Can anyone help do i need surgery or nothing

[thinkingme]

Im not sure what i must go for improve my profile and teeth. I go 2 orthodontist and one of them say my profile normal other say 4 extraction with surgery or 4 extraction without surgery he want extract my 4 premolar anyway. I dont know must i try to find more orthodontist or surgeons? Or what can i do look photos and radiographs
http://imgim.com/img_20151129_180115.jpg side profile
http://imgim.com/img_20151129_185022.jpg teeth
http://imgim.com/img_20151129_184024.jpg teeth
http://imgim.com/img_20151129_180623.jpg front profile i have no issue with front
And maybe u know anb angle difference is if below 0 its class 3, if 0-4 normal, if 4+ its class 2 and mine is 8

NEW i add this photos cuz my teeth photos not good u think i have ultra narrow jaw(maybe i had but not ultra) 09,03,2016
http://imgim.com/snapshot_20160309.jpg adding new teeth photos with light. i just want to see my jaws not so narrow and u can see my 2n molar teeth stay out of line

http://imgim.com/201incix9720402.jpg 2 year ago 2 week at braces. u can see my teeth they are not flared they are just crowded. and i dont have big jaw estetical problems .

2 year ago, 4 month at braces http://imgim.com/img_20140519_210424.jpg when everything perfect but they didnt stop change teeth they change teeth places with elastics(triangle elastic both side top canine to lower canine and lower first premolar) i dont know WHY u can see.

And problems start after elastics. My teeth start come front without a reason. and they get crowded. and i dont know where the space go

(then i learn i just made a big mistake idont know who take my braces is not orthodontist and ididnt search i just trust he say he is ortho then learned he is just dentist).

[thinkingme]

guyz no one here who did wisdom+ 4 premorlar extraction for surgery or only 4 premolar extraction?

[kjohnt]

Visit one or more maxillofacial surgeons before making a decision.

[notrain]

you have two narrow dental arches, bimaxillary protrusion and a recessed mandible.

you can either:

- yank out 4 premolars with decompensation orthodontics followed by bimax surgery (will take at least 15 - 18 months pre surgery ortho to close the extraction gaps)
- expand both arches surgically followed by decomp ortho (takes longer, more risk, more surgery, most expensive)
- do nothing at all
- have 4 premolars pulled followed by compensation orthodontics (imo worst option since it will shrink dental arches, shrink mouth, leave s**tty profile, expensive)

you could combine options 3 and 4 with a camouflage genioplasty.

best compromise for time and effort is option 1 although people will murder me for advising to pull teeth. option 2 is risky because lower jaw expansion is a difficult and risky surgery.

[kjohnt]

Don't do extractions unless decompensating for surgery, ever.  That's why half the people on here are, well... on here.

[thinkingme]

you have two narrow dental arches, bimaxillary protrusion and a recessed mandible.

you can either:

- yank out 4 premolars with decompensation orthodontics followed by bimax surgery (will take at least 15 - 18 months pre surgery ortho to close the extraction gaps)
- expand both arches surgically followed by decomp ortho (takes longer, more risk, more surgery, most expensive)
- do nothing at all
- have 4 premolars pulled followed by compensation orthodontics (imo worst option since it will shrink dental arches, shrink mouth, leave s**tty profile, expensive)

you could combine options 3 and 4 with a camouflage genioplasty.

best compromise for time and effort is option 1 although people will murder me for advising to pull teeth. option 2 is risky because lower jaw expansion is a difficult and risky surgery.

my ortho said i have protruding teeth which need to come back. another ortho said i have no issue i dont need braces i didnt agree him. And guyz these are not my natural teeth ihave a bad braces journey 1,5 years ago(iwas 17) and 1,5 years ago i have no problem with my jaws and mouth. My teeth are crooked they try straight teeth without pulled or widening arches(they are not ortho i learn it then they are dentist). Only my teeth was protruding but they make all teeth come front. I dont rly want to extract 4 premolar because of internet stories :/.I have no functional problems now. And if i extract teeth i think my palate get narrower my lower jaw get narrower and my smile get narrower to and i will be very sad.

[notrain]

Then don't do anything.

[thinkingme]

Then don't do anything.

But my side profile seems bad i think. I dont know really extraction is really bad all cases. Or its internet legends only.

