Things to do to avoid relapse?

[Benjaminh]

Hey guys, I have Double jaw surgery coming up in 30 days. I have TMJ, Sleep apnea, and an underbite. My surgeon is doing CCW, moving my lower jaw slightly forward and my upper jaw to match. The thing is since I have TMJ from poor posture cause by sleep apnea I'm worried about relapse. Especially since I'm doing CCW.  I'm wondering what I can do to prevent it from happening. I'm going to fix my posture by doing yoga that's for sure. Anything else?

Thank you

[GJ]

Eat super foods during recovery.

There's not much you can do outside of just treating the body well and making sure it needs ample nutrients to heal.

Something else to try might be stretching the muscles, because in a battle between muscle and bone the muscle will win. The latter I was told by a surgeon. Ask your surgeon about all this, obviously, because these are just my lay man ideas or things I've heard.

I don't think they really understand relapse well so it's hard to say how to prevent it. The condyle will remodel to some degree; you just hope it's normal and then stops.

[XXRyanXXL]

I've seen this time and time again, especially on this forum. Orthodontists will take off the braces too early. The bones tend to settle even after 1 year from surgery. The braces themselves, and even the titanium plates and screws they use to fixate the bones, are there to stabilize the bony structure. You can talk to any Oral Surgeon, and they will say that even with these plates and screws and braces, the bone is almost considered a fluid medium, meaning they are subject to movement, it's not a completely rigid structure, so the screws and plates will move within the bone.
Leaving the braces on for at least a year, can help at least, but taking them off at approximately 3-6 months is premature. I've recently seen a poster on this forum who had hers taken off after 6 months and she has a cant to occlusional plane, and it was severe to notice at resting lip posture.
So when the swelling initially goes down, your final facial structure won't be apparent, but years after. Also, are you having bone grafts for the CCW rotation? Or HA paste? I read the study by Wolford on using HA paste, and the first 3 months are critical, eating soft foods only, any undue stresses on the bone graft can cause instability of the structure around it, because of indifference of materials, unless it's your own bone or cadaver.

[kavan]

Agree with XXXRyanXXX. Also with GJ about the foods and recovery.

Keep stabilization devices in for as long as possible which initially are braces. I believe there are other stabilization devices that can be put in daily (or nightly).  Most certainly, ask this question to your max fax as to which devices are aimed at long term stabilization.

[GJ]

I've seen this time and time again, especially on this forum. Orthodontists will take off the braces too early. The bones tend to settle even after 1 year from surgery. The braces themselves, and even the titanium plates and screws they use to fixate the bones, are there to stabilize the bony structure. You can talk to any Oral Surgeon, and they will say that even with these plates and screws and braces, the bone is almost considered a fluid medium, meaning they are subject to movement, it's not a completely rigid structure, so the screws and plates will move within the bone.
Leaving the braces on for at least a year, can help at least, but taking them off at approximately 3-6 months is premature. I've recently seen a poster on this forum who had hers taken off after 6 months and she has a cant to occlusional plane, and it was severe to notice at resting lip posture.
So when the swelling initially goes down, your final facial structure won't be apparent, but years after. Also, are you having bone grafts for the CCW rotation? Or HA paste? I read the study by Wolford on using HA paste, and the first 3 months are critical, eating soft foods only, any undue stresses on the bone graft can cause instability of the structure around it, because of indifference of materials, unless it's your own bone or cadaver.

But leaving braces on that long is dangerous for the teeth (short roots, lost enamel, reduced bone levels, periodontal detachment, etc). Braces inflame all that tissue and destroy it, especially if you're an adult. If you're 18-24 range you can probably get away with a year in braces post-op.

If the surgery is performed correctly, the bite should be ideal or very close when you leave the OR. Maybe 3 months after to fine tune it. Then you're done. You have to get out of braces ASAP to avoid the problems above.

I had my braces off after 3 months and nothing has moved in years. A lot of it his hormonal. Females are more prone to relapse for unknown reasons. Also, the larger the movement, the more the odds of relapse. Open bites are most prone to it. So, it goes well beyond braces.

The way to minimize the risk is having a great ortho who does efficient movements and gets your bite correct and then out of braces ASAP, a surgeon who nails the bite and only does the minimum movement required to get a great bite and aesthetic, and then treating your body well during the healing process. Doing all the stretching exercises, etc, for the jaw and facial muscles will help a bit. After that, it's all about hormones and how the condyle remodels and is pretty much out of everyone's control. 

[kavan]

Agree with XXXRyanXXX. Also with GJ about the foods and recovery.

Keep stabilization devices in for as long as possible which initially are braces. I believe there are other stabilization devices that can be put in daily (or nightly).  Most certainly, ask this question to your max fax as to which devices are aimed at long term stabilization.

I guess i should clarify that 'as long as possible' is length of time where they do good and don't do damage. 'As long as possible could be same time frame as 'as short as possible'. Long enough to do good but short enough to avoid damage. But I can't define the time period.

[secondtimearound]

In my case relapse was due to them trying to accomplish too much orthodontically. If you expect to move the teeth massive amounts through orthodontics, and don't have a major amount of maxillary/mandibular bone within which the teeth can "set", you will end up with either relapse or gum recession as a consequence.

Surgeons need to aim to do most of the correction surgically, and just use orthodontics for small scale re-alignment.

The other type of relapse is where the bones themselves shift. Hope your surgeon secures your bone well with good hardware and don't do anything you shouldn't with food until it's well healed.