Author Topic: Double Jaw Surgery Relapse  (Read 23129 times)

PloskoPlus

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Re: Double Jaw Surgery Relapse
« Reply #15 on: May 16, 2014, 04:15:17 PM »
The lower jaw could have simply grown more again after the surgery.

elysium87

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Re: Double Jaw Surgery Relapse
« Reply #16 on: May 16, 2014, 09:57:12 PM »
Wow that is an obvious relapse :(

Did you wear your retainer religiously for the first year? I'm talking about 15 hours+ per day.

I wore my fixed braces for 12 months after surgery then retainers full time for 3 months and then part time for a couple of years....

elysium87

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Re: Double Jaw Surgery Relapse
« Reply #17 on: May 16, 2014, 10:03:22 PM »
The lower jaw could have simply grown more again after the surgery.

I was 22.5 at time of surgery so I think it is unlikely to have grown more but more of a case that the muscular forces have pulled the jaw forward a touch. Discrepancy between top and bottom was about 10mm before op. Top jaw was moved forward 3.5mm and upwards 2mm whilst bottom jaw was moved back 6.5mm on one side and 5.5 mm on the other.

PloskoPlus

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Re: Double Jaw Surgery Relapse
« Reply #18 on: May 17, 2014, 12:32:24 AM »
I was 22.5 at time of surgery so I think it is unlikely to have grown more but more of a case that the muscular forces have pulled the jaw forward a touch. Discrepancy between top and bottom was about 10mm before op. Top jaw was moved forward 3.5mm and upwards 2mm whilst bottom jaw was moved back 6.5mm on one side and 5.5 mm on the other.

Hmm, AFAIK, usually in Class III cases they try move the top jaw more than the bottom.  But every case is different, of course.  And if the discrepancy pre-op was 10 mm and the total movement was 10 mm, you should have ended up with an edge-to-edge bite immediately post-op.

elysium87

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Re: Double Jaw Surgery Relapse
« Reply #19 on: May 17, 2014, 10:16:05 AM »
Hmm, AFAIK, usually in Class III cases they try move the top jaw more than the bottom.  But every case is different, of course.  And if the discrepancy pre-op was 10 mm and the total movement was 10 mm, you should have ended up with an edge-to-edge bite immediately post-op.

Sorry I was not very clear in what I wrote. I actually meant that the total combined movement was 10mm, I am not sure what the discrepancy itself was but you can tell at those movements, it was certainly significant. Please do not get me wrong, my profile has changed drastically, my chin no longer looks like I am sticking my tongue behind my bottom lip....I have a normal exterior look, but my bite has moved. I have to say if the jaws have moved, I believe it cannot be more than a couple of mm. I am not so sure that they would have been able to move my top jaw forward more than the bottom jaw was moved back, my bottom jaw was very "overgrown" it would not have looked right unless they moved it back a rather drastic amount. I am seeing my surgeon in the upcoming weeks and without x-rays all of this is pure speculation.

Unfortunately, the harsh reality is that us individuals who were not blessed with good bites / profiles need to understand that this is dynamic tissue we are dealing with. Our bodies will always have this tendency to attempt to revert back in to their original position. I do question the  impact of such surgeries when clearly there is an issue with long term stability of these operations. The same muscular-skeletal forces which caused these deformities to occur during growth periods, are clearly still present. I had always assumed that my jaws had not "grown correctly" but perhaps the real answer is to do with the muscles which surround these bones.

I await the result of any X-rays which I assume my surgeon will send me for, I do hope that this is the maximum extent of the relapse but honestly, who knows. I was not informed at any point prior to my operation about the risk of relapse but I sure as hell know a lot about it now.

elysium87

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Re: Double Jaw Surgery Relapse
« Reply #20 on: May 24, 2014, 11:21:08 AM »
OK so, I have had my review appointment with the surgeon. He did not seem too concerned. We took an Xray and it did not show bone resportion which is a common cause and occurrence from these procedures. He said that often when a relapse occurs you see "funny things" going on at the jaw joints. Such as shortening of the height of the jaw and causing wonkiness and a shortened appearance. None of this occurred to me. My Xray was completely clear of this. He says that if my jaws have moved, it is by such a small amount that he cannot actually see it on the Xray. However, the orthodontist came in to the room for a few minutes to take a look at me. He says that he cannot correct my bite fully without another Bimax surgery involving removing the upper premolars, moving my top teeth back to fill the gaps, creating an underbite and decompensating. Then performing another surgery....obviously I am extremely reluctant to do this. The surgeon did not seem 100% confident with the ortho's assessment as he could not see a problem with the relationship of my top and bottom jaws from the Xray.

The surgeon noticed from old pics and how I am now that some gaps which were left in my bottom teeth around the canines...have closed up which indicates that the teeth have moved out of their post op position and he initially felt that my teeth have moved and caused this problem. The ortho (who by the way is not the same guy who treated me since he has moved on) thinks otherwise....despite xray not showing a problem.

