accepting relapse?

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#1 Post by **acrobat** » Wed Nov 11, 2009 12:54 am

Hello everybody.
My story in short: Three years ago i started braces combined with lowerjaw surgery to fix my 9 mm overjet.
All went really well, 1 year of braces, then surgery (which wasn't too heavy for me, but i was well prepared) and another six months in braces.

14 months ago i was brace free again and the result was great!!
Even the ortho and surgeon said they could not have done any better on an adult.

I kept this stable bite (and jawline) for a year, untill this summer when my jaw started to relapse...

I'm back from the ortho now and he says my overjet is now 2.4 mm in rest and 3.4 when i pull my jaw as much back as i can.
It should stay like this though, they don't predict worse...
But also my teeth appear to slant outwards again (which makes the overjet looks bigger).

Nor the surgeon nor the ortho talk about a new threatment. They admit something went wrong, but for them it's not serious enough to do something about it.

I'm not really a vain person, but this makes me feel horrible.
So my question is: should i accept this? Of course i don't want to go back in braces and have surgery again...but is a 2.4 mm overjet ok as end result? Honestly i wish i could accept it....
What would you do?

#2 Post by **Faerydust** » Wed Nov 11, 2009 7:20 pm

I would get a second opinion from another ortho.

Did your teeth tip forward while wearing your retainers?

I had my 10mm overjet fixed without surgery. I'm happy with the result even though my jaw is slightly retruded, but if I had decided to go with jaw surgery and experienced relapse, I know I'd be very upset.

Did you ask your ortho if he could tip the teeth back with a retainer? I'd try that first to reduce the overjet at all if possible. I wouldn't accept that there's nothing the ortho or surgeon can do.

Sorry you're going through this.

Don't give up hope though! There might be a way to fix it without going through surgery again.

#3 Post by **acrobat** » Thu Nov 12, 2009 1:30 am

I don't think i'm more upset because i had surgery as well.
I'm upset because i had the perfect bite for six months and then the jaw relapsed..
I'm also not sure if my teeth are really shifting, my ortho claims they are not and that it just feels different because the jaw moved.

To be honest, going back in braces after being out of them for a year would be extremely hard. It was hard to take the road of braces and surgery when i was 23, but the idea of having good teeth when i was 25 made it worth it. Now i'm 25 and a half..and i don't want to start all over again.
I wish i could just leave it all behind and accept, cause right now it's dominating everything in my life, not good!
2.5mm overjet... hehe

#4 Post by **drrick** » Thu Nov 12, 2009 8:14 am

If the upper teeth are in fact slanting out then an inman retraction appliance could work great. You may need some minor IPR but that could work out well.

Then overjet when you pull your jaw back doesnt really count but at rest it does.

I wouldnt think you would need to go back into braces for that small of a discrepancy -- I know it seems big to you since it was 'perfect' but 2.5mm is a small discrepancy from the docs point of view.

#5 Post by **acrobat** » Thu Nov 12, 2009 9:47 am

Interesting! Never heard of that appliance, i wonder if ortho's in belgium use it. And what is IPR? i googled it but only find dutch pages about private law

#6 Post by **acrobat** » Thu Nov 12, 2009 10:15 am

hah found it!

The surgeon is already doing some IPR.
Unfortunatly that still doesn't bring my jaw back forward...
It might have moved just 2mm but it feels like my mouth is too small for my upper teeth again (so like it was before treatment: underdeveloped lower jaw).
But i guess doing the surgery again for just a few mm won't happen eh?

#7 Post by **acrobat** » Thu Nov 12, 2009 11:54 am

Some pictures!
http://www.flickr.com/photos/44608362@N04/?saved=1

i hope this works..

#8 Post by **drrick** » Thu Nov 12, 2009 12:51 pm

Personally, I wouldnt do anything...but it's not my mouth.

You are right the Inman Aligner will do nothing about the position your jaw but can move the teeth within the jaw to reduce your overjet.
(either the uppers back/lowers forward or both)

#9 Post by **acrobat** » Fri Nov 13, 2009 12:43 pm

i think my lowers are quite forward already, that's the only reason why they still almost touch my uppers. But my uppers are forward too..too much i think...

