We need to talk.....

[beyondconfusedtbh]

Okay lads, its time we addressed the issue that no one seems to want to talk about.

RELAPSE.

The lack of jaw & midface development that many of us are trying to remedy has in many cases been caused by years of incorrect posture. Mouth breathing, incorrect tongue posture (and by extension incorrect swallowing patterns) & so on are all at least partially to blame.

So why is this important? Well I feel as though failure to correct such problems significantly increases the chance of relapse, possibly even past the usual timeframe that it can occur.
@Lazlo even stated (here: http://jawsurgeryforums.com/index.php?topic=5142.msg43727#msg43727) that he's met people who's jaws have recessed yet again in the later years post surgery.

Now I have NO IDEA about class 3's bc it doesn't concern me but as someone with a class 2 bite this makes me feel very uneasy.

I'm aware other factors effect relapse rates much more. There is evidence that shows a strong correlation between relapse and the 'magnitude' (for lack of a better word) of the surgery, with certain procedures also being accompanied by higher % of relapse ie. CCW or downgrafting.

I also understand that the rates of relapse really only skyrocket when a certain threshold is crossed in terms of degrees rotated or mm's advanced.

But regardless in my opinion 10-20% relapse rate is still pretty high, & if I could give myself a better chance of avoiding complications I'd always take it.

I know for a fact no one wants to get a revision if it is avoidable & so I'm asking everyone who's suffered from relapse to come forward, remember that the relapse i'm talking about is specifically for those of us with class 2 bites.

And furthermore, I'd like to ask the people on this forum who are far more versed on these matters, do you believe myofunctional therapy is the solution? correcting postural problems BEFORE surgery could make a difference no? This way your muscles aren't working against you as much, and the underlying issues have been solved as well.

Anyway its food for thought. Any insight would be greatly appreciated!

[beyondconfusedtbh]

Quick addition:

The only material on myofunctional therapy is pretty old so honestly everyone else’s ‘guess’ is as good as mine.

Also I swear I’m not mew in disguise lol

[JawKid7]

keep mewing!

[GJ]

Okay lads, its time we addressed the issue that no one seems to want to talk about.

RELAPSE.

The lack of jaw & midface development that many of us are trying to remedy has in many cases been caused by years of incorrect posture. Mouth breathing, incorrect tongue posture (and by extension incorrect swallowing patterns) & so on are all at least partially to blame.

So why is this important? Well I feel as though failure to correct such problems significantly increases the chance of relapse, possibly even past the usual timeframe that it can occur.
@Lazlo even stated (here: http://jawsurgeryforums.com/index.php?topic=5142.msg43727#msg43727) that he's met people who's jaws have recessed yet again in the later years post surgery.

Now I have NO IDEA about class 3's bc it doesn't concern me but as someone with a class 2 bite this makes me feel very uneasy.

I'm aware other factors effect relapse rates much more. There is evidence that shows a strong correlation between relapse and the 'magnitude' (for lack of a better word) of the surgery, with certain procedures also being accompanied by higher % of relapse ie. CCW or downgrafting.

I also understand that the rates of relapse really only skyrocket when a certain threshold is crossed in terms of degrees rotated or mm's advanced.

But regardless in my opinion 10-20% relapse rate is still pretty high, & if I could give myself a better chance of avoiding complications I'd always take it.

I know for a fact no one wants to get a revision if it is avoidable & so I'm asking everyone who's suffered from relapse to come forward, remember that the relapse i'm talking about is specifically for those of us with class 2 bites.

And furthermore, I'd like to ask the people on this forum who are far more versed on these matters, do you believe myofunctional therapy is the solution? correcting postural problems BEFORE surgery could make a difference no? This way your muscles aren't working against you as much, and the underlying issues have been solved as well.

Anyway its food for thought. Any insight would be greatly appreciated!

Basically this is correct. Fixing something like a tongue thrust before surgery is wise. I'm not sure you need myofunctional therapy to do that. You can do it on your own with some awareness. And the magnitude of surgery does effect relapse, but it's also joint condition, hormones (female), etc. It sucks that magnitude is a variable, because many need a large magnitude and yet the very thing they need will cause relapse. It's pretty hard to predict, all that being said.

[beyondconfusedtbh]

keep mewing!

hahahaha

[beyondconfusedtbh]

Basically this is correct. Fixing something like a tongue thrust before surgery is wise. I'm not sure you need myofunctional therapy to do that. You can do it on your own with some awareness. And the magnitude of surgery does effect relapse, but it's also joint condition, hormones (female), etc. It sucks that magnitude is a various, because many need a large magnitude and yet the very thing they need will cause relapse. It's pretty hard to predict, all that being said.

Yeah it is a shame, at the end of the day we can just try our best I guess.
Been working on tongue posture, a little uncomfortable at the  moment but should be easier after SARPE.

Thanks for the information!

[treevernal]

I don't post that often anymore but I'll chime in and say that I believe myofunctional therapy saved my result from relapsing and continues to do so.  I started therapy 1 year prior to surgery and for 2 years after.  Now I know enough to do it on my own. 

I was a mouth breather with poor tmjs and I had a very large advancement of both jaws 20mm+.  I'm very happy with the result but my tmjs are half the size they used to be due to post-surgical remodeling. 

In addition to myofunctional therapy and your retainers, your bite itself is supposed to "hold" your result in place, especially if your joints cannot.  I started out with teeth worn down from grinding that had to be "built up" on the cusps by my orthodontist with a temporary bonding material meant to get me through surgical recovery.  Unfortunately, now 5 years post surgery, the temporary bonding has naturally worn away and I need to get it replaced by a restorative dentist with permanent bonding material.  Unfortunately again, this will cost $$.  In the meantime, my proper myofunctional habits are, I believe, keeping things stable until I can afford to have the restorative work done. 

[beyondconfusedtbh]

thanks for replying man, I'm amazed you managed to pull off such a large advancement. which Dr. was this with?

as for the myofunctional therapy, what exercises would you recommend?
as i said in the previous post, im practicing correct tongue & swallowing posture currently but I don't know what else is appropriate. my surgery will most likely entail posterior downgrafting, ccw (possibly) & the advancement of both jaws (like you).

[treevernal]

I went with Dr. Arnett in Santa Barbara. 

For myofunctional therapy, it sounds like you're doing the right things so far; swallowing posture is probably the most important part of it.  My therapist also had me keep a small dental rubberband in my mouth on the top of my tongue during all of my waking hours (aside from eating and exercising) as a reminder to keep my tongue on the roof of my mouth and my lips closed at rest.  I still do this most of the time.  Another thing is sleeping with your mouth taped shut in a criss-cross pattern using micropore tape (don't worry, you won't suffocate) but over time this will force you to breathe through your nose more; especially if you tend to sleep with your mouth wide open and snore.  If you're stuffed up in your sinuses on a particular night, your mouth will force itself open to breathe and you may wake up with the tape off and on the floor or on your face, etc lol.  You can find this stuff online/on youtube if you look. 

Good luck with your surgery!