I've always had a really recessed chin and what I feel is a pretty recessed jaw, though less so and I never thought it was that much of an issue until now. I had braces as a kid but my dentist never took my wisdom teeth out since they never showed signs of moving. Unrelated to that because of my recessed chin and the insecurities resulting from it I had a sliding genioplasty done around 19 to bring my chin in line with the rest of my face and I was pretty happy with that.
Recently though I went to an orthodontist to ask about shifting in my teeth and how my jaws don't perfectly align, he told me that in part because of then not removing my wisdom teeth as well as issues with my jaw I would need either braces again or Invisalign to correct the issue, as well as having my wisdom teeth out. What really surprised me though was when he brought up jaw surgery. He said that even with my wisdom teeth out and 12 months of Invisalign/braces it would at most solve 90% of the issue but it would require jaw surgery to totally solve. I had never heard in my life from any of my dentists that I might need jaw surgery so I was really surprised by that. These were the findings he gave me.
The upper and lower jaws are disproportionate in size
• A combination of adult and baby teeth are present
• Upper and lower teeth meet edge to edge
• Mild crowding of the upper teeth
• Mild crowding of the lower teeth
• Upper front teeth are right of center with the facial midline
• Missing the lower right 2nd bicuspid
• Oral hygiene appears good at this time
He recommended just the Invisalign since he said it was simpler and cheaper but I wanted to ask here before deciding since it seems like a big decision and I know so little about it I don't even feel like I know the right questions to ask. But here they are.
1.) Will the genioplasty (which was only on the chin) prevent me from getting jaw surgery if I decide on it?
2.) How comparable would you guys view the end results when choosing between the Invisalign and jaw surgery, both functionally and aesthetically?
3.) If I choose to just do braces/Invisalign now, could I then go back and choose to do jaw surgery at a later date? Or does the way they move the teeth for Invisalign sort of impede that?
4.) How significant of a recovery and how bad is the pain with jaw surgery?
5.) Do you agree that just Invisalign is the best option for me or should I go with Jaw Surgery?
6.) What is the price of jaw surgery generally for my specific issue if these were the findings they had?
I included a picture of the x-ray if that helps, let me know if any other pictures will help as well. And thank you guys for any advice you can give me!
I've looked at your photos.
There looks to be some facial asymmetry and chin surgery alone doesn't substitute for jaw advancement if the situation is one where chin advancement tries to compensate for lower jaw recession. Ortho alone would not correct facial imbalance. Your case, most likely, resolves to jaw surgery. The part of the surgery to advance the lower jaw (BSSO) is contingent on the lower wisdom teeth being removed BEFORE having jaw surgery (because they are in the way of the cut they use to advance the lower jaw). The part of the jaw surgery (upper jaw) can change the position of the upper jaw in many ways so that both jaws are in better balance with each other. The upper wisdom teeth usually don't have to be removed for that part of the surgery. However, if there is something about them (like how they are positioned) that could pose an infection risk within the time frame of HEALING from the cuts made in jaw surgery, they might want them removed before a jaw surgery.
That's the salient information with which some of your questions can be addressed.
1: Prior genio will not preclude a jaw surgery. Although the genio would not prevent you from having jaw surgery, there's always the possibility the surgeon would want to revise the position of the chin as part of the entire jaw surgery. It's something they can do during the surgery.
2: The salient info conveys jaw surgery would improve/correct the facial imbalances and ortho alone won't.
3: The salient info conveys you are a candidate for jaw surgery and not ortho alone. So, it is better to realize that and to have ortho in PREPARATION for a jaw surgery. For example, ortho alone can make the 'bite right'. But preparation for a jaw surgery could involve UNDOING that. ONE time in braces is better than 2X, first to do and second to undo.
4: That type of question is best addressed during a consult with a jaw surgeon. It depends on the specifics involved with all the surgical displacements to be done. Pain tolerance can differ from person to person and pain medication can be adapted to that.
5: The salient info provided here should allow you to answer this question yourself.
6: There is no answer this question other than to convey all depends on what the surgeon charges and what specificities would be involved in your particular case.
