Lower SARPE - Widening your entire smile?

[Fannie Mayson]

Hello, longtime lurker here!

I understand that SARPE surgery is the common starting ground for Jaw surgery; on the upper palate that is. But what about on the lower palate as well? The surgery does exist...

I have read it is more complicated but not incredibly so. So do you know of any instances of where both the upper and lower bites were given SARPE? Obviously both the upper and lower bites have to be lined up properly for proper dentition. A broad dental palate is a very attractive feature and getting a wider smile is very enticing.

[Modigliani]

Interesting first post.

Can it be performed on adults?

[bpanther]

Yes, this surgery exists - but it isn't called SARPE as that's only for the upper palate. This specific procedure is called mandibular widening by distraction osteogenesis (it's quite a mouthful, I know!)

Here's another picture, you can clearly see the gap forming:

[attachment deleted by admin]

[Fannie Mayson]

Interesting first post.

Can it be performed on adults?

No clue

Yes, this surgery exists - but it isn't called SARPE as that's only for the upper palate. This specific procedure is called mandibular widening by distraction osteogenesis (it's quite a mouthful, I know!)

Here's another picture, you can clearly see the gap forming:

Very nice. Have you ever heard of this being done cosmetically, and if so, what surgeons? If the bone split goes through the entire mandible this has great potential for widening the chin. 

[LoveofScotch]

Not sure about this (could be amazing!), but the picture of the two women shows up everywhere. I've seen it used at least half a dozen times in varying places. Maybe you were just using it as an example (wide smile/face vs not so much), but I don't think the women on the right had this done.

Cheers!

[Alue]

Isn't the picture above an extraction/non extraction case done on two identical twins? 
In any case I could probably benefit aesthetically from pallet expansion in addition to bimax advancement, but that just sounds like too much surgery for me.  Is there anything that is less invasive that can give the impression of a wider smile without pallet expansion? 

If one were to do both expansion and mma, would the expansion have to be done first? 

[Fannie Mayson]

Not sure about this (could be amazing!), but the picture of the two women shows up everywhere. I've seen it used at least half a dozen times in varying places. Maybe you were just using it as an example (wide smile/face vs not so much), but I don't think the women on the right had this done.

Cheers!

Yeah, I just saw it as a comparison of a narrow vs a wide palate.

Isn't the picture above an extraction/non extraction case done on two identical twins?   

I read it was a twin who had palatal widening(nonsurgical) vs the twin who didn't, but you could be right.

In any case I could probably benefit aesthetically from pallet expansion

I think we all could really. But the question is if you could widen both enough for there to be a noticeable improvement, and if this could even be done cosmetically. I can't find any info on the net of 'mandibular widening by distraction osteogenesis' being done on patients without malocclusions or deformities. A SARPE + MWDO combo would do so much for my tiny palate.

  Is there anything that is less invasive that can give the impression of a wider smile without pallet expansion? 

I only have one thing to offer you; look up the "DNA Appliance". I stumbled upon it doing my own research about palatal expansion and found it interesting. I'd just be concerned about whether or not you'd have to wear a retainer for the longterm to maintain the results(You'd have to do more research about this)

[Fannie Mayson]

Yes, this surgery exists - but it isn't called SARPE as that's only for the upper palate. This specific procedure is called mandibular widening by distraction osteogenesis (it's quite a mouthful, I know!)

Here's another picture, you can clearly see the gap forming:

I just saw on your other thread that you're having this done along with SARPE. Very encouraging! Did you approach your ortho about wanting to expand your palate, or did he diagnose you with a small palate and suggest this to you? Just curious.

[Bazarov]

I read it was a twin who had palatal widening(nonsurgical) vs the twin who didn't, but you could be right.

You're both correct; it was palatal expansion vs. extractions/no expansion.

I wonder if the results of the girl on the right could be achieved in adults. Probably not, but one can dream.

The extraction twin is likely incredibly bitter.

[Alue]

You're both correct; it was palatal expansion vs. extractions/no expansion.

I wonder if the results of the girl on the right could be achieved in adults. Probably not, but one can dream.

The extraction twin is likely incredibly bitter.

I don't think expansion is possible in adults without surgery.  I have a very narrow pallet in addition to very recessed jaws, thanks to genetics and poor orthodontics that made it even worse.  I'm sure it would be beneficial esthetically, but I honestly don't want to go through with expansion then MMA (if that's even possible).   MMA seems traumatic enough when you are older.  I had 4 premolars extracted in addition to 4 wisdom teeth, so I'm not sure what the use would be .

[bpanther]

I just saw on your other thread that you're having this done along with SARPE. Very encouraging! Did you approach your ortho about wanting to expand your palate, or did he diagnose you with a small palate and suggest this to you? Just curious.

My ortho noticed that I had a narrow palate from the beginning, but our first priority was straightening my crooked teeth before deciding on a further course of action. I got my braces last year and my teeth have completely straightened out by now - as a matter of fact, my palate actually expanded quite considerably with braces alone (I guess it's because my bones are still quite malleable at 18/19? Everyone grows differently I guess).

She thinks that I could do well with a regular palate expander because of the way my palate just expanded with braces, but we aren't going to do that because there's still a risk of tipping involved with that option and it wouldn't be worth it at all. We then spoke about surgical options and factored in my overbite (caused by a retrognathic mandible), and then decided that SARPE and the widening of my lower mandible, followed by double jaw surgery, would be the best option for me. I recently got four wisdom teeth removed (lower two were completely impacted, upper two were kind of 'squashed' with no space and were giving me discomfort) and my expansion surgeries will be performed in a little over a months' time. I was completely against surgery at first, but I eventually warmed up to the idea.

[Nataliepryor]

I'm surprised SARPE after braces, as the expender does make your teeth a bit crooked with the movement and lining them up perfectly to mess them up a bit seems strange.

[toothfairy]

I had SARPE  surgery on my upper jaw and it made my smile look fantastic. Then after the second surgery in which the surgeon brought my lower and upper jaws forward the orthodontist then narrowed my upper jaw to match the lower jaw again.

It now looks awful in comparison. I really wish he'd left my upper jaw wide. I don't even understand why they bothered expanding the upper jaw and then narrowing it again.

[Nataliepryor]

How did they narrow it? I thought SARPE was pretty much un-changeable? The expander stays in for a long time and the mouth heals in the expandered position.  They usually over expand by 20% to allow for some narrowing but certainly not the whole lot.

[Modigliani]

I had SARPE  surgery on my upper jaw and it made my smile look fantastic. Then after the second surgery in which the surgeon brought my lower and upper jaws forward the orthodontist then narrowed my upper jaw to match the lower jaw again.

It now looks awful in comparison. I really wish he'd left my upper jaw wide. I don't even understand why they bothered expanding the upper jaw and then narrowing it again.

That happened to me too, like you say what the hell was the point of the expansion