[kjohnt]

Go to a couple of max fac surgeons, not orthos, but surgeons.  See what they recommend and why.  Then move forward with a plan.

[Bobbit]

But my side profile seems bad i think. I dont know really extraction is really bad all cases. Or its internet legends only.

Where do you live ?   Makes a difference in what surgeons may be available to you .

[thinkingme]

Where do you live ?   Makes a difference in what surgeons may be available to you .

Im from turkey. There is good surgeons and not high values and sometimes goverment help for cost. But my family think i have no issue and they are not supporting i must earn money

[molestrip]

you have two narrow dental arches, bimaxillary protrusion and a recessed mandible.

You forgot the exaggerated curve of Spee, looks mostly mandibular. Don't think I've ever seen that before.

- expand both arches surgically followed by decomp ortho (takes longer, more risk, more surgery, most expensive)

They can be lengthened too. Surgical widening of the mandible is not widely practiced, for reasons I can only speculate about.

- do nothing at all

Always an option. Or do something later. However, airway looks small so CPAP may be needed at some point.

you could combine options 3 and 4 with a camouflage genioplasty.

Chin looks normal to me.

best compromise for time and effort is option 1 although people will murder me for advising to pull teeth. option 2 is risky because lower jaw expansion is a difficult and risky surgery.

I don't love pulling teeth either but I'm coming to the conclusion that it makes sense in a lot of cases. Cases like these are good candidates for surgically assisted orthodontics. Very few people know how to do it though, probably not in Turkey. Then extractions can be avoided and surgery is simplier. I really don't love the surgery they'd have to do for those lower incisors though. It looks like it's still unclear to me whether vertical changes are possible with SFO, maybe it could help there too.

[thinkingme]

You forgot the exaggerated curve of Spee, looks mostly mandibular. Don't think I've ever seen that before.

They can be lengthened too. Surgical widening of the mandible is not widely practiced, for reasons I can only speculate about.
Always an option. Or do something later. However, airway looks small so CPAP may be needed at some point.
Chin looks normal to me.
I don't love pulling teeth either but I'm coming to the conclusion that it makes sense in a lot of cases. Cases like these are good candidates for surgically assisted orthodontics. Very few people know how to do it though, probably not in Turkey. Then extractions can be avoided and surgery is simplier. I really don't love the surgery they'd have to do for those lower incisors though. It looks like it's still unclear to me whether vertical changes are possible with SFO, maybe it could help there too.

First sorry i dont know what is sfo and surgically asister orthodontics(if its different mean) mean. And exaggerated curve of spee probably cause of my protruding teeths. lower back teeths look inside so much and fronts look frontside. I know widening mandible is possible in turkey i search a same university cases but ithink they did it on very special cases.

I will discuss with plastic surgeons and jaw surgeons that what can they do but for me a ccw rotation of mandible can improve my profile.

[Lazlo]

shut the f**k up you moron (op) don't get extractions. Just got to Gunson and Arnett and have them instruct your ortho what to do. You need a plan from them and you need full out bi-max plus genioplasty. If you don't have the money you better start saving now.

YES EXTRACTIONS OF PREMOLARS ARE 19th CENTURY ORTHODONTICS APPLIED TO 21ST CENTURY. IT"S NOT AN "INTERNET LEGEND". ORTHODONTISTS ARE JUST STUPID AND EVIL PEOPLE.

[molestrip]

shut the f**k up you moron (op) don't get extractions. Just got to Gunson and Arnett and have them instruct your ortho what to do. You need a plan from them and you need full out bi-max plus genioplasty. If you don't have the money you better start saving now.

YES EXTRACTIONS OF PREMOLARS ARE 19th CENTURY ORTHODONTICS APPLIED TO 21ST CENTURY. IT"S NOT AN "INTERNET LEGEND". ORTHODONTISTS ARE JUST STUPID AND EVIL PEOPLE.

+1 to the orthodontists are stupid/evil comment. Doesn't change my opinion about extractions for most people, if it were me I'd be seriously looking into all this new age stuff to avoid it, like DO, surgically faciliated orthodontics (SFO), etc. We're not gonna see replacement natural teeth in our lifetimes. Implants are better than no teeth but you don't want them.