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General Category => General Chat => Topic started by: Mandibular on January 11, 2018, 09:25:54 PM

Title: Getting Orthodontic treatment rather than double jaw surgery?
Post by: Mandibular on January 11, 2018, 09:25:54 PM
Hi,

I have a severely recessed chin/jaw and a narrow airway, so would like to correct these both for aesthetic and functional/health reasons.

Let me begin by saying my oral posture is good most of the time with my teeth lightly together, tongue on roof of mouth, and I try my best to keep lips together but due to my lacking chin, there is muscle strain. No tongue thrust swallow.

I had an online consult with an oral surgeon in Australia, who largely focuses on airway improvement. His plan of action was to move both my mandible and maxilla forwards as well as a sliding genioplasty. I hesitated going ahead with this as I know how invasive the surgery is and the lengthly recovery time as well as possible nerve damage and other complications.

I looked into Orthodontic/Orthotropic treatment that could possibly give me a decent result and came across someone 2 hrs away from where I live. After going for a consult and getting all measurements done, his plan is to put me in braces with a palate expander, correct my lower incisors which are currently extremely tilted from previous orthodontic work, and bring my lower jaw forwards. He doesn't guarantee there will be good results as I am 22 and my condition is pretty severe.

So basically, I am all set to get the orthodontic work done in 3 days from now, but I just want to make sure I am making the right decision. I understand that if I opted for surgery, I would still need braces before and after, so if I went with the orthodontic approach, then at the end of treatment, if I still need surgery, then it could possibly be less surgical work seeing as most of the work was done non surgically..?

What option would you opt for? I still would get a sliding genioplasty after orthodontic work seeing as I have no chin point at all. What would be the best option to enhance my airway? I think he said it was 5mm but I could be wrong.
Title: Re: Getting Orthodontic treatment rather than double jaw surgery?
Post by: GJ on January 11, 2018, 11:40:23 PM
Just going off the photos, I think you'd benefit most from 1 to 2mm of impaction, some CCW, and advancement/CCW of the chin.
It's a long and risky journey, though, so you have to weigh all that. In an ideal world, you need the above, IMO.

I don't think moving your jaws surgically in a linear way makes any sense.

You look fine as-is, too. Yes, you're recessed, but you're not unattractive. Opting to try braces and genio first is a conservative but totally reasonable approach. Realize the genio may have to be re-cut if you elect for surgery later, which does increase odds of nerve damage.
Title: Re: Getting Orthodontic treatment rather than double jaw surgery?
Post by: PloskoPlus on January 12, 2018, 12:39:11 AM
If you choose to get surgery later on, you'd have to redo the orthodontics.  Australian surgeons are shit (and even that pompous jackass that you spoke too.).  Nobody in Australia does CCW surgery which is what you need.
Title: Re: Getting Orthodontic treatment rather than double jaw surgery?
Post by: kavan on January 12, 2018, 07:24:53 AM
Great photo presentation.

Looks like classic case of CCW with anterior impaction, BSSO with genioplasty to advance. Maxfax needs to have a good rhino technique because anterior spine of nose is what causes the tethering of the upper lip (labial ledge) you see in profile which would get exaggerated with forward advancement if the anterior nasal spine is not altered also during the surgery.


ETA:

I entered my statement BEFORE reading your concerns. I would like to stress that you are not a 'Fix the face case' with orthodonture alone. You are a straight forward case for bimax surgery for both profile improvement and airway improvement. Since your teeth are already 'bucked' forward somewhat, it should be LESS time in braces for the surgery. If you get ortho where they will want to push your upper teeth inwards, then they will need to push them outwards again for the maxfax surgery. Hence your face case resolves to the SURGERY and NOT ortho alone.