A lot of people know a lot about orthodontics on this board so I thought I'd ask what you would do in a situation like mine (pics attached).
I really want to avoid surgery, but I'm not sure how effective braces will be. The surgical questions going through my mind are:
1. Are my buccal corridors so bad that I should get SARPE?
2. Should I get lower jaw surgery to cure my 6mm overjet once and for all?
3. As a wildcard option, could I get segmental le fort 1 and at the same time, set the maxilla back 2 millimetres and so cure both problems? Is it worth the nasal flaring?
My lower jaw is 3mm recessed and so I don't think there would be any cosmetic benefit to getting BSSO given that I am already conscious about the prominence of my chin when I smile.
I had a 12mm overjet when I was 11 and this has been halved since having twin blocks around that period, but I'm not sure braces alone can be as effective given that I am now in my twenties.
For braces, I was thinking of ceramic Damon, with many orthodontists telling me 2mm overjet reduction is likely from lower arch braces only, but it would come at the expense of gum recession.
On the uppers, I could either:
1. Extract premolars to allow the upper arch to retract
2. Interproximal reduction to allow some upper arch retraction, but possibly at the expense of tooth sensitivity
3. None of the above, but accept that my upper arch can retract maybe 1mm at most due to the presence of crowns on my front two teeth cancelling out the force from the braces
With non-extraction, non-surgical treatments, I reckon the overjet would likely reduce by around 3mm. And even if I do wear my retainers, there's a chance of this relapsing 10 years down the line. How much the arch would widen, I don't know but then again, stability is a big issue there.
I am really unsure what to do, and have been pondering it for months...any ideas would be warmly welcomed. What would you do?
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