I am now in the process of obtaining all of my medical records from the hospital and then I am going to see one of the UK's leading orthodontists in London to see what he thinks and if this can be corrected with braces especially if no apparent skeletal malocclusion is present. The surgeon did say that if any jaw movement has occurred it is so marginal and accompanied with some tooth movement which is resulting in my present day bite. He did say that if I were to have an operation...again (which by the way he does not advocate) it will not change my profile since any discrepancy between jaws is so marginal.

pekay

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Re: Double Jaw Surgery Relapse
« Reply #21 on: May 24, 2014, 11:35:41 AM »
What do think they caused you to have a minor relapse? Upper or lower jaw grew and threw everything off? bite was slightly off?
Chopsticks > Spoons

elysium87

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Re: Double Jaw Surgery Relapse
« Reply #22 on: May 24, 2014, 12:20:11 PM »
What do think they caused you to have a minor relapse? Upper or lower jaw grew and threw everything off? bite was slightly off?

Well they cannot be sure, the surgeon was leaning towards the teeth moving. He could not see any movement in the jaws from the xray. I understand that the muscular forces that were pulling on the jaws and cause these defects are still present after surgery. He could not see a reason to operate from my xray. I did have a pallet expander during my orthodontic treatment and I do wonder if I have lost some of the horizontal expansion through not wearing my retainers enough as the top retainer seems too wide and i cannot even get it to fit. I don't believe my jaws continued to "grow" as I was almost 23 by the time of my op. If a change in jaw position occurred, it is down to muscular forces, otherwise teeth have moved. Actually my bite looks worse in pic, i get a slight overlap on top teeth.

Ben

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Re: Double Jaw Surgery Relapse
« Reply #23 on: May 26, 2014, 03:07:36 AM »
What about oral posture, did you make sure your tongue sat in the right position after the surgery?

elysium87

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Re: Double Jaw Surgery Relapse
« Reply #24 on: May 26, 2014, 06:48:18 AM »
What about oral posture, did you make sure your tongue sat in the right position after the surgery?

everything seemed normal after surgery. My teeth fitted together so well that surgical splints were not required to be left in position. I have another friend who had a bimax and he says his bite has changed also, he was operated on at a totally different hospital by a different team. I think relapse is part of these surgeries and it happens to everyone to some degree, whether it be an immeasurable amount or indeed in severe cases returning back to the original position. The annoying thing is, my bite is the just out by a marginal amount and I am very happy with my profile.

The hospital ortho is adamant that to achieve proper occlusion i require another bimax procedure, but ultimately one has to consider if the juice is worth the squeeze. It won't yield the dramatic improvement in my appearance like the first op and it will just help my teeth mesh together that little bit better. That is all. Plus he wants to go down the route of extracting premolars and I just think it is ridiculous given that my teeth are all straight and healthy.

Ben

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Re: Double Jaw Surgery Relapse
« Reply #25 on: May 26, 2014, 02:34:02 PM »
Yeah this whole relapse thing is no good. Having teeth mesh together is quite a big deal though it is an important part of complete oral health in my opinion.
Even though it causes me discomfort I've been keeping my teeth meshed as much as possible since surgery. When I wake up at night if my jaw is relaxed and hanging down I close again. Hopefully this and keeping my tongue constantly pressed into the roof of my mouth and into the back of the alluvial# ridge will limit any relapse to a minimum.

Surely if in your last surgery they had properly decompensated your dental arches then there should be something to play with in tooth angles which will again give you an overbite. I doubt looking at your picture it will take much.


elysium87

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Re: Double Jaw Surgery Relapse
« Reply #26 on: May 26, 2014, 02:56:52 PM »
Yeah this whole relapse thing is no good. Having teeth mesh together is quite a big deal though it is an important part of complete oral health in my opinion.
Even though it causes me discomfort I've been keeping my teeth meshed as much as possible since surgery. When I wake up at night if my jaw is relaxed and hanging down I close again. Hopefully this and keeping my tongue constantly pressed into the roof of my mouth and into the back of the alluvial# ridge will limit any relapse to a minimum.

Surely if in your last surgery they had properly decompensated your dental arches then there should be something to play with in tooth angles which will again give you an overbite. I doubt looking at your picture it will take much.

Yes that is what I thought too but the hospital orthodontist who is some new guy is basically saying it is a whole new op if I want to correct my bite. The surgeon though was not convinced as I mentioned previously, he could not see any skeletal abnormality from X ray. I am going to have my post op and current Xrays super imposed over one another to actually see if there has been a noticeable improvement. Problem is, if I do have another surgery then there is still the risk of relapse after all of that, and there's nothing to say that my bite won't be even worse. I will wait and see what the private ortho in London has to say next week. I did have a severe underbite to begin with and I guess having my jaws in the correct position was almost unnatural for me. I don't believe I could have done anymore other than not been so slack in wearing my retainers.

elysium87

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Re: Double Jaw Surgery Relapse
« Reply #27 on: May 27, 2014, 12:46:42 PM »
Have many people had jaw surgery 2 times?

Ben

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Re: Double Jaw Surgery Relapse
« Reply #28 on: May 27, 2014, 01:15:00 PM »
Yeah just find out your current skeletal base, and proceed from there. Still even if you are class 3 there's still every chance an orthodontist could make an overbite for you dentally.


elysium87

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Re: Double Jaw Surgery Relapse
« Reply #29 on: May 28, 2014, 01:19:34 AM »
Yeah just find out your current skeletal base, and proceed from there. Still even if you are class 3 there's still every chance an orthodontist could make an overbite for you dentally.

Well that is what is confusing me, surgeon is saying he cannot see anything abnormal from Xray