jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: needadvancement on February 10, 2015, 10:04:33 AM
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Had a few more consults and preperations, braces will be placed first and then surgery will be in a couple of weeks. I'm learning more and seeing more results and gotta say I'm impressed. Here are some results on adults:
(http://www.smilesforever.com/pao-6-mo-tx-1345061413.jpg)
(http://www.beugel.nu/wp-content/uploads/Versnelde-orthodontie-Wilckodontics-PAOO_1a.jpg)(http://www.beugel.nu/wp-content/uploads/Versnelde-orthodontie-Wilckodontics-PAOO_4a.jpg)
Almost everything I want is in this treatment:
-fixing my bimax pro and overbite without extractions. This is still 'camouflage' on my recessed mandible, but my airways are good and no TMJ so I think I'll be fine in the long run.
-the new bone growth fills in the dented parts of my jaw, so likely no more deep mentolabial fold and a better looking mouth all around.
-A wider smile. They can broaden both arches from incisors up to the first and second premolars. I asked and they can't change the molars in the back but it's ok.
-Only about half a year in braces and more stable results because of the new fused bone growth.
This is pretty much jaw surgery though. They advised me to take a week off from work when I have the surgery. I'm prepared for the worst, I'm expecting lots of swelling and liquid diet for a while. But I think this will all be worth it. A genioplasty for chin height is still in the back of my mind but I'm starting to chicken out of that..
What do you think about filling up the mentolabial fold and achieving lip competence? Aside from jaw surgeries I can only find people getting filler and I think it's a nice improvement.
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Thanks for the information, I'll reply properly later when I have more time, but I'm glad you've brought some new knowledge to the board.
Is there any reason why molars can't be 'corticotomised/accelerated?
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^I don't know, he didn't specify. I'm pretty sure that I did read one person's experiences online who said he did get arches widened, though it was like a lesser SARPE. He went through weeks of hell though. Maybe it's too invasive messing with the molars?
Anyway, here's a good page which covers all of the basics about this treatment:
http://www.archwired.com/AOO1.htm
I've been getting the pre-surgery jitters. Seeing testimonials, some report a lot of pain and brutal recovery period. Others say it's no worse than wisdom teeth removal. I gotta keep my mind right going into this..
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awesome! thanks for the update!
Does this procedure also work on the lower jaw? From the pics its looks like all they did was straighten the teeth. Do they also add new bone on the teeth in the mandible?
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^Yes, they place artificial bone into the gums, 'weaken the bone' in a way which will make the jaw grow more of its own bone. This of cource is what will affect the lips and mouth since the teeth and bone/gums give support to the lips. I don't know how significant the change can be, but my ortho assures me that my lower lip will be brought forward and my deep mentolabial fold will be gone afterwards. My jaw surgeon took a look at me and told him "Yes this is probably the best option, otherwise he will get that sunk-in appearance(reffering to extractions)". I liked his statement a lot :D
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amazing! when will you be starting? also the thing I don't understand is that with bimax protrusion the teeth are tipped forwards. So I guess this wikodontics they'll but tipped upright, still in a forwards position? Or are they still kind of moved backwards?
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^Hopefully in two weeks, I gotta wait for my health care service to see if they will cover any costs and stuff. Plus I'll need the braces in before surgery.
Good question. I think it's gonna be a bit of both but they're not gonna pull the teeth into my mouth much I don't think. I think it's better because otherwise the wrinkles around my nose and mouth(nasolabial folds) could get worse.
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How far forward can they bring the lower teeth? By how much will your sublabial fold be reduced?
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^I was told they can be moved several milimeters. I have enough gum tissue and there will be enough bone to do this after about 3 months.
I wish I knew the answer to your second question, he doesn't seem to know exactly. But I'll take any improvement, this fold is really unattractive especially when I smile.
I made a photoshop of my xray but only changed the bone, I don't know exactly how it's gonna affect the surrounding tissue:
http://imgur.com/a/jjB1Q#0
and after
http://i.imgur.com/BngPuYY.jpg
Whatever it ends up as, I'm pretty confident that I will atleast no longer look like I have bimax protrusion, plus the other benefits(wider arches and smile, no extractions, no more crowding etc.) are worth it.
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nice, I'm excited for you man. keep us posted with how everything goes!
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Thanks, I certainly will ;)
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What will they graft the area with? Your own bone?
