Over-impacted upper jaw?

[jawregret1]

Hi everyone,

I'm 3 months post-op double jaw surgery and genioplasty, for a class 2 bite.

I didn't have a gummy smile before nor excessive tooth show at rest (I already had 2 mm) but the surgeon impacted the maxilla 3 mm and moved it forward 3 mm as well.

I have zero tooth show at rest now, and I have to reeeeaaaalllyyy force all the muscles in my face to work overtime to show as much teeth in my smile as I did pre-op. It doesn't look natural at all.

Has anyone had problems with this? Is it too early to tell? I've tried to hold judgement for the first three months, but it's really getting me down as I'm only 21 and feel like I've been aged considerably.

Thanks!

[LyraM45]

Do you know why they wanted to impact you if you didn't have a gummy smile to begin with? Maybe to offset the fwd movement, but that is still an awful lot if you didn't have a high lip line to begin with.

[Lostfaith]

Not another one that's been over impacted , I have been as well and am in contact with lots of others . Will it get better , probably not as a impaction doesn't really relapse . Do you now show a lot of lower tooth when speaking ? I am having a revision to bring it down again which is complicated and will need a graft of either bone or a bone substitute. Your right it is very aging. Where are you from ?

[jawregret1]

[quote="LyraM45"]Do you know why they wanted to impact you if you didn't have a gummy smile to begin with? Maybe to offset the fwd movement, but that is still an awful lot if you didn't have a high lip line to begin with.[/quote]

He said something about how my occlusal plane was too steep, but now I have zero tooth show and I'm very depressed.

[Lostfaith]

Can you live with it the way it is? It can be bought back down but it's complicated to do so. Have you told him how unhappy you are with it ?

[jawregret1]

He told me to wait 6-12 months for everything to settle down, but by this time most people show an adequate amount of upper teeth.

The surgery is so invasive and downgrafting seems unstable.

I don't know what to do, possibly nothing because of that, but I'm still so depressed over how it looks. He says I'm also making a big deal. I don't understand how he can brush it off.

[mmkay]

He told me to wait 6-12 months for everything to settle down

Usual fob-off BS.

I don't know what to do, possibly nothing because of that, but I'm still so depressed over how it looks. He says I'm also making a big deal. I don't understand how he can brush it off.

Based on that alone I'd describe this guy using terms against the rules of this forum. When I discussed with my orthodontist, pre-treatment, the choice of an impaction vs anchorage devices (closing open bite), he mentioned that in the 'old days' they'd impact too much at the front and destroy incisor display because they didn't know better. It really is very difficult to justify...lack of incisor display is a massive issue and you have every reason to be depressed. If this was in fact medically justified he needed to clearly warn you in advance. Being angry at him doesn't solve your problem though...you need to consult a different surgeon, and at least get an opinion.

[jawregret1]

I'm not sure what I would do if another surgeon agrees that I was over-impacted. Do I go see my surgeon?

I know most people absolutely love their results, but this feels like the biggest mistake I've ever made. I could have survived with my receding chin. I had previously had braces that had compensated for the overbite I had, so my occlusion was good enough.

[Dureena]

Is there a relationship between moving the upper jaw forward and increased tooth show? I've not any gum show show and they were suggesting impaction with a large movement forward because my midface is underdeveloped.
It's NHS so I'm not sure if aesthetics is their to priority.

[jawregret1]

They impacted my upper jaw and moved it forward but for me it just ended up with even less tooth show than before.

Moving it only forward shoukd increase the show however.

[mmkay]

I'm not sure what I would do if another surgeon agrees that I was over-impacted. Do I go see my surgeon?

Is that going to resolve your issue? He's not going to admit his error (difference of opinion) and it's not like you'd want to let him do anything else to you or trust his advice. It's not going to meet the threshold for negligence.

[Lostfaith]

I have def been over impacted, I have seen a lot of other surgeons for opinions and they have all Said the same. I'm having a revision to bring it down again, they will use plates to hold which is standard now and also a inter positional graft to stabilize it .

[jawregret1]

Wouldn't the downgrafting make your face longer? Just wondering.

[Lostfaith]

Yes it will , but I'm to short and need to come down slightly

[Zola]

[quote=Lostfaith post_id=484947 time=1473971113 user_id=27351]
Not another one that's been over impacted , I have been as well and am in contact with lots of others . Will it get better , probably not as a impaction doesn't really relapse . Do you now show a lot of lower tooth when speaking ? I am having a revision to bring it down again which is complicated and will need a graft of either bone or a bone substitute. Your right it is very aging. Where are you from ?
[/quote]

Hey where did you find the people who have the same problem as you? I really would like to get in contact with them too and the ones who had a revision done. Did you get a revision btw? And how are you now?