Scared of going through with surgery

[GJ]

Can you elaborate? My understanding is that this only happens in cases of tmj inflammatory issues like rheumatoid arthritis.

From what I've been able to deduct, every case of late relapse I've seen has been due to joint changes.
Whether those joint changes came from jaw surgery, some other condition, or a combination of both, I don't know. Surgeons (good ones at least) diagnose joint problems ahead of time and inform the patient of relapse and/or possibly even limit the movements.

Open bites are notorious for relapse years after the surgery. From what I can tell from looking at x-rays of patients (i.e. people on this forum who sent me their records for opinion) with this type of relapse, it again looks to be at the joint.

In general, if your joints are healthy and you don't have an open bite, you'll experience most of your relapse in the first year or so. But as mentioned, muscles pull on bone, and in any battle of muscle vs bone the muscle always wins. This battle will take place until there is equilibrium in the forces, so time can vary.

[kavan]

Forever.
I know people who relapsed at 10 years.

They have to wear a retainer at night for ever to make less the circumstance of relapse right?

[GJ]

They have to wear a retainer at night for ever to make less the circumstance of relapse right?

That will keep the teeth from relapsing. Jaw relapse is usually at the joint level (skeletal relapse). The latter is usually do to large movements where the muscles "win" over the bony movements, causing changes in the joints.

Regarding ortho: many surgeons and even orthos think wearing a plastic retainer causes bite changes due to the space created by the plastic. This is probably especially true for open bite patients. A Hawley retainer is best if the person had an open bite and the bite fits well post surgery. If the teeth don't meet well you'll probably get an unnatural amount of extrusion with a Hawley since the teeth will want to touch. So not even all retainers are created equally when it comes to stability. If I had an open bite pre-surgery and my bite fit well after, I'd go Hawley. If you're a grinder that can pose some problems, too, though.

[kavan]

That will keep the teeth from relapsing. Jaw relapse is usually at the joint level (skeletal relapse). The latter is usually do to large movements where the muscles "win" over the bony movements, causing changes in the joints.

Regarding ortho: many surgeons and even orthos think wearing a plastic retainer causes bite changes due to the space created by the plastic. This is probably especially true for open bite patients. A Hawley retainer is best if the person had an open bite and the bite fits well post surgery. If the teeth don't meet well you'll probably get an unnatural amount of extrusion with a Hawley since the teeth will want to touch. So not even all retainers are created equally when it comes to stability. If I had an open bite pre-surgery and my bite fit well after, I'd go Hawley. If you're a grinder that can pose some problems, too, though.

Thanx. Very informative.

[Lestat]

Forever.
I know people who relapsed at 10 years.

Thank you for your answer. Does that also apply to a chin wing?

[GJ]

Thank you for your answer. Does that also apply to a chin wing?

I don't know much about chin wings, but I doubt it because most changes occur with the bite and at the joint. The chin wing shouldn't mess with either. If the chin wing has huge advancement, maybe in theory it could relapse where the cut was made if there's enough muscle tension to override the fixation. That seems unlikely to me, but in theory I guess it's possible.

Maybe ask a surgeon who does chin wings for a definitive answer. Mine is just a deduction.

[Post bimax]

From what I've been able to deduct, every case of late relapse I've seen has been due to joint changes.
Whether those joint changes came from jaw surgery, some other condition, or a combination of both, I don't know. Surgeons (good ones at least) diagnose joint problems ahead of time and inform the patient of relapse and/or possibly even limit the movements.

Open bites are notorious for relapse years after the surgery. From what I can tell from looking at x-rays of patients (i.e. people on this forum who sent me their records for opinion) with this type of relapse, it again looks to be at the joint.

In general, if your joints are healthy and you don't have an open bite, you'll experience most of your relapse in the first year or so. But as mentioned, muscles pull on bone, and in any battle of muscle vs bone the muscle always wins. This battle will take place until there is equilibrium in the forces, so time can vary.

Well, this is depressing.

Odd question - I typically train my neck as part of my weight lifting routine (usually neck curls, so the sternocleidomastoid muscle).  Do you think this could increase the chance and/or degree of relapse by strengthening muscles in the area? Or do only the masseter and tiny TMJ muscles matter.

[GJ]

Do you think this could increase the chance and/or degree of relapse by strengthening muscles in the area? Or do only the masseter and tiny TMJ muscles matter.

I'm not sure.
My guess is there's a gradient where eventually one muscle transitions to another and it's effect on the ones surrounding it are close to zero, though it's probably never fully zero at that transition line. Asymptotic curve, probably.
I'm basing this off a calf injury I had, and the orthopedist suggesting as much. It would be best to ask a surgeon...a curious one who thinks about those types of things. Many don't.