Before and After X-Rays

[nem8685]

I had overbite jaw Surgery on March 9th now just recovering, to correct a 9mm overbite. I had upper and lower + genioplasty.

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[Nataliepryor]

How is the recovery going? Hope your feeling ok. 

I'm due for same (9mm also) in September.  Are you happy with result aesthetically? X-ray looks good.

[nem8685]

Recovery is comming along every day bit better , it's too early to tell aesthetically until the swelling subsides but so far a lot of people tell me I look different and some can't recognize me. I notice a big change in my side profile so far though so that is good and so far I can see a change in my face

[Nataliepryor]

Yes sorry would be too early for judging yet.  Glad it's looking good though.  I bet it's strange when people don't recognise you!

How are you going on syringe diet? Do you have much feeling back? Are you wearing a splint? Question, questions! Sorry, you probably just want to switch off 

[nem8685]

Yes sorry would be too early for judging yet.  Glad it's looking good though.  I bet it's strange when people don't recognise you!

How are you going on syringe diet? Do you have much feeling back? Are you wearing a splint? Question, questions! Sorry, you probably just want to switch off 

I'm eating soft foods like pasta , eggs,beans and such. I do have most feeling except around the chin area and I am only wearing elastics

[Nataliepryor]

Soft food diet is great at your stage and having most feeling return, fairly early on.

How are your energy levels at this stage?

[nem8685]

Soft food diet is great at your stage and having most feeling return, fairly early on.

How are your energy levels at this stage?

They are back to normal I believe

[jesterofmalice]

what country are you in? How much did it cost? Would braces alone not have been  enough to correct your overbite?

[Nataliepryor]

Anything over 4-6mm overbite is generally surgery category. 9mm is a significant amount and cannot be fixed with braces alone.

[nem8685]

what country are you in? How much did it cost? Would braces alone not have been  enough to correct your overbite?

I am in Canada. It cost me about 3600$ approximatley rest is covered by insurance the price went up to 5000$ later but the surgeon had to keep by his promise of his initial 3600$. The braces were not enough to correct my overbite I have four more months of braces and Im finished so very happy about that.

[terry947]

Who was your surgeon and what province you live in?

[notrain]

I waited a bit with commenting on your post, but if I am being perfectly honest I think you should have been treated differently.

In your pre-op x-ray I can see very narrow airways (increased risk for sleep apnea) and a somewhat steep occlusal plane, both of which are indicators for a downward and backward rotated face (clockwise).

Post-OP, your airways are still narrow, the occlusal plane was left steep which results in a convex facial profile even though both jaws were advanced.
The surgeon then tried to camouflage the profile with a straight advancement genioplasty which would have been completely unecessary if he had performed CCW Rotation of both your jaws.

Given that you had a Bimax surgery, this should have been the way to go in the first place.

Your bite is good, no doubt about that, but your surgeon forgot about the airways and the face.

All in all it's an okay result - the bite was fixed. But considering how stressful the entire braces / jaw surgery journey is, I think your surgeon came up short.

[terry947]

Notrain can you put the final nail in the coffin and answer this?

In a CCW rotation does the back of the maxilla come down or do they impact the front of my maxilla and rotate it upwards?

To me the second one makes sense. Sortens the face and also rotates the maxilla forwards and well and the mandible. While molestrip seems to think the back of the maxilla comes down. Wouldn't this technically make the face longer?

[notrain]

It really depends on the bite. CCW Rotation basically just means flattening the occlusal plane angle. The face doesn't have to get longer.

For instance you could perform CCW rotation by impacting the back of the maxilla less than the front. This would still be CCW rotation but it would shorten the face and would be intended for patients with steep occlusal plane angle and an open bite (or an open bite tendency). Basically you move the entire maxilla upwards, but asymmetrically.

For patients with a Short Face Growth pattern, you could downgraft the entire maxilla, but more in the back than in the front. This would also be CCW rotation but with a lengthening effect. The forum member celticcavegirl has a short face but a steep occlusal plane. She would be a candidate for this type of ccw.

Again, ccw rotation is intended for patients with an occlusal plane angle > 8°. If your occlusal plane is normal, you get linear advancement. If it is flat or negative, you need CW Rotation. Bear in mind that the occlusal plane needs to get measured once you are decompensated and the curve of spee in both jaws is level. I had a flat occlusal plane in my compensated bite, now it is normal (5-6°).

[kjohnt]

It really depends on the bite. CCW Rotation basically just means flattening the occlusal plane angle. The face doesn't have to get longer.

For instance you could perform CCW rotation by impacting the back of the maxilla less than the front. This would still be CCW rotation but it would shorten the face and would be intended for patients with steep occlusal plane angle and an open bite (or an open bite tendency). Basically you move the entire maxilla upwards, but asymmetrically.

For patients with a Short Face Growth pattern, you could downgraft the entire maxilla, but more in the back than in the front. This would also be CCW rotation but with a lengthening effect. The forum member celticcavegirl has a short face but a steep occlusal plane. She would be a candidate for this type of ccw.

Again, ccw rotation is intended for patients with an occlusal plane angle > 8°. If your occlusal plane is normal, you get linear advancement. If it is flat or negative, you need CW Rotation. Bear in mind that the occlusal plane needs to get measured once you are decompensated and the curve of spee in both jaws is level. I had a flat occlusal plane in my compensated bite, now it is normal (5-6°).

I realize this is an old thread, but this is great information.  I've been searching everywhere to try to understand how ccw/cw rotation is achieved.  I didn't understand the relationship between maxillary impaction and ccw/cw rotation, and this makes perfect sense now.  It sounds like in a long face situation with a steep occlusal plane, a maxillary impaction with less shortening in the back of the maxilla would be appropriate to achieve both shortening of the midface along with flattening of the occlusal plane (ccw when looking at right side profile).

I've also been searching everywhere regarding ideal occlusal plane angle.  Where did you learn 5-6 degrees?