Undoing extraction orthodontics?

[applebrownbetty]

Hi all! I'm 31 and I had two upper premolar extractions when I was around 12/13 to correct an overbite. To make a long story short, I opted to not have the jaw surgery I was originally slated to have, and I'm now disappointed with the results. I may be in the minority for those after extractions, but I do have a sunken in, flat look to my face, and a weak chin which makes my already full nose look bigger. When I was younger and my face was fuller, it was less noticeable. But now that I'm showing some of the beginning signs of aging, I can tell my orthodontic work was less than ideal.

Have any of you heard of how this can be corrected? I was thinking maybe orthodontics and implants, as well as jaw surgery.

That sounds like a um, major construction project. :-)

I know I need to consult with an orthodontist, but I want to have some idea of what can be done beforehand.

Thanks!

[diegorgeous]

If you do a search, you'll find a few people who are doing this. Hope someone replies soon!

[karina]

Personally if you are just worried that it looks like you have no chin, you should opt to have chin implants. They can make your chin poke out even more giving it an even proportion.

[Lynette]

There was someone on here not that long ago that was looking into a similar thing. Maybe try searching through the archives?

It's not impossible to reverse it. Just costly and time consuming.

The last time I had braces, I had extractions and everything was brought backwards. My current ortho has moved everything a tiny bit forward and I am finding that my chin is so much more defined and my upper lip has more definition.

If you go forward with it you may find that moving everything forward just a tiny bit is enough to give your chin more definition and you may not need any work done on your chin.

[applebrownbetty]

Thanks Lynette--I will look into doing that because it isn't just the chin that's the problem. It's my whole mouth area. Braces are going to be necessary anyway because my crossbite has shifted back (and looking all wonky...).

:-)

[Ravioli]

I *just* got back from a consultation for this exact purpose (well, one week ago). I had the luck to get two different opinions, one from a functional orthodontist and one from an orthognatic surgeon.

The functional orthodontist stated that there would be no guarantees. He said my TMJ condyles are probably displaced (I'm not in any severe pain or anything but it's always been difficult to chew) and that I would need an MRI to determine their exact position (=expensive). Then he would bring my lower jaw forward with a functional splint, to about where my front teeth are right now (this seems to be the norm and for me that's about 3-4 mm). At the same time I would get an ALF appliance to widen the upper arch and I guess create a small overbite so that everything fits together. He said implants wasn't an option and not needed. The extraction/retraction orthodontics made my mouth "grow into" a small size and therefore, he said, it wouldn't be possible to replace the teeth.

The orthognatic surgeon, of course, wanted to push for his method that he said would make more drastic and guaranteed results. He would bring my lower jaw forward about 6 mm, then bring my upper forward and upwards too with surgery (to correct a gummy smile while they're at it). I asked if any SARPE would be necessary but he said my upper arch could be expanded enough with Damon braces. Cosmetically this method would be much more noticable and I can also feel how much easier those little extra millimeters would make it to breathe. This doctor said the same thing about implants: not necessary and not possible.


When I left my head was full of thoughts and I must say I was a little disappointed as I had hoped for implants (you see, I lack a second molar on the bottom so I don't have that many teeth and placing an implant that far back might not be possible - I've seen a periodontist about that).

Despite what they said, I've heard of people who reverse the whole thing and get implants. Their jaws are expanded and brought forward with orthodontics and somehow this creates room in the mouth for implants to be placed. I believe we've had a member on the forum who had that done? One guy that talks a lot about this is Tooth975 over at Yahoo Answers and when he describes it, it doesn't seem that difficult at all. Plus I know Dr. Hang in LA does this and, I think, Brendan Stack in Virginia is open to this approach as well.

So need I say it's confusing?! I would love to come in contact with other people who want to undo this kind of treatment and maybe we could help each other, because finding practitioners who will actually do this is hard. But I'm a new member here.

Anyway, I hope this helped and let's try to keep this thread alive.

[Eurodude]

I am an orthodontic retreatment case (if only I had known this phrase even existed back as a teenager), 4 pre-molars extracted, then bands and braces and rubber bands to pull everything back.

Grew up, got on with my life but was always consious of my weak chin, accepted it as the way God made me. Little did I know.

Developed horrible TMD problems around 40, dislocated jaw joints, the part of the jaw bone going back to the condyles bent like shephards crooks, grinding, headaches, sore neck.
Wore a pivot appliance to find where the lower jaw wanted to go and it was down and forward and beyond where the upper was forcing it to go.
Now I'm 8 months into wearing an ALF to widen my maxilla. I am almost at the correct lateral (side to side) dimension, between the canines I was 34.5 mm, now 39mm, 40mm is the target. I still need a lot of sagittal development (back to front) because the 7mm gap of the extracted premolar was closed in.
I notice already major facial changes. I look a lot better. Much stronger profile, smile starting to widen out nicely, cheeks not so sunken in, lips fuller, generally not so pinched looking.
Once the ALF has created enough space the plan is to get implants or bridges to replace the extracted teeth

[hs2000]

I've had 4 pre-molar extractions too and now I want to undo my previous orthodontic work. An orthodontist I spoke to said we can use expanders and that I'm a candidate for Invisalign.

Does anyone know if Invisalign is strong enough to reopen those closed spaces for tooth implants? Should I consider conventional braces over Invisalign in this case?

[malilou25]

hey all,

I was surfing through the forum and I found this thread, so I was wondering if Ravioli and Eurodude can update on their retreatment. How is it going so far? How much time will the whole process take? And will you get implants to reverse the extractions?

