jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: sweptaway91 on December 24, 2014, 07:04:13 AM
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here's how my bite looks like (my molars are already very crowded). two orthos say that I need premolars extractions (upper and lower). does it make sense?
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It looks like your teeth are protruding, so yes it makes sense as they need the space to move your teeth back and straight
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I would not have premolars taken out under ANY cirumstances. Ask the ortho if he can either expand the jaw OR go see a Damon braces doctor and ask how thy will straighten teeth. Brother, you're in for a WORLD of agony and pain if you get your premolars extracted, they're there for a reason.
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I think you should watch this:
https://www.youtube.com/watch?v=7g2xKDwsmdg
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where was this goddamn video when i went for ortho treatment. well this site was just beginning then. f**king hell. at least no on else who reads this will have this brutal procedure done to them. I only hope that jaw surgery and bringing my jaws and cheekbones forward will rectify the deformation I have gone through. And turst me fellas my lips etc. are f**ked now, all sunken inn like an old man.
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where was this goddamn video when i went for ortho treatment. well this site was just beginning then. f**king hell. at least no on else who reads this will have this brutal procedure done to them. I only hope that jaw surgery and bringing my jaws and cheekbones forward will rectify the deformation I have gone through. And turst me fellas my lips etc. are f**ked now, all sunken inn like an old man.
What can you do to go back to normal after having Pre-molars out?
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I would like to know how they counteract Bi-max protrusion without taking teeth out
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I would like to know how they counteract Bi-max protrusion without taking teeth out
That's what I will be getting next year. I got crowding on the mandible incisors and some bimax. Luckily my teeth are going inward like a cross bite so my orthodontist thinks he can fix it without extractions. That was a big relief for me to hear that.
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my lower arch looks like this... upper kinda similar but teeth more protruded. is there any hope to do sth without extractions?
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How old are you sweptaway91? It's best to avoid premolar extractions if at all possible. I don't think they should ever be done in people before they are finished growing. Even if you are finished growing, I would avoid it if possible.
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I am no expert but the arch does not look that crowded.
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my lower arch looks like this... upper kinda similar but teeth more protruded. is there any hope to do sth without extractions?
No way. No way. Stop asking. Do what you want. You will regret it more than anything in your f**king life. Just find a good surgeon, if your wisdom teeth are out you're ready for surgery. The extractions will create so much excess space, even when the teeth are brought together your face will melt and your tongue will be compressed in your mouth. Now stop asking!
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my lower arch looks like this... upper kinda similar but teeth more protruded. is there any hope to do sth without extractions?
Palate expander in the middle? The whole front of the teeth look good though.
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You need your upper jaw shortened. You also need your upper jaw widened so that there is room for your teeth to come backwards.
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A lateral x-ray might help to see what is back or forward and to see what your other options might be.
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Btw about 10 years ago i was advised to have my lower premolars extracted. They were out of the arch. I am glad i resisted but alas I didnt get all of the issues resolved at the time either. I know a little more now.
Thanks yxcvb for the video.
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This is an interesting blog. This person is currently undergoing extraction reversal and so far so good...
http://claimingpower.com/reverse-extraction-orthodontics-is-it-possible-for-adults-progress-report/ (http://claimingpower.com/reverse-extraction-orthodontics-is-it-possible-for-adults-progress-report/)
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Not really sure where to jump into the forum so I guess I will start here. I am a 55 year young male in braces preparing for bi max surgery to correct a deep overbite and sleep apnea. I suffer from short face syndrome and underwent orthodontic treatment when in my late teens.
At the time my Ortho decided that I needed four first pre molars removed. Two upper, two lower. When I looked at my face at the time, I remember thinking that my upper face looked fine, just my lower jaw was too small. Although I had reservations about taking our four perfectly good teeth, I was young and too trusting of their "expertise". As treatment went along I became concerned as my face receded backwards and my upper teeth seemed to disappear behind my upper lip. I remember complaining to the Otho about my concern and he would get irritated and tell me that it wasn't that much and things would turn out fine. Well they didn't, in my opinion.
I did not like my smile or my profile. I spent the next several decades disliking and being self conscious about my appearance. Much too long to do that. On top of that, my deep bite, that never really was corrected anyway, relapsed and I developed sleep apnea as well. I needed, REQUIRED, surgical treatment back then.
Upon the recommendation of my new, young, dentist, I was referred to an orthodontist who worked as a team with a jaw surgeon at a University hospital. Too make a long story a little bit shorter, I found out what my problems were and what would be needed to make corrections.
At first I was angry with my first Ortho but after researching this subject, this forum a big part of that, I have come to the conclusion that back then jaw surgery was not nearly as advanced as it is today and he did what was the norm at that time.
