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Daedalus Journey

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Daedalus:
As a premises:
Long story short, I was a mouth breather during childhood due to adenoids and developed a common mouth breather face ” with underdeveloped mandible. Fast forward to my early teens I get braces and two upper premolar extractions to pull my more developed maxilla to meet retruded mandible.

Today, I constantly have a problem with snoring (I still open my mouth during sleep) which snowballs a variety of other issues. Not so long ago I tried to fix my problem with a new orthodontist using  a palatial expander but I was warned that at my age (20 y.o) it will not be able to change the bone, it will rather shift the teeth. Furthermore it will not help out with the mandible.

Now, functional problem out of the way. I would really like discuss and more than glad to hear out opinions about the aesthical side of the issue.  Here is an X-ray (half a year old, now the wisdom teeth are extracted)  https://imgur.com/a/WRUv29W

After I've done some research and  I have reached a conclusion that  I will require some sort of double jaw advancement with a genioplasty  and possibly some malar augmentation with implants or bone grafts to even out the mid face . Of course the final plan will be set by the specialist of choice, but for now I'm also interested in hearing out your  opinion on the matter.

In conclusion, I intend to keep updating this post and overviewing the entire process.

kavan:
I agree. You would benefit from double jaw surgery and those with whom you plan to consult all are good with optimizing aesthetics via CCW rotations if that is needed.

Daedalus:
Thank you for your reply, appreciate it.

Daedalus:

--- Quote from: kavan on September 03, 2019, 08:41:39 AM ---I agree. You would benefit from double jaw surgery and those with whom you plan to consult all are good with optimizing aesthetics via CCW rotations if that is needed.

--- End quote ---

Hello, Kavan. I hope you will have some spare time to read through my comment.

Recently, I was extensively researching about orthodontic decompensation before the surgery. I just see no way they can decompensate my upper jaw, as then it would require  protraction with skeletal growth to reverse it back. Alternatively they might want to extract lower premolars to reduces the lower incisors tipping and then advance both jaws with or without rotation. I would definitely like to avoid extractions beyond all, so I'd like to ask if potentially retracting entire lower arch is possible, or the advancement and rotation of existing occlusion is  sometimes possible? Of course I understand that prior to any orthognatic treatment, orthodontics should ensure the stability of the entire structure.
On the other hand, what do you think about surgery first approach? I personally see it as inferior, since its impossible to reverse everything back after the surgery have been conducted.  Thank  you in advance!

kavan:

--- Quote from: Daedalus on September 05, 2019, 02:24:00 AM ---Hello, Kavan. I hope you will have some spare time to read through my comment.

Recently, I was extensively researching about orthodontic decompensation before the surgery. I just see no way they can decompensate my upper jaw, as then it would require  protraction with skeletal growth to reverse it back. Alternatively they might want to extract lower premolars to reduces the lower incisors tipping and then advance both jaws with or without rotation. I would definitely like to avoid extractions beyond all, so I'd like to ask if potentially retracting entire lower arch is possible, or the advancement and rotation of existing occlusion is  sometimes possible? Of course I understand that prior to any orthognatic treatment, orthodontics should ensure the stability of the entire structure.
On the other hand, what do you think about surgery first approach? I personally see it as inferior, since its impossible to reverse everything back after the surgery have been conducted.  Thank  you in advance!

--- End quote ---

They might elect to 'buck out' the upper front teeth somewhat to get some more forward movement to the lower jaw. The doctors you consulted with use CCW posterior downgraft where they don't need to rely on extracting more pre-molars from lower jaw to bring it forward.

Post surgical braces move the teeth faster into place with surgery first method. However, even with doctors who do use that method,  they need to determine which patients can have it or not.

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