Just SARPE?

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BracketRacket
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Just SARPE?

#1 Post by BracketRacket »

Hi,
Just reading around, it seems like a majority here have SARPE, and then down the road end up having upper/lower or other surgery. Is that typical, or just the nature of it being an oral surgery forum?
My ortho has sent me to an OS because of my narrow upper arch, and I'm just wondering if I should be surprised if another surgery is mentioned -- my ortho has not said anything about it, just that the braces would be placed after the surgery. I assume that most of you started out the journey knowing that the other surgery would be coming down the line -- is that something that the ortho mentioned right off the bat?

AF104
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#2 Post by AF104 »

Rapid maxillary expansion will widen your narrow arch. You should consult with a surgeon about whether or not any other surgery would be appropriate. The advice of an orthodontist is not equivalent to that of a surgeon in regard to skeletal issues.

BracketRacket
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#3 Post by BracketRacket »

Thanks -- I do have an appointment in a few weeks with the oral surgeon...as far as I know, just to discuss the palate expansion. I guess I'm just wondering if I should be expecting him to mention anything else -- I'm not one for surprises! :roll: I know a lot of it depends on my specific case.

It just seems like from reading here that many people have SARPE as a precursor to other treatment down the road, and not just as a means to expand the palate so that braces can do everything else. I was just wondering if SARPE only was more frequent and just not reflected here.

crazybeautiful
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#4 Post by crazybeautiful »

It's more a case of a narrow upper arch being a main contributing factor to other problems. So SARME first of all is necessary before the 'serious' surgery can be done to fix the bigger problem.

But if you just have a narrow upper arch, then that's it. It's not just a precursor treatment, but it just happens to be that lots of people (like me!) have numerous issues that make up the problem as a whole.
~SARME, Nov 2007. 10mm expansion

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My blog: http://crazybeautifulsurgery.blogspot.com/

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avy
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#5 Post by avy »

I only needed SARME - the braces are taking care of everything else :D

fosterp
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#6 Post by fosterp »

I guess theres a few factors involved

A narrow upper arch is a very common orthodontic problem that can only be corrected surgically as an adult

And the surgery is often done as the first step in orthodontics before even being banded

Other surgical procedures are often done towards the end of orthodontics because...it just works better that way (best answer I can give off the top of my head, sorry).

Generally an ortho can tell you in a consultation if you will need surgery for anything. Sometimes they can tell you that things "might" be able to be corrected with braces alone, but may need surgery for later for ideal correction. I doubt theres any case of taking a non surgical treatment and being "surprised" by needing surgery because the treatment doesn't work. If that did happen I would think the ortho wasn't very good.

If you can tell us what is wrong with your bite, or post pics/xrays we might be able to guess if/what surgery would be needed.

BracketRacket
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#7 Post by BracketRacket »

Sorry for the poor quality -- photos of photos in bad light! :oops:
It's weird when I look at these, because I don't feel like they look like my teeth. Also, to some extent, they didn't feel natural when they were taking them because they would be like "bite down" and my response would be "how?!?" My bite is always different, I have to concentrate to bite down on my left or right side on cue -- I guess the jaw size inequity is a good reason! Like, none of these feel like my "true" bite or what my mouth does at rest. Although I supposed photos don't lie! The giant filling on the left side is a baby tooth that supposedly had the equivalent of a root canal quite a few years ago -- the rest of the fillings are all me, although I'm sure the crowding doesn't help :oops: :oops: ) I promise I take much better care of my teeth now!

I know the quality is bad and the colors are off, hopefully not a waste of time for you guys!

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Left side (the last tooth you can see is a baby premolar, no adult tooth under it (hence the icky filling and broken tooth -- they've been telling me it's going to fall out soon for a long time!)
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Right side (for instance, I definitely don't feel like the front juts out that far)
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Front open
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Front closed (I promise that bottom tooth is, in fact, there, you can see it above!
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Phew, that took a bit of nerve to post!

fosterp
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#8 Post by fosterp »

well the narrow upper jaw is obvious need for expansion

its really hard to see in the pictures but it looks like you have a normal molar relationship and the narrow upper arch is causing your incisors to be flared out, causing the overjet

normal molar relationship is basically when the grooves of your second bicuspid on the upper arch rest in the grooves between your second bicuspid and first molar on the lower arch

not an expert on surgery but from what i've found out it seems that surgical cases are for the class 2 and 3 molar relationships, the only way to fix that is by moving the jaws forward or backward (overbites and underbites with normal molar relationships are generally caused by protrusion of incisors which can be corrected with braces alone in many cases)

also surgery is needed i believe for open bite cases

the reason your bite might feel "off" is because your muscles may have adapted to close in a way that feels better for your TMJ (the joint that connects mandible to your skull)

orthodontists want to correct your bite so that your teeth will come together correctly in a position thats natural but they need to see how all the teeth close together in their current position in order to assess how they need to be treated

so my unprofessional opinion is that you would only need upper jaw expansion to fix the crossbite, and nothing else

BracketRacket
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#9 Post by BracketRacket »

fosterp wrote:
so my unprofessional opinion is that you would only need upper jaw expansion to fix the crossbite, and nothing else
Your unprofessional opinion is spot on! (At least thus far!) Saw the OS, no mention of any other surgery. :D

A bit more at ease about some things, others more worried -- but a relief to have taken a few more steps toward getting the ball rolling! Thanks!

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