Hey guys, I'm looking at having another round of jaw surgery as the first lot was so poorly executed and my so now bite is very uncomfortable and end to end at rest. I need advice on my situation and what is possible when lengthening the maxilla and also any potential complications a second round of surgery may bring.
I've lost some vertical dimension on my maxilla from the first surgery so this time I hope it can be drop down 4mm and then after healing it will stabilise at 2-3mm and I'll be happy. I certainly do not want to lose anymore vertical height as I presently do not show teeth by about 3mm at rest. I know this is going to require bone grafts.
My jaw will need to be advanced by about 3mm. I'm not sure of exact amounts because I had bad braces with extractions as a teen which has left me with a pointy chin and very recessed smile. I've had a surgeon check my x-rays and records and he said that I'm still a class 3 skeletal base with a dentally compensated overbite. I do not think I would have had major crowding if I'd never had these extractions and braces and I'd probably be just fine right now but that is life. I'm now just trying to get the best outcome I can. I do not want to have another drawn out treatment of braces before surgery. The last lot of surgery required nearly two years before surgery and just made my situation worse.
Since I'm located in New Zealand I'm a little worried that our surgeons are behind the rest of the world. Maybe because any jaw surgery in New Zealand is privately funded, so the number of cases surgeons do is limited. The guy who is the best surgeon as far as I know in my city believes that a multi piece Le Forte is better than SARPE. He is reluctant to do SARPE on me. I need about 8mm of expansion. Unfortunately the surgeons here do not think that expansion is of significant importance and I find this worrying.
I do not want a complicated surgery so maybe I will just look at having the advancement and impaction resolved first and then seeing where I go after that. I do not want to do a 3 piece Le Forte again where the maxilla is cut to pieces and doesn't seem to heal, at least in my case been a year so far, to gain a maximum of 4mm of expansion if I'm lucky.
Any thoughts/advice?
Thanks for reading
Ben
