Posterior open bite after BSSO?

[baldguy83]

Just wondering about something ...

I've had extractions of the first premolars done in my lower jaw (on advice of MM...), and the front arch (incisors and canines) in my lower jaw was pulled back (using jaw anchors) to close the gap. All this was done to fix a very deep labiomental fold. As a result, the front teeth in my lower jaw now stand up straight rather than being slanted forward, but I also ended up with an overjet and a significant anterior open bite (i.e., no incisal contact at all). Hence, I cannot bite stuff off at all.

I'm now planning on fixing my bite with a BSSO, but if I move my lower jaw forward 'manually' so that the incisal edges of my lower incisors rest on the lower distal surface of my upper incisors, there is no way my molars can touch, i.e., I end up with a posterior open bite. It seems like my lower incisors are too 'tall' now that they're standing up straight rather than being slanted forward. Is there any way to fix this?

[Modigliani]

f**k me, what is it with Mommaerts and his love of creating anterior open bites, is this the new fashion in Belgium or something? 

Sorry, I'll be back with a more constructive answer later when I've taken a Xanax.

[molestrip]

Need x-rays. It should be fixable but may need to be a double jaw surgery case, possibly with segmented LeFort. Dental movements to mandible are considered stable. I would look at reopening the extraction spaces, like Dr Hang does in the US. Don't worry, it's fixable.

Anterior open bites are hard to fix and occur easily. I have one too Mostly skeletal with a small dental component.

[baldguy83]

Well it's not the worst thing in the world really, I actually prefer being able to chew over being able to bite stuff off (which I don't do that often anyway).  If it turns out that fixing the anterior open bite has a big risk of introducing a (hard to fix) posterior open bite, I might just leave it alone. Unless an anterior open bite can lead to serious issues later on (aside from being able to bite stuff off)?

[baldguy83]

Here's a sagittal slice from my CBCT:

http://i.imgur.com/AWgwBQ5.jpg

I've got three implants in my maxilla (traffic accident when I was younger), hence the extreme whiteness of my upper incisors :p Also, braces and bone anchors in lower jaw.

[baldguy83]

Here's an X-ray from before the extractions, you can see the slanted front teeth in my mandible:

http://i.imgur.com/xCzEh6s.jpg

[molestrip]

Oh, I see what you mean Those implants greatly restrict your orthodontists options. Did you just relapse from braces in the CBCT? It looks closed there even. Apparently, osteotomies can be done on the lower segment of the mandible. I wouldn't do a big double jaw surgery over that, just as likely to create other problems. You've got a great x-ray otherwise, not perfect but pretty good.

[baldguy83]

What do you mean by relapse? The braces were used to pull the front arch in the mandible back, they seem to have done a good job.