complex and lots of questions (newbie)

[amyD]

Briefly:
About a year ago, I have been to treatment for tmjd with orthotic, (bite collapse and poor occlusion generally) which helped lower jaw forward and relieve pain, and sleep alittle. The tmj guy refereed me to nm orthodontist, and they said they would only work with me if I accept orthognathic surgery as part of plan. Since then I researched and consulted with other specialists, including chiropractor, prosthodontist and another orthodontist in the area I live. Also, researching and reading some blogs, youtube, and surgeons in europe and north america, so much to learn. So, I have missing teeth, a comfortable tmj at edge to edge bite, but classed as class 2 bite (because of where crowns were restored years ago after some bad work was done, but i cannot chew because of pain, and collapsed bite). There are the issues of bone loss and aging (over 40), but apart from this I am healthy. I cannot chew, havent been able to for long time, have poor sleep and wake up alot. I want to go ahead and do what is best for my health long-term, and am going to consult with surgeons in Los Angeles, and have possibility of going to Europe if that doesnt work out. I want only to go to the most experienced, because I have been advised on bone graft, implants, orthodontics, prosthodontics, orthognathic, all of it must be done.

Questions/ experience/ advice: (and please links are good to other pages if allowed)

Does/ can you recommend who else to consult with?
(i can mention who i am seeing if allowed?)
Does anyone have experience with particularly, surgeons in Europe or Los Angeles?
What is best insurance?
Titanium or osseo-integrative screws?


Thank you for all the posts, I see information about so much, and will take time to read through everything.

[BracedSurgeryStudent]

Hey I think you def need to consult with a few Oral and Maxillofacial Surgeons or just oral surgeons. FOR SURE! I did but my orthodontist was cool with me not being able to get it done.
I've had Boston Surgeons experience and some of them are just rude and want to break my jaw for no reason. I had a consult in one of the surrounding areas and met a great surgeon, but her and I decided that orthodontics would be the best for my case.
ANY insurance accepts that surgery but the orthodontist is going to make your under/'overbite worse.
Titanium for sure.

[Bullfighter]

I have (positive) experience with a maxillofacial surgeon in San Diego, so if that's a possibility I can share who/where. He does everything from dental implants and cosmetic procedures to orthognathic to full facial reconstruction after accidents. I would guess that whatever your issues are that he has seen them before.

I'm over 40, and recovered fine. Bones heal, and I don't believe your maxilla/mandible are really a prime concern for bone loss -- unless you're actually 80 and rounding down.

Your history is complicated, with many existing issues, so you're probably not going to get relevant advice on a web forum.

Would definitely say you need a consult with a maxillofacial surgeon before doing anything...

[BracedSurgeryStudent]

I agree with Bullfighter

[amyD]

thanks for your responses.
i have consulted with someone, have consults with couple more, and after tons more research i have a slightly better idea what is imminent. it really helps to know what others have gone through / dealing with. these forums and blogs are amazing
important to me to see someone experienced.

bullfighter, sure, i would like your referral. in san diego?