As I said, I have short face syndrome with retronathic upper and lower jaws. My treatment consist of decompensating both arches followed by bi max surgery to bring both jaws forward, down grafting the maxilla with clockwise rotation of both jaws. I have been back in braces for 18 months and hope to be forwarded to the surgeon soon.
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I am a little older than you and had bimaxillary plus genioplasty in November. Before the operation I had 67.5 apnoeas an hour but I have not used my CPAP since the op. Results of my sleep study stated that I now had ZERO apnoeas an hour. The aesthetic benefits are worth it too.
You will really notice the difference. Best of luck.
( check out my before and after pictures in the section on Overbites)
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Not really sure where to jump into the forum so I guess I will start here. I am a 55 year young male in braces preparing for bi max surgery to correct a deep overbite and sleep apnea. I suffer from short face syndrome and underwent orthodontic treatment when in my late teens.
At the time my Ortho decided that I needed four first pre molars removed. Two upper, two lower. When I looked at my face at the time, I remember thinking that my upper face looked fine, just my lower jaw was too small. Although I had reservations about taking our four perfectly good teeth, I was young and too trusting of their "expertise". As treatment went along I became concerned as my face receded backwards and my upper teeth seemed to disappear behind my upper lip. I remember complaining to the Otho about my concern and he would get irritated and tell me that it wasn't that much and things would turn out fine. Well they didn't, in my opinion.
Man that sounds pretty much like my story. Only that was a little over a decade ago for me. Orthodontist are still doing the same s**t today, although not all are.
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What can you do to go back to normal after having Pre-molars out?
You can't. You're f**ked. If you try and open up the spaces and put in implants it'll destroy the roots of your other teeth. You can wait till 2040 when by sure they'll have a way to generate and grow real teeth from stem cells and then you can have all your teeth replaced, but you'll still have to have distraction osteogenesis to grow back your jawbone.
When they take out teeth the jaw bone in that area actually shrinks too, so it does the opposite of jaw surgery and shrinks for most of us our already defecient jawbones. I didn't know any of this when I let that motherf**ker of an orthodontist send me to have my teeth pulled.
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Lazio, you have an anger issue.
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Whats the effect of extracting wisdom teeth on the jawbone? Does it cause bone loss? I'm talking about in an adult case when jaw development is finished.
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Lazio, you have an anger issue.
To be fair, I get angry every time I think about what my orthodontist did to me when I was a kid.
Anger is one of the many complications of premolar extractions.
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I think that on an open forum it's worth expressing views in an appropriate manner. Nothing can be gained by venting one's rage.
I think we all feel angry at times, but it is preferable to exercise control, especially with one's choice of language. Also, some of the content of this person's other posts leaves a lot to be desired.
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At first I was angry with my first Ortho but after researching this subject, this forum a big part of that, I have come to the conclusion that back then jaw surgery was not nearly as advanced as it is today and he did what was the norm at that time.
A short history of jaw surgery to soothe all the angry people:
late 1960s: obwegeser pioneered lower jaw surgery which then became widely used (BSSO).
late 1970s: the current LeFort 1 Osteotomy gets pioneered in the U.S.
Between 1968 and ca. 1980, only the lower jaw was operated on regardless if the patient needed advancement of the upper jaw as there was no osteotomy to advance the entire upper jaw in one piece. Bimaxillary jaw surgery was impossible.
Also, orthognathic surgery and orthodontics were not used like today where the orthodontist DECOMPENSATES the skeletal anomaly prior to surgery. Rather, a patient would be treated orthodontically COMPENSATING for his skeletal malocclusion as much as possible and then he would get referred to the surgeon to make up the last bit the orthodontist was unable to move the teeth.
Unsurprisingly, with this treatment approach and without modern imaging technology, jaw surgery results back then were utter s**t aesthetically speaking, especially during the time where only single jaw surgery was possible.
The shift to the current approach - ortho decompensates and surgeon harmonizes the skeleton fully - is actually pretty recent (~20 years) and it took quite some time to become standard level of care.
The strong focus on improving facial aesthetics along with the occlusion is even more recent. So it's not like an ortho treating a patient 10,15,20 years ago with compensation orthodontics was doing the patient a disservice necessarily. It should also be noted that decompensation orthodontics are an entirely different animal. To get a good surgery result, your orthodontist has to be top tier as well as the surgeon because decompensation orthodontics tooth movements are done abstractly while naturally occuring compensation forces are still present in the patient pre op. To decompensate a patient in all three dimensions fully is an art in itself.
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A good ortho is super important. But I still think that it's important to find the right surgeon first - he will have a good ortho that he works with.
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So I saw a top orthodontist this week and he mentioned that I'd have to get my pre-molars removed to fix my bimaxillary protrusion. I'm wondering if this is something I should consider or just get jaw surgery with my bimaxillary protrusion? Is that any way to fix it without removing teeth?
