It stunted the growth of my lower jaw. My top teeth look good, they don't protrude out much at all. It's just my front lower teeth that look like they're going back in my mouth.

Did anybody else have the same problem with sucking their thumb that caused the overjet or was there some other problem that happened?

[alyssabunny]

Hi buffaloborn69,

Hmm thumb sucking...I think I did that until I was 9 or 10...I hope that wasnt what screwed up my teeth...I could kick myself now


Wow a 17 mm overbite, when are you having your surgery?

I also wonder if this problem is more common in women than men (everyone I have personally known with this problem has been female)

I started wearing braces 6 months ago and i had an 8mm overjet so my upper teeth do protrude quite a bit. If this were my only problem I definately wouldnt want surgery.

My lower jaw is canted at a weird angle and my lower jaw on the left side bites into the roof of my mouth and all the teeth are tipped almost horizontally. I think my lower jaw is significantly narrower than my upper. My ortho is trying to fix this for me but I havent seen much progress (and the pain is worse than before)

And some how my lower jaw is also stunted from all this (I feel like i should have more jaw bone than I do and a chin would be really nice).

Here is the gallery of my before pics (the two bottom ones are really scary)

http://www.picturetrail.com/gallery/vie ... uid=438098

[buffaloborn69]

I don't know when I'll be having surgery. I'm only in an removable expander for my top jaw right now. On the 20th I get spacers on my bottom teeth, 27th I get the braces. My ortho told me I'd be in braces for about 12-18 months, so I could have surgery as early as next year. I'm hoping! So this is the beginning for me. My top teeth are in pretty good shape, my top front teeth don't protrude out at all, it's just the bottom front teeth that are, what looks like, going back in my mouth and my teeth almost touch the roof of my mouth. I also have crowding.

[geekgirl]

buffaloborn69 - I'm very interested in hearing your stories. I have an 11mm overjet, and I'm just starting the process of getting it fixed. Mine do protrude quite noticably, however. I've got my very first ortho consultation today (it's actually my "2nd opinion"; my consult with the recommended ortho is *still* 10 weeks away!). Every dentist I've seen has told me surgery is the only way to go, but i'm really curious to hear from a orthodontist.

The fact I sucked my thumb as a kid added to the fact I bite my nails horribly has probably not made the situation better, I'm sure. I'm kind of hoping that with braces, i'll be physically unable to bite my nails and will finally break the habit!

[buffaloborn69]

Have you seen an oral surgeon (OS)? I think it's wise to see one since he's the one that will be doing the surgery. It's good that the dentist and orthos tells you that you need surgery, but only an OS will know for sure. If you haven't, ask your ortho for a recommendation on who he would choose. Most orthos and oral surgeons know each other and most of the time they see the same patients for braces and surgery.

Do you need surgery on your lower jaw to move it forward?

[geekgirl]

Actually, I just saw had my ortho consult yesterday, and as expected, he wants surgery. I'm going to get a second opinion just in case, but it's pretty obvious my lower jaw needs to come forward a bit. Basically, ii was told it'll involve 18-22 months in braces, surgery, then another 3-6 months back in braces to tweak the bite.

[dafdesign]

Hi Alyssa,

I was considering surgery to correct my Class II overbite as well. My ortho said that they could correct my bite with just braces, but my profile could not be corrected without surgery. When I met with the surgeon, he said that for anyone over 35 (I'm 52), there was a good likelihood that the surgery would result in permanent numbness of the lower lip and chin. He said because of my age, he could almost guarantee it with 99% certainty. That was a definite deal-buster for me.

We did discuss the cosmetic options. He suggested the possibility of a chin implant, and a mini face and neck lift (along with some lipo in the neck area) to get the results I want. There is nothing wrong with going the cosmetic route, IMHO, as long as your orthodontist can correct your overbite with braces.

I've elected to go just with braces and possibly consider cosmetic surgery at a later date. Unfortunately, medical/dental insurance does not cover cosmetic surgery and the $11-16,000 price tag is more than I'm willing to pay, especially if my teeth are straight and my overbite corrected without surgery. The good thing about the cosmetic surgery is that you can decide to do it at any time, so you'll always have that as an option if you are not happy with the results (but you may be surprised -- you might look better than you think!!)

Good luck!!

Linda

[nvcarissa]

When I met with the surgeon, he said that for anyone over 35 (I'm 52), there was a good likelihood that the surgery would result in permanent numbness of the lower lip and chin. He said because of my age, he could almost guarantee it with 99% certainty.

HUH? My OS didn't say anything of the sort with me. I will be 50 when I get my surgery. I haven't heard any such thing any where else.

[Chris]

Apparently that surgeon doesn't have much success with adults. Maybe its his technique.

Even though surgery should be a last option, I'd get another opinion, several actually.

[dafdesign]

Wow, that's really weird. This guy came highly recommended (of course that doesn't necessarily mean anything) and is both a dentist and an oral surgeon. Plus, he was one of only a couple doctors who were on my medical plan.

Guess I'll need to figure out what I want to do quickly. I'm scheduled to have my top 2 teeth removed this Thursday, and that's based on the non-surgical treatment plan.

Linda

[alyssabunny]

Hi Linda and everyone,

I think I am pretty much settled on cosmetic surgery after this (as long as my bite is functional). I may be having extractions but I wont know til the end of the year. My ortho is one of those "wait and see types" but I am assuming that I am having extractions to make room to correct most of the 7mm overjet. He has told me that it wont be perfect but should look pretty good ( I think 2-3 mm of overjet wouldnt be that bad).

Not having surgery seems to be cheaper in the long run (and less painful) but I will be wearing braces longer (I was quoted 24-28 months but it could run up to 6 months longer) and will need crowns on my left molars to raise those teeth up high enough to line up with the top molars and will be having my chin "done" about 6-12 months after the braces are coming off. Luckily I can put off the cosmetic stuff and see how my profile comes out with all the cheats and camoflauges.