#10 Post by **Faerydust** » Tue Nov 17, 2009 2:59 pm

Actually, in your pictures your bite looks good to me. The lowers aren't tipped that much and your overjet is within normal limits.

#11 Post by **felicia** » Wed Nov 18, 2009 10:38 am

I got my braces on 2 and 1/2 months ago. My teeth were not very crowded, they were vertical, I could say 90 degrees, and I had no over jet at all, no overbite, no under bite, nothing like that. At my first consultation, the orthodontist explained me that he will slightly tip my upper and lower front teeth forward(outward).....so, my ortho is doing exactly the opposite of what you want. My teeth are already tipping forward, and I don't mind, actually I kind of like the way they look.
I think your teeth look beautiful, I would be happy if my final results would be even close to the way your teeth look right now.

#12 Post by **acrobat** » Thu Nov 19, 2009 9:21 am

Thank you everybody for the very positive messages!
It means a lot to me, because i know it's all about accepting.

I still have my moments where i would go in braces immediatly again if that would be an option..but how much would it really help?

I still think my front teeth or way too much forwards.
ALlthough as felicia says: my ortho also mentioned the upper front must be tipped forward to have the best looking result..i think my teeth are just a bit too eager to go that direction

I think if my lower and upper front would be pulled back a little it still would fit nicely and fit better in my mouth. Now i sometimes feel like my mouth is too small to take it all (like when i had the big overjet to begin with).

A part of me wants the surgery again, to fix two mm (because it does make a difference in my face!!), but that probably won't happen...

next week appointment with surgeon..i want to ask him again if there is no option at all to fix the jaw, but i'm sort of afraid he will think i'm crazy...

#13 Post by **GrizzlyB** » Sat Nov 21, 2009 12:09 pm

acrobat,

Just want to chime in and say that I think your teeth and your bite both look great. I do think it was a good idea of you to consult with your surgeon and orthodontist once your bite shifted the way it did, but if it is indeed stable, as they predict, I'd personally just shrug this off and move on.

I'm not an orthodontist or a surgeon, just an orthognathic surgery patient, but there's just nothing about your bite that looks wrong to me. I'm also pretty sure that the vast majority of regular people out there who've never had to care about their teeth and bite to the degree we do will think the same as me.

#14 Post by **acrobat** » Sun Nov 22, 2009 12:21 pm

thank you for the rational words

I'm afraid i'm clearly not close to acceptance though

I see a change in my face as well (not just teeth), so every time i see a glimpse of my reflection in a window or mirror i can't help but dislike it.

I see my surgeon next friday and decided to be very clear with him. Last time he admitted it shifted but he never suggested surgery again probably because it's not terribly bad and also because most patients wouldn't consider that as an option.
But i do want something to be done now, so i'll be clear about that and see what the options are to really fix it.
I'm also going to see another surgeon for a second opinion.

I don't think surgery will be an option but if it would be, then i need to hear two surgeons, cause it won't be an easy decision.

I'll update later.

PS thanks everybody for responding and i hope my story isn't discouraging other people. I'm sure my situation really is just an exception! (and i'm still glad i went through braces and surgery!)

#15 Post by **acrobat** » Fri Nov 27, 2009 1:37 pm

So, i saw my surgeon a few hours ago.

I told him straight away i'm really troubled about the situation.
He took it really seriously. He admits there is some relapse, but that those things can be excepted...the body always changes and all that.

He said having surgery again would probably not be an option right now because it's just about 2 mm or so and also because there's absolutly no guarantuee that there wouldn't be relapse the second time around.

He did see that my bite is now also going too much to the left, because my teeth don't fit properly anymore.

He says i should go to ortho again to take..erhm bitesamples??? and then they will discuss together what my best option is.

I must say i'm relieved he took it seriously this time. Allthough it may mean i need braces again..not so good...but we'll see how it goes.

Seeing ortho in two weeks.