PICTURES INCLUDED bimax protrusion

[pearlyteeth]

Here are the links to my previous posts:
http://www.archwired.com/phpbb2/viewtop ... 13&t=42651
http://www.archwired.com/phpbb2/viewtop ... 13&t=42656

I want braces for cosmetic reasons.
1. Will my gums move with my teeth when I get my extractions done?
2. Do you suggest first premolars or second premolars?

Here are the pictures:

http://i45.tinypic.com/m2cjq.jpg
http://i46.tinypic.com/1115yr8.jpg
http://i50.tinypic.com/117z91w.jpg

[hopeless20312]

I think I have the same problem as yours so I'll stay tuned to this. I think my problem is much worse than yours. My ortho didn't really like extractions so I have none. I don't know if that's the right decision.

[bellarina]

Hi pearlyteeth,

Just saw your other posts as well as this one and wanted to weigh in since I started treatment a couple months ago for the same problem. (Looking at your pictures, though, I see that mine's more severe.) That's why orthodontists only suggested first premolars for me; none said anything about second premolars. I can see why either one would be suggested for you. Taking out the first premolars will create a lot of space, but if the ortho controls how much the back teeth come forward (vs. the majority of movement, which will be the front teeth moving backward), it shouldn't create a sunken in face. But taking out the second premolars might be less of a risk. I've definitely read articles about both methods getting good results..I'll try to dig up the links for you.

Also, in all the pictures I've seen, the gums move back with the teeth.

Aside from mine being more severe, I have to say that our cases are really, really similar. I also had braces a long time ago, and my teeth were basically straight when I started treatment this time - the only issue was the protrusion. My parents were also opposed to the idea of extractions, especially since my protrusion was much milder years ago. But they were the ones to tell me to go for it after meeting with my current ortho, who assured them that he's done this before and showed us previous results, which looked great. I think my parents had assumed that getting extractions for straight teeth was really odd and an extreme measure (no one they know has it/gotten it treated), even though getting 4 extractions is the standard for bimaxillary protrusion treatment. (Not to say there aren't risks, etc with extractions, but the treatment isn't as extreme or odd as my parents thought it was!)

Feel free to PM me if you want to see my pictures before treatment! Honestly, of course I started really recently, but I don't regret it one bit. And I asked some people around here with bimax before starting, and none of them regretted it either. I'd say think carefully about what each ortho said, and if you decide this is something you want to do, don't be afraid to go for it

[pearlyteeth]

Thanks guys for your opinions!
I still have 2 weeks before I see my orthodontist, so I think I'll do more research and ask him about it.

Bellarina, I would love to see your pictures. I'm glad to have someone in the same boat as me. It's a tough decision when people don't understand why you are taking out 4 teeth when they are "straight."

That's really good that your parents agreed with extractions. I think I'm going to ask my orthodontist as well if he's ever dealt with this kind of case before and ask to show previous results.

I will definitely keep posting if I get more info.

[alyssaroo27]

Sorry for digging this up but I'm about to start this process as well. I'm pretty nervous as I have psyched myself out by reading "horror stories" about results gone wrong after extractions but then I usually always see something about how extractions are generally a "safe" treatment for those with bimaxillary protrusion.

My teeth are straight as well and my orthodontist is planning to extract the first premolars. I'm also worried about getting a sunken in profile but I'm hoping that won't be the case as my protrusion is pretty severe to begin with. I don't want a super flat profile, but I don't want results that are barely noticeable either.

I'm glad I keep stumbling upon more users who are going through the same process. Keep us posted and thanks for sharing!

[artichokeenthusiast]

Hi guys, I'm totally in the same boat! (first time poster!)

I also have fairly straight teeth except for very minor crowding and an overbite, along with my main concerns of bimax protrusion and lip incompetence (lips don't close naturally at rest).
I've consulted with 4 orthos so far (and I'm seeing one more on Wednesday!) who have pretty much all told me I could just fix my overbite with IPR & braces, but if I want to correct my bimax protrusion and lip incompetence I have to extract 4 (healthy) premolars.

I recently found a review article that addresses our collective fear of getting a "dished in" profile after extracting 4 premolars to correct our bimax protrusion:

(Edit: I'm not allowed to post url links, possibly because it's my first post? Anyway, if anyone wants the link to the scientific review article, feel free to PM me! The most pertinent quotes from the article are as follows:
"The lip procumbency improves following the extraction of four premolars and this improvement is predictable. However, the changes are small and do not dramatically modify the profile. A ‘‘dished in’’ profile is not to be expected. Individual variation in response is large."
"Soft tissue changes involve small entities and do not dramatically modify profile. Therefore, a ‘‘dished in’’ profile is not expected following premolar extraction in biprotrusive patients.)

I guess I'm going to take the plunge. I'm also glad to find that some of you are going through the exact same process!! :) Let's keep each other posted!

Do any of you know whether you will be going with traditional metal, ceramic, or clear self-ligating (ie Damon clear) brackets? Any particular pros/cons, especially considering that we'll be dealing with extractions?
I can already tell that my extraction gaps will be very visible when I smile. :( Guess I have a really wide smile/mouth...

[artichokeenthusiast]

Pearlyteeth, sorry to hijack your post again. I just wanted to add on to my last comment about the brackets:

I've heard that ceramic brackets (ie In-Ovation C) tend to be bulkier and stick out from the tooth surface farther than traditional metal (and farther than the Damon Clear brackets).
If any of you have ceramic brackets, did you find it to be a concern, considering that we are suffering from protrusion and lip incompetence in the first place?! Or is it a very small difference?

Of my 4 prospective orthodontists, two use ceramic brackets and two use Damon clear...of course there's a lot of other factors that will go into my final decision to choose an orthodontist, but I can't stop obsessing over the bracket types at the moment...

[BracedSurgeryStudent]

Here are my befores worse than yours and I made out fine with Damon braces:
http://imageshack.us/photo/my-images/46/before5i.jpg/
http://imageshack.us/photo/my-images/802/before4p.jpg/
http://imageshack.us/photo/my-images/809/before3i.jpg/
http://imageshack.us/photo/my-images/705/before2n.jpg/
http://imageshack.us/photo/my-images/204/before1g.jpg/

And Recently the other day:
http://imageshack.us/photo/my-images/81 ... 124xu.jpg/