Sarpe?

Message

#1 Post by **tdawg7669** » Thu Oct 21, 2010 8:06 am

I also posted this in the other forum but I wanted to get your opinions too

Alright so I am about 5 months in. Anyway I started this journey because of my crossbite and openbite, which were pointed out to me by my dentist when getting porcelain veneers put over my top front teeth. He told me since I was 20, I would need to get Sarpe to fix these issues and possibly(but he didnt think it would be necessary) further jaw surgery.

So I saw an oral surgeon who said he did think I would need SARPE. He referred me to an ortho, I got the records taken blah blah. He tells me he thinks surgery wont be necessary. That should be great news but I am worried because when you are told two different things you second guess yourself.

So here are the 2 best photos I was able to take of my upper palate.

So what do you guys think? Does my palate look normal or too narrow? Should I have received Sarpe?

I just want the best result

#2 Post by **heidis** » Thu Oct 21, 2010 11:22 am

I think it is hard or maybe impossible to tell if you need SARPE just by looking at the upper arch. I'm no dentist/OS/ortho but I know in my case, my upper arch didn't necessarily look that small but the crowding and leaning of my lower teeth made it necessary unless I opted to pull one or more of my bottom teeth. I'm guessing it has to do with your bite and how all of your teeth are going to fit together.

In any case, if you are second guessing the ortho's recommendation, it is never a bad idea to get a second opinion. If you paid for all the records, ask to have them sent to another ortho for another consultation. If they both agree that you can proceed without SARPE, then I think you would rest easier with that recommendation. I personally would trust the ortho over both the dentist and the OS.

#3 Post by **tdawg7669** » Thu Oct 21, 2010 12:03 pm

Why would you trust the orthodontist over the oral surgeon? I can see trusting him more than the GP, but I figured the Oral Surgeon basically specializes in those types of surgeries.

#4 Post by **chicago29** » Thu Oct 21, 2010 12:54 pm

It is impossible to tell just with pictures, but it does appear you have a narrow arch. And, you can't greatly expand the upper without keeping in mind the bottom arch.

Your teeth are straight and they don't look crowded or tipped at all. The only justification I could see for a SARPE is a pretty severe crossbite that an orthodontist feels they could not fix with braces/elastics.

I'd speak with at least 2 or 3 orthodontists and get their opinion, choose the one you trust the most, and go from there.

Best of Luck!
Chicago29

#5 Post by **heidis** » Thu Oct 21, 2010 12:56 pm

I suppose it can be looked at as a joint effort between the OS and the ortho...but the ortho has the master plan. When I ask my OS questions like - how long will the expander stay in to stabilize as my jaw heals?; how far/how many turns will I open?; etc. he cannot or will not answer those questions. The ortho is the one that ultimately determines your treatment from start to finish.

I had SARPE exactly 4 weeks ago today and I can tell you that, at least in my case, the OS has done the procedure and seen me 2 times for post-op follow ups to look at the incision, monitors the nerve damage in my lip and face, asks about pain and how I'm sleeping but never makes any recommendations regarding my expansion or my orthodontic treatment. He says things like "oh, you are making some good progress with your expansion. I'm sure Dr. XXX (ortho) is pleased with the outcome of the surgery." I'm sure all OS/ortho relationships are different but in my case, the ortho made the recommendation to get SARPE, the OS reviewed my case and said yes I can do it, and that was about it from his end.

Regardless of who you want to trust, I still recommend getting a second opinion. I did. Good luck to you.

#6 Post by **tdawg7669** » Thu Oct 21, 2010 5:12 pm

chicago29 wrote:It is impossible to tell just with pictures, but it does appear you have a narrow arch. And, you can't greatly expand the upper without keeping in mind the bottom arch.

Your teeth are straight and they don't look crowded or tipped at all. The only justification I could see for a SARPE is a pretty severe crossbite that an orthodontist feels they could not fix with braces/elastics.

I'd speak with at least 2 or 3 orthodontists and get their opinion, choose the one you trust the most, and go from there.

Best of Luck!
Chicago29

Was that a typo? I only ask because you say that it does appear my arch is narrow but then say that you probably wouldnt recommend a SARPE.

#7 Post by **chicago29** » Thu Oct 21, 2010 6:13 pm

No it wasn't a typo, although I probably didn't convey my thought very well...

You have a narrow arch, but that in and of itself is no reason to have surgery. A TON of people have narrow arches. I was just stating this as an observation. Even after my 2 surgeries I would still classify my arch as narrow as compared to what you traditionally see as the "Hollywood" smile.

I think SARPE is only a good idea if you have upper crowding, or if you have a crossbite that can't be fixed with elastics. If you have neither, I don't see what the surgery does for somebody. The reason I say that is because you just can't expand the upper jaw for the sake of doing it and making it wider, if somebody has a good occlusion. This would throw it off as you need to have the proper contact with the lower arch.

I hope that clears up my post.

Best of luck...

-Chicago29

#8 Post by **tdawg7669** » Thu Oct 21, 2010 8:23 pm

Thank you.

Final question, besides a wider smile, does a procedure such as Sarpe have an effect on the aesthetics of the face?

#9 Post by **BracketRacket** » Thu Oct 21, 2010 10:15 pm

Keep in mind, it's also not just the width of your jaw that matters, but the relationship of it with your bottom jaw (as chicago mentions, a crossbite, etc.) Your upper jaw may be narrow, but if it OK in relation to your bottom jaw, it may be fine without surgery. If the relationship between your jaws is good, having surgery would cause more problems.

#10 Post by **chicago29** » Fri Oct 22, 2010 6:11 am

tdawg7669 wrote:Thank you.

Final question, besides a wider smile, does a procedure such as Sarpe have an effect on the aesthetics of the face?

For me, personally I would say "no" as it is hard for ourselves to detect differences, but for those that know me they'd say "absolutely". I have had many people say it has made a very positive impact on my facial aesthetic.

However, I was so messed up prior to my surgeries that it was bound to look better. So, I hate to say with certainty that it will improve facial aesthetics. There is a good chance it will make your mid-face appear "fuller".

Best of luck!
Chicago29