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For those who will need jaw bone spaces filled as part of surgery, do you prefer your own bone, artificial substances, or is a cadaver bone ok with you. The reason I ask is because I am going to need space filled as they cw rotate my upper jaw down anteriorly. I worry about something artificial being rejected or reabsorbed. Taking part of my hip bone will add to my ordeal. Cadaver bone makes me uncomfortable in always knowing that I am walking around with some one else inside of me. Does that sound ridiculous? The other thing that I question about cadaver bone is if it is obtained from the area that it will be used in? Maybe if it is itself malar bone, it will work better in its intended use. Age in concert with the rest of the jaw bone. Would my own hip bone age or behave differently do to its being a "different" kind of bone? Inquiring (over thinking) minds would like to know.
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^For me, artificial is fine. Grafting from my own bone will require more evasive surgery and recovery which I don't want.
What will they graft the area with? Your own bone?
No, artificial bone. Plus my own jaw is going produce more bone matter as well so I'm thinking they're gonna form together. I will ask about this for more details.
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Braces are in, last week the upper jaw and today the lower. But I couldn't put my teeth together so they put pieces of glue on my upper molars to bite on but my molars don't meet now. They say that after some time the teeth will move enough and then they can take them out so I can bite again. I'm worried about this because I probably won't be able to chew food well at all and I hope I don't get TMJ. Is this a standard procedure or is this crazy?
Anyway surgery is next tuesday, it will be a tough week. I'm glad the treatment will be going so fast so I can get my bite fixed soon because this is a little tougher than I expected.
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good luck man! hope all goes well!
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Hey man, good luck with the surgery. I just had a consultation with my surgeon and am looking at an August surgery. He recommends cadaver bone for down grafting my maxilla as it will make my recovery better not having to endure an added procedure of having a piece of my hip harvested. I suppose less time under anesthesia as well. I have heard that the less time under the better. The donated bone is supposed to be replaced with my own over time through normal natural processes.
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Thanks guys. @ Buzzhead that sounds like a good plan, what type of surgery are you getting?
Currently I still got these pieces of glue on my upper molars to prevent me from biting on my braces. So annoying and it makes eating very difficult. Summer can't come soon enough ;D By then it's just 3 months of braces keeping my new bite in place.
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I have short face syndrome. Four bicuspid extraction orthodontics when younger. Both jaws will be moved forward. Upper will be lowered with bone graft and plates and widened slightly. Jaws rotated CW.
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segmental lefort1.
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Yes. I have been in my second set of braces for two years this next month. This was to decompensate my bite so that the jaws will fit together correctly after surgery. The time really did pass much more quickly than I originally thought that it would.
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Most importantly, I have obstructive sleep apnea which I think was exasperated by pushing my tongue back into my throat by my previous orthodontics. I tried every mask they make and settled for one that still is a pain in the xxx. If my nose is plugged forget it. It slips off my face at night which wakes up my wife who then wakes me up! I also am left with strap marks on my face that last most of the day. I really really want to be free of this torture device!
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Soo I had the surgery today. I haven't been in any pain because I've used medication well and local anesthetic worked great, most of the discomfort are from the shots and now the swelling. But man, this is not for the squeamish. I layed there for an hour and I could visualize everything they were doing, it takes a lot of effort to open up the gums, and it's loud when work on the jaw bones etc :o I took it well though and I feel pretty good now after a nice nap. I'm glad that is over with!
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Thanks for updating.
I'm glad you're okay. I had surgery under local anaesthesia once and it wasn't painful at all, but it's weird knowing they're burning your skin open.
Has there been any changes to the segments yet or is it that exacted by the braces? And how long will it take before you notice any difference?
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@sean, yeah scariest part is your own imagination, I can now see how some people traumatised themselves because you tend to think about how they're slicing you open and using a lot of force and you can hear it all etc. For some reason I wasn't freaked out at all, even now when I think about it. Phew.
The change I can see at the moment is how the gums are filled with artificial bones that they placed and stitched up. Since they strategically damaged the bones of my jaws it's now a waiting game. It was stated that my teeth will be straightened in the first six weeks. 3 months total for the tissue and bones to fully fuse, and then 3 months of braces left to stabilize the new bite.
@jawbone, no I had this done in North Europe where I live. I do not know the exact costs yet(I've read that in the US this can go up to 10 to 15k dollars, not 100% sure on that though), but I was delighted to hear from my insurance that they will cover the costs of the surgery. My surgeon and ortho were kind, they showed that some of my teeth have been worn down because of the bad bite. Thankfully I'll fix this @25 before I damage them any more.
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@ needadvancement - how are you going to fix you worn down teeth?
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^Hey terry. I'm not sure what I can do at this point to reverse that kind of damage, and thankfully it hasn't got to a point where it's hurting during chewing unless I consume something cold. Atleast the good news is that soon they'll stand correctly and won't continue to wear and tear eachother down.
