Hello all, my first post here.
So, my story. My lower face/mandible is pretty underdeveloped both vertically (ramus) and horizontally (mandibular body) (i.e.retrognathia and microgenia). This is mainly genetic as I have the same face shape as my father (ie round and IMO very unattractive)
I had my original braces on the NHS a teen, starting around 13 with retainers and finishing at 16. I had 4 molars removed due to crowding. No palate expansion, MARA, twin block, dahl appliance or headgear - just retainers and archwires. I got my wires later than most as I was waiting for my 2nd molars to be fully erupted - my ortho chose to remove the first molars as they had developed with poor enamel. The 2nd molars were then moved forward, so that my wisdom teeth had space to come in (which they did at 17.)
I don't really remember what my teeth were like before the braces - despite the retrognathia I don't recall having a huge overbite, but I would have had some. I can't recall what the depth was like before and after the braces either.
Currently my top teeth are basically fine, but I have a slight overbite and crossbite with significant deep bite (about 80%), and a tiny posterior open bite on one side. My face looks absolutely awful front and side when I fully close my mouth
Like a frog! I am going to assume that it's skeletal (rather than dental or soft tissue) as I have a deep sublabial fold and everted lower