Reversing previous orthodontic treatment

[wolfhero]

I am a 21 year old male that has had braces twice, the first time was to just straighten my teeth, the dentist had no idea on how to use functional appliances to stimulate growth and left my lower jaw underdeveloped/receded when I asked him what the reason for it was he said that it was just the way it was.

Fast forward three years later, when I was 18, I started to get conscious about my lower jaw and started jutting it forward because it made me look a 100x better.

I decided to go to another orthodontist to hopefully rectify the situation. He told me that I needed to have 2 of my premolars extracted to fix my overbite. Worried about a sunken in profile, I told him that I wanted to get lower jaw surgery to bring my lower jaw forward but I was stupidly convinced to go ahead with what he wanted.

Fast forward a year later, my face has become flat and people have noticed that I look so different compared to before. My upper teeth are tipped too inwardly as I wore my elastics everyday for a year and a half. I am now unable to jut my lower jaw forward to improve my looks.

I am in agony over this because not to brag, I was a heart throb before and a lot of girls used to like me, even this one girl that I'm dating right now after being apart for many months has noticed how different I looked and I could sense that she wasn't attracted to me anymore.

I have now only gone to a functional orthodontist that knows what he's doing and he has told me that the best solution for me is to get orthognathic surgery to bring my lower jaw forward and that I should have never have had my upper teeth extracted because there was no problem with my upper jaw to begin with.

My new orthodontist once suggested extracting 2 of my lower teeth to make enough space to slide my lower jaw forward but now he has changed his mind and plans to bring the upper teeth forward to make room for orthognathic surgery. I wonder though how that could be done since 2 of my premolars are gone, and I can't see him until the next month.

Does anybody know the ways and methods that the previous orthodontic treatment can be reversed? Especially considering that 2 of my premolars are gone and the only way that I can get jaw surgery is to create enough space for my lower jaw to move forward by moving the front of my teeth forward.

[snapdresser]

I'm not sure anyone on here knows enough about your previous treatment or what's possible with orthodontics to be able to answer that question. But maybe someone will chime in and impress us all!

[Nozzelnut]

From what I've read there's a couple different routes.

First; reopen the premolar spaces using orthodontics, upper implants, and lower jaw surgery to bring the lower jaw forward to meet the upper.

Or second; orthodontic work to get uppers and lowers in the right place individually and double jaw surgery to position both jaws in a better place for facial appearance and function.

Oral maxillofacial surgeon will be able to take measurements and some will be able to provide simulated post surgery pics. I'd find a surgeon near you, and set up an appointment to have things checked out. Bring a list of your concerns and look through the threads here for questions to ask them. Your OMFS surgeon and ortho should work together to find a suitable solution for you.

[wolfhero]

[quote="Nozzelnut"]From what I've read there's a couple different routes.

First; reopen the premolar spaces using orthodontics, upper implants, and lower jaw surgery to bring the lower jaw forward to meet the upper.

Or second; orthodontic work to get uppers and lowers in the right place individually and double jaw surgery to position both jaws in a better place for facial appearance and function.

Oral maxillofacial surgeon will be able to take measurements and some will be able to provide simulated post surgery pics. I'd find a surgeon near you, and set up an appointment to have things checked out. Bring a list of your concerns and look through the threads here for questions to ask them. Your OMFS surgeon and ortho should work together to find a suitable solution for you.[/quote]

I'm going to a jaw surgeon next month. Actually the gaps are still open, although I would say that about 50% of the gap is remaining, but my upper teeth have been retracted really far. I was wondering whether it is possible to push the upper teeth forward to eliminate the flatter profile. If so, how? I know it requires gaps to be reopened, but I don't want to get implants as I hear a lot of horror stories about it and it is very expensive in conjunction with jaw surgery.

If you would possibly know, would it be possible to reopen the gaps and bring the upper teeth forward, and use dentures or maybe retainers with fake teeth to replace the missing premolars? I know I should be asking my dentist this but I can't see him until next month.

[wolfhero]

Here are pictures in case anyone is curious to see what I'm talking about.

https://imgur.com/a/BCdT2

[newbite]

Implants are the only option to replace extracted teeth which will retain your bone level. If there is no anchor in the bone, the bone recedes. Bridges and dentures do nothing to maintain bone level. Bone level is key to maintaining your appearance.

What horror stories of implants have you heard? If you smoke you won't be a good implant candidate. If you brux you may ruin your implants before they can set in the bone. And of course if your bone is insufficient to begin with, you may not be a candidate even with bone grafts.

I only know what I've read, so take it for what it's worth, but the only way to do what you want done is to get implants to replace the extracted teeth and then bring your lower jaw forward with surgery. Hopefully your ortho has a satisfactory solution for you!

[audax719]

I had 4 of my bicuspids extracted when I was 21 as well. They should have moved my lower jaw forward. So instead of having a class 2 division 1 bite it changed to class 2 division 2(which is worse).
I'm 27 now, and I'm working with an orthodontist to reopen the spaces and get implants in. Both jaws will be expanded and moved forward. Will probably have to wear Bio bite to re-position my lower jaw.

I would keep surgery as a last option,since the chances of relapse are high, not to mention side effect of Post Op like possible nerve damage or numbness in lips.

[kjohnt]

You need an ortho to both re-procline your upper incisors to an appropriate amount and open those extraction spaces. You will need dental implants to fill the spaces. Ideally the opening of the extraction spaces and implants will create enough space such that your incisors sit correctly, but it depends on your canines and how your bite was before. You may have to get some bonding on the incisors to create enough tooth width so they can be proclined properly without spaces between them.

Lower incisors should sit upright.

Once all teeth are in proper positions within arches, BSSO to bring mandible to appropriate position relative to maxilla.

Keep in mind this is based only on your writing and the pictures of your teeth, so under the assumption that your maxilla doesn't need moved.

Before you do anything, visit a well-known orthognathic surgeon and get a complete analysis, or at the very least get your cephalometric x-rays analyzed.

[abro884]

Wolf hero - u commented on my post and then I found this. It's pretty much my exact situation as I'm sure you're aware! You don't happen to be in NZ do you? This was my exact story - no extractions with a general dentist and huge OJ resulted - go to ortho, u need teeth out. I raised surgery and asked frequently, but he discouraged it massively. I figured I was a poor candidate.

8 months later and I'm being told he "gave me the option and I decided not to". What am absolute.... well. Expletive here.

Have the new ortho opening gaps now, but looking to eventually file a complaint and ask for the costs back at least from the old one.