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it didn't "grow back", the broken tooth just erupted more out of the jaw bone. the damaged tooth is still shorter than the other, it's just that the crowns are of the same height while the height difference is now hidden beneath your gums where you cannot see it.
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Damn the middle of my face pretty swollen right now. I almost looked normal yesterday before I went to bed but then I wake up looking like a primate lol. I think that's the reason the surgeon was so adamant about taking a week off from work. Bleeding stopped and healing looks to be going well though.
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Damn the middle of my face pretty swollen right now. I almost looked normal yesterday before I went to bed but then I wake up looking like a primate lol. I think that's the reason the surgeon was so adamant about taking a week off from work. Bleeding stopped and healing looks to be going well though.
Day 3 is peak for swelling.
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Alright:
http://i.imgur.com/rsx8EOi.jpg
http://i.imgur.com/MZ5nAef.jpg
I let my beard grow out for like a week and it camouflages the swelling well but I can't do anything about the swelling around the nose. I'm tired of applying ice packs.
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Damn the middle of my face pretty swollen right now. I almost looked normal yesterday before I went to bed but then I wake up looking like a primate lol. I think that's the reason the surgeon was so adamant about taking a week off from work. Bleeding stopped and healing looks to be going well though.
I went back to work 2 weeks after a Le Fort I. Either no one gave a s**t, or I work with super-tactful people.
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lmao plosko.
also NA, i spoke with my dentist and she said that they can build up tooth height with porcelain type of material. Problem is that the teeth need to be slightly impacted and the jaw has to be in a perfect position before changing the tooth surface, so that the jaw locks together in harmony. tbh this is probably something im going to do pre-surgery, so that after surgery, i have a bite that is good in height and surface condition. Cuz over time they;ll only get worse, im 23 atm and they're getting pretty bad.
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^That sounds interesting, never heard of that method before. Are you sure that's safe in the long run though?(no bone resorption) And I would imagine that the aesthetic benefit would be good too.
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Day 3 is definitely the peak of swelling. I wonder if sleeping too much is making it worse since I'm getting 10-11 hours a day now. Got some racoon eyes going on too now but atleast it did one good thing: No scleral show for the time being. ;D
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Day 3 is definitely the peak of swelling. I wonder if sleeping too much is making it worse since I'm getting 10-11 hours a day now. Got some racoon eyes going on too now but atleast it did one good thing: No scleral show for the time being. ;D
Oh, don't worry the scleral show will come back. Try to sleep with your head more elevated. The swelling will happen regardless, but it will go down into you neck and lower cheeks more instead. You will have chipmunk cheeks, but it beats having the whole face swollen.
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It's been about 4 weeks since the surgery. It's going steady and my orthodontist is quite satisfied. There is far less crowding now and finally the premolars have started to move too, they were the hardest I think. Feels like my tongue has more space now.
Here's the befores:
http://i.imgur.com/tqsOU3C.jpg
And I took these pictures today(not the best quality but I think you can see the difference)
http://i.imgur.com/td5sYjW.jpg lower arch
http://i.imgur.com/N7OYHSu.jpg upper
I was coming in weekly, they've put the thickest wires on the brackets yesterday(I think they're damon braces) and I won't have to come back in 6 weeks. By that time the teeth should be mostly done moving and close to ideal position.
It's amazing to see teeth move that fast. They were very sensitive at times and your can't use your incisors to bite off pieces of food. But it's all worth it I believe.
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nice man! glad youre happy with your surgery. I can notice the difference already
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Thanks man. The worst thing so far are the cement blocks I still have on my molars(to prevent me from biting on the braces). I haven't been able to bite for some time now and as a result the masseter muscles on my jaws have shrunk because I couldn't use them. It narrowed my lower face, but surely they have 'muscle memory' as well right? It should be back to normal once I can use all my teeth again to chew.
Btw found a pretty cool link to some wilckodontics results.
http://www.tisserontorthodontics.com/wilckodontics/
Their dental arches have all become wider. This one is pretty good:
(http://www.tisserontorthodontics.com/wp-content/uploads/2015/01/melissa-profile-before.jpg)
(http://www.tisserontorthodontics.com/wp-content/uploads/2015/01/melissa-profile-after.jpg)
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Can this operation be used to build up the alveolar ridge to a significant enough degree to influence soft-tissue?
Could someone get this done plus sliding genioplasty for example?
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Can this operation be used to build up the alveolar ridge to a significant enough degree to influence soft-tissue?
Could someone get this done plus sliding genioplasty for example?
That is what I was told. The growth of bone mass and forward movement of teeth is supposed to help make the labiomental crease less deep, and the lower lip will move forward too.