I would really appreciate answers. I'm also trying to undo my extraction orthodontics and I would like to hear from people who are doing it also.

thanks

[Eurodude]

With the ALF I have gained the required space on the upper arch to replace the 2 extracted teeth, there are spaces of 1 - 2 mm between most of the teeth now (except the molars). In the final stage when I get the Damons for the last 6 months or so these spaces will be consolidated into one of 6 - 7 mm behind the canine.
Now I am wearing a lower ALF to widen my lower arch to match the upper. This will be another year.

On aspect that concerns me though is that my upper jaw is not level, looking from the front it cants up on one side. When I say this to the dentist he's dismissive and I'm like well if the cranial base isn't level then how can the mandible and TMJs sit in a balanced way?

[malilou25]

Thanks for the reply, and good luck with the rest of the treatment.
Why don't you consult with another functional orthodontist and tell him your concerns? That way you will be sure that you're not messing up your jaws again.

Anyone reversed the extractions without having to get implants?

[sirwired]

Malilou,

The idea of "reversing" extraction treatment without implants is a contradiction. If you want to reverse an extraction, you need to put a tooth back, and the only way to do that is implants.

[malilou25]

You're right it is a contradiction, but someone on this forum already informed me that she is getting them reversed without having implants. So I was trying to find more people in the same situation. Maybe it depends on each case, but i was just trying to get more information about the whole process.

[chorith]

HI everyone here !! i am new here and i also have the same problem as you all. Here is my story :
i had braces since i was 15, now i am 23 ys. My 2 upper second molars were extracted in order to gain spaces for my crowed teeth. i also had 2 of my lower first Molars extracted as well as they are already dead. on my first time of orthodontic, i didnt notice some change on my face as my upper teeth is not move back instead of my molars move forward. but my lower teeth is move back a bit that make my chin weak and i got a bit over bite at that time and i couldnt close my mouth properly. After 3 months braces were offed, my teeth started to move back to their original position. Then my orthodontic start the treatment again. after my 2nd treatment, everything seems gone worse. I actually had more over bite and TMJ, breath harder. My face is not balance each side ( bigger at right side, skinny and small at left side ). After 2 years I got the braces again with different orthodontic. He said everything will be better and he didnt explain me the treatment plan by just told me that my main problem is my lower teeth not my upper teeth. I trusted him at that time but then he placed Mini crew implant at between my upper molars and try to pull everything back. i really dont understand. After a year and almost 2 months with him, my face look more flat and sunk in. my face look small and short. weak chin and weak jaw line. My tmj is much worse and i cant breath normally, cant breath at all when i sleep on my back and my face is much different from the sides. i really regret for doing these. i really want to be healthy as i was before.

i really want some suggestion from you all and i really appreciate all your suggestion here.
I also made a group of people who have the same problem on fb names as "Reverse Fail Orthodontic treatment'' ( made it this morning ) . So hope you guys share your experiences and solutions to help those who seeking for. We are in the same situation, so you may know how worst the feeling is.

Best regards,

Chor sovannarith

[maxhammer]

The best thing you can do is understand your face. Look at old photos, and your pretreatment photos. Try to see if you lost a lot of bone due to extractions. Try to understand how far the front went back vs the back molars coming forward. Inform yourself. Then you can figure out where it went wrong.

My guess is that you all had the front retracted and the arch constricted with little movement of the back molars forward. I went down this path (had extractions 1 year ago, freaked out at the results, and took charge in my case). I informed myself and went to my ortho with the complaints. We pushed the front 6 teeth forward 3mm using coils. Found out that TADS could be placed in that newly created space to pull the back molars forward (why wasn't this done to begin with? Oh, because orthos are lazy and want the quickest treatment rather than the best treatment). Okay, a generalization, but I think true. Anyway, we put a wider wire on my arch, which helped with the small, caved in mouth, then we pulled the back molars forward using TADS (reveres head gear is a cheaper option). I'm a few months into this modification, and it's way better than the pure retraction method, though I am struggling to close the remaining 4mm of space in an aesthetic manner. I might have to concede and retract a mm.

One thing to remember: our jaws are too small; it's why we needed extractions. So to me extractions weren't the problem, but (a) were the right teeth extracted (e.g. second bicuspids are smaller) and (b) was the space closure handled correctly? I had about 6mm of crowding, but by pulling two front bicuspids we created 16mm of space. The difference is 10mm. Now, I had an overjet, so 4mm of that was closed by pulling the overjet back and constricting a little. That was fine. It was the remaining 6mm that was the problem. I'm down to about 4mm now. I might just leave a 1 or 2mm gap behind the bicuspids. That might be better than pulling the back molars forward or retracting. The latter is horrible, and the former runs the risk of the cheeks caving in (though my ortho swears this won't happen). Also, pulling the back molars forward tends to open the bite.

Something to understand about implants: the smallest ones require 6mm of space. If you needed extractions, that will be difficult to find. You'd have to have the ortho torque and expand the teeth to the outer limits of the jaw bone. This will result in a "monkey face" for many people in that you'll be too far out. Consult with a periodontist about getting bone grafted. They call it ridge augmentation. This will provide support. You can also get bone grafted in the cheek area. This might help some peoples' problems. It really depends on your bone structure, something orthos don't consider enough.

Orthos should reject patients. That is the bottom line. If a patient has a configuration where the space can't be closed in an aesthetic manner, they should be told to keep their current smiles and be happy. They never do this, though. People have a lot of trust in orthos and think "since they're professionals they know best." No, a patient knows their face best, and they know what they want to look like. Don't trust an ortho with that. They're all about mechanics and function. If the teeth are straight, they say they've achieved a desired result. As you can probably tell, I am very much against orthos (and I consulted with 4, all are the same) after my experience. It's not a total disaster like some, but it's definitely not what I was picturing when I went in to fix my bite.