jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Framboise on November 27, 2017, 08:23:20 AM
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Hi everyone,
I've read that it is possible to widening the upper jaw during a Lefort 1 when a small amount of widening is required.
However, I don't understand where the bone is cut to obtain a widening.
Can someone explain this to me please ?
It is more or less stable than a SARPE ?
Thank you very much
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Hi everyone,
I've read that it is possible to widening the upper jaw during a Lefort 1 when a small amount of widening is required.
However, I don't understand where the bone is cut to obtain a widening.
Can someone explain this to me please ?
It is more or less stable than a SARPE ?
Thank you very much
Either in 3 pieces where the division is a 'Y' shape or kind of straight down the middle in 2 sections which would leave a space between the 2 front teeth that would need to be closed.
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Thank you Kavan :-)
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why would you not do this via orthodentics (either before or after)
I also require widening in addition to some standing up of my uppers..
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why would you not do this via orthodentics (either before or after)
I also require widening in addition to some standing up of my uppers..
Dental expansion is not stable in adults. If you have a narrow arch and need expansion, it really means the maxilla is too narrow and needs to be done surgically (SARPE or segmental LeFort).
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Can surgical widening make more room so teeth wouldn't need to be extracted? Can this be achieved with the lower jaw as well?
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Teeth are extracted because there isn't enough room in the GUMS to displace them (with braces) in preparation for a surgery to advance the jaw. Surgical widening refers to the palate.
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Teeth are extracted because there isn't enough room in the GUMS to displace them (with braces) in preparation for a surgery to advance the jaw. Surgical widening refers to the palate.
Ah, I see. Thanks for the response!
I guess I had thought that widening the palate or jaw would perhaps ‘stretch’ the gums and make room.
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Extracting teeth doesn't make room : it is a myth.
It makes LESS room : it reduces the size of your jaw in longer and in larger. It is inevitable.
Search faces of guys or girls who missed teeth like premolars and wisdom teeth and decide if you want to straighten your teeth at that price.
On the contrary, a widening of the jaw makes room, definitely...
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Extracting teeth doesn't make room : it is a myth.
It makes LESS room : it reduces the size of your jaw in longer and in larger. It is inevitable.
Search faces of guys or girls who missed teeth like premolars and wisdom teeth and decide if you want to straighten your teeth at that price.
On the contrary, a widening of the jaw makes room, definitely...
Nonetheless, surgical widening is to the palate and not used as modality to preclude extractions. I interpreted his question as one wanting to know if surgical palate expansion would spare him from extractions. Perhaps your interpretation of his question was different than mine.
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Nonetheless, surgical widening is to the palate and not used as modality to preclude extractions. I interpreted his question as one wanting to know if surgical palate expansion would spare him from extractions. Perhaps your interpretation of his question was different than mine.
Sorry, I misunderstood palate widening with jaw widening. I meant about widening the jaw itself.
On the contrary, a widening of the jaw makes room, definitely...
So, (please forgive my ignorance, because I feel like this is probably so fundamental, but I never really understood it) since the jaw can be widened to make room, why doesn't forward advancement/lengthening also make room for the teeth and prevent the need for extractions?
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Sorry, I misunderstood the difference between palate widening and jaw widening. I meant about widening the jaw itself.
So, (please forgive my ignorance, because I feel like this is probably so fundamental, but I never really understood it) since the jaw can be widened to make room, why doesn't forward advancement/lengthening also make room for the teeth and prevent the need for extractions?
The palate is the base of upper jaw. Consult an anatomy diagram. The lower jaw is not widened with surgery. In some cases, forward advancement of the lower jaw can't take place UNLESS the teeth in the lower jaw are FIRST pushed backwards. IF pushing them backwards would crowd them or there is not enough inter tooth space to push backwards, they remove the pre-molars. The 'space' made is in reference to the space they need to make to push the lower teeth backwards IF advancing the lower jaw is CONTINGENT on that.
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The palate is the base of upper jaw. Consult an anatomy diagram. The lower jaw is not widened with surgery. In some cases, forward advancement of the lower jaw can't take place UNLESS the teeth in the lower jaw are FIRST pushed backwards. IF pushing them backwards would crowd them or there is not enough intermolar space to push backwards, they remove the pre-molars. The 'space' made is in reference to the space they need to make to push the lower teeth backwards IF advancing the lower jaw is CONTINGENT on that.
Thank you again for the response. And thank you Framboise for yours as well.
What I had meant by my previous question is: instead of extracting then pushing the teeth back, couldn't the jaw first be advanced/lengthened/widened to make the extra space necessary for the teeth to be pushed back, thus avoiding extractions?
The downside to this (besides probably not being possible) would be having protrusive teeth after surgery for a few months as you wait for the braces to push your teeth back into a position normal with your jaw.
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Thank you again for the response. And thank you Framboise for yours as well.
What I had meant by my previous question is: instead of extracting then pushing the teeth back, couldn't the jaw first be advanced/lengthened/widened to make the extra space necessary for the teeth to be pushed back, thus avoiding extractions?
The downside to this (besides probably not being possible) would be having protrusive teeth after surgery for a few months as you wait for the braces to push your teeth back into a position normal with your jaw.
No. The cut to advance is in back of second molar. The space needed to push the teeth back is the pre-molar space. Space in the GUMS.
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I am also interested in this. I had a consultation with DeFrancq who proposed widening the jaw with a small expander.
But you are suggesting this can all be done in one surgery with a Le Forte and lower jaw surgery? Are there any European surgeons that perform this?
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Hi Sam !
Actually, Dr Defrancq does this at the same time of a Lefort 1 but only if a small amount of widening is required (like 2 or 3 mm not more).
If he proposed you a SARPE, then you may need more than 2 or 3 mm of expansion.
I read several studies about these two procedures and a SARPE is more stable than a 3 pieces Lefort 1. Moreover, with a 3 pieces Lefort 1, the risk of hemorragia and necrosis is majored (I don't know if this word exist in English "majoré"), higher.
If I were you, I'll go with a SARPE, without hesitation
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Generally speaking a multipiece lf1 can cover up to a max of around 1 cm expansion. That's the upper limit. The bone may relapse a bit while healing too so it's not guarantee of 1 cm. Certainly anything above 1 cm requires sarpe.