If you look at the picture of the woman above that is exactly what happened to her. But she's the only wilckodontics patient I've seen profile pictures of before and after. It's hard to find more pictures like this online.
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That is what I was told. The growth of bone mass and forward movement of teeth is supposed to help make the labiomental crease less deep, and the lower lip will move forward too.
If you look at the picture of the woman above that is exactly what happened to her. But she's the only wilckodontics patient I've seen profile pictures of before and after. It's hard to find more pictures like this online.
Picture is deceptive. She isn't as side on in the after.
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Her lower jaw did move forwards. Look at the relationship with her upper and lower lip. Though she is tilting her head back slightly in the after photo.
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4 months in on my lower arch:
http://i.imgur.com/99jbkcF.jpg?1
I'm impressed with the expansion. I'm almost done hopefully the braces can be removed before the end of the year.
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wow needavancement, thats amazing!
Did they cut into your lower arch as well?
AFAIK, wilkodontics only cuts into the upper maxillary teeth, how did you get so much mandibular expansion? also you get any expansion in between the last two molars?
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Thanks terry.
Yes I had my upper and lower arch done, they did work on all the teeth except the first and second molar and wisdom teeth, those have stayed in the same positions. Which works out fine because they were far enough from eachother, it's the premolars all the way to the front where my jaws got very narrow and troubled.
My orthodontist has the good quality photos I'm gonna get a hold of those.
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oh i see, do you know if its possible for them to move the first and second molar?
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I'm done with the treatment so I wanted to make one last update. So here was my situation before:
http://i.imgur.com/tqsOU3C.jpg
http://i.imgur.com/5UiaMpp.jpg
http://i.imgur.com/Rs6DQAc.jpg
Here it is now:
http://i.imgur.com/zH04Fvv.jpg
http://i.imgur.com/d5uRYqP.jpg
http://i.imgur.com/yy2YA4h.jpg
Dental arches have widened quite a bit and crowding was completely corrected which has improved my dental health tremendously, the bimax protrusion look has decreased and my smile is much wider now. barely 6 teeth showed before but now my first premolars are fully visible and even a little bit of my second premolars.
(http://i.imgur.com/A1klTaE.jpg)
Took about 9 months but there were some mistakes/delays so I think it could have been finished in 6 or even less. So I'm pretty happy with it and it did live up to my expectations. I'd recommend it to others.
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I'm done with the treatment so I wanted to make one last update. So here was my situation before:
http://i.imgur.com/tqsOU3C.jpg
http://i.imgur.com/5UiaMpp.jpg
http://i.imgur.com/Rs6DQAc.jpg
Here it is now:
http://i.imgur.com/zH04Fvv.jpg
http://i.imgur.com/d5uRYqP.jpg
http://i.imgur.com/yy2YA4h.jpg
Dental arches have widened quite a bit and crowding was completely corrected which has improved my dental health tremendously, the bimax protrusion look has decreased and my smile is much wider now. barely 6 teeth showed before but now my first premolars are fully visible and even a little bit of my second premolars.
(http://i.imgur.com/A1klTaE.jpg)
Took about 9 months but there were some mistakes/delays so I think it could have been finished in 6 or even less. So I'm pretty happy with it and it did live up to my expectations. I'd recommend it to others.
Brilliant results, I'm really pleased for you.
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^Thanks man, I'm glad it's over(although there's only a few weeks left of wearing my retainer for the upper arch but it's invisible anyway).
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^Thanks man, I'm glad it's over(although there's only a few weeks left of wearing my retainer for the upper arch but it's invisible anyway).
Has your profile changed? Did your mandible come forward like the girl in the posted pics?
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Has your profile changed? Did your mandible come forward like the girl in the posted pics?
Only the spot where the mentolabial fold is and generally around the bones covering the roots of the teeth. The fold is less deep now and the lower lip has more support whereas it sort of hung down before.
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This is really awesome. Great results!
Why don't more people do this before jaw surgery or sliding genio? It seems like it could only improve the final outcome since you can expand your mandible and add more bone. I definitely will have to look into this.
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Dude great results. Did your mandibular arch widen a lot? You have numbers regarding that?
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Dude great results. Did your mandibular arch widen a lot? You have numbers regarding that?
Yes I would say it was quite significantly widened. They didn't give me numbers though sorry. How is it going with you, got any plans for your surgeries set?
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No actually I'm going to be starting a procedure that is non surgical which can create jaw surgery like results. . ATM I'm just saving up for possible surgery in the future.
Exciting times. I can't really give details as to what the procedure (I signed some documentis) but if it works I'll post an update here.