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Why are pre-molars specifically significant? People remove wisdom teeth all the time. And what about the suggestion that I remove bicuspids? I don't see why either would impact TMJs necessarily as long as you get good occlusion and a functional jaw relationship. As to bone loss, that's natural with aging anyway but there's plenty of ways to augment bone these days.
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Idiot, premolars ARE bicuspids. And quite trolling this topic moron. I've explained a million times why you shouldn't. GO AHEAD AND f**kING DO IT AND WEEP.
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Lol good point. I didn't connect those two for some reason. I see your point but OTOH, I'm pretty sure my joints are screwed if I don't do anything too. I mean, all those joint people are basically sleep apnea, long faced, and anterior open bites. I see your point about the jaw shortening, especially in kids with developing jaws. They're already threatening to do that to my kids and no way I'll let them.
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Well he only recommend removing them in the lower jaw. I said no obviously. But all I worry that the bimax protrusion will look worse after jaw surgery, not to mention the functional side of it. Theres a reason we have 32 teeth, and I'm note sure if pulling any of them is a good option.
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I have 30 left, 2 wisdom teeth removed over a year ago because they were very impacted. I'm glad I was able to find an orthodontist who can help me without going the extraction route. Everybody should have an ortho who has more options than just extractions. And it should be a crime to do this to young children with no severe problems, there are orthodontists who treat 95% of their underaged patients without going this route.
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I have 30 left, 2 wisdom teeth removed over a year ago because they were very impacted. I'm glad I was able to find an orthodontist who can help me without going the extraction route. Everybody should have an ortho who has more options than just extractions. And it should be a crime to do this to young children with no severe problems, there are orthodontists who treat 95% of their underaged patients without going this route.
I agree. My ortho did premolar extractions on almost all of his patients. When I started considering jaw surgery about two years ago, I first consulted with a bunch of orthodontists and they all still swore by premolar extractions. I had 4 premolars extracted and 4 wisdom teeth. Only left with 24 teeth, making my already small jaw even smaller. My premolars were extracted before they even fully came in, I had 7 teeth extracted at once 3 baby teeth and 4 premolars!
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Are you in a world of pain?
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I agree. My ortho did premolar extractions on almost all of his patients. When I started considering jaw surgery about two years ago, I first consulted with a bunch of orthodontists and they all still swore by premolar extractions. I had 4 premolars extracted and 4 wisdom teeth. Only left with 24 teeth, making my already small jaw even smaller. My premolars were extracted before they even fully came in, I had 7 teeth extracted at once 3 baby teeth and 4 premolars!
Well your ortho sure had a big pay day after that!
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Its absolutely scandalous. They are completely ignorant of the evidence against what they are doing. There is lots of evidence against it and little evidence for it, except in certain rare cases.
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What are the rare cases for it?
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probably only aesthetics
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Its absolutely scandalous. They are completely ignorant of the evidence against what they are doing. There is lots of evidence against it and little evidence for it, except in certain rare cases.
They all claim that there is actually no evidence against it and use cases of people who had it done but didn't suffer any problems from it, as evidence of the opposite.
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Well, actually, I have been giving this a lot of thought seeing as I had this done to myself. As for my dento facial situation I wonder if having had 4 bicuspids removed is conducive to my treatment now. I need to have both jaws moved forward with cw rotation and the top jaw moved down anteriorly. I need my airway opened up due to sleep apnea. Part of this procedure is supposed to bring the hyoid bone forward opening up the airway. I only have just so much "lip" tissue to work with. It seems that if I didn't have the front teeth moved back first thus creating some lip excess and only had my dentition moved forward intact, I might have ended up with some degree of mentalis strain. Does this make sense?
Some where in my cyber travels, it seems that I remember reading about some one preparing for bimax advancement where they were to have 4 premolars removed first
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It seems like most jaw surgeries that require a significant change to the bite will need extractions.
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Ya it seems that way. I could see why pulling teeth makes sense because If you have bimax protrusion then it could sort of fix it aesthetically, but the teeth are healthy and theres nothing wrong with them. Plus I've read that after extraction, there could be some bone loss in old age, would could also be bad. Another thing that bothers me is that I've had my wisdom teeth removed so now I have 28 teeth, plus two or fouth teeth pulled you're left with 24 teeth. Thats 8 teeth gone. 1/4 of you teeth gone. The jaw will also be smaller as well due to less surface area biting.
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You make some good points, but those would apply in a "perfect world". Not everyone has large enough bone structure or face tissue to support the full compliment of the teeth they were born with. For example, we all see people with a large full dentition with large teeth and large full "lip opening" to work with it. You can see plenty of people with small mouth tissue. Again, lip tissue can only be stretched so far. Genetics don't always work in harmony. Here I am defending tooth removal of all people. I do believe that it was done too much, maybe still, but I also believe that there is a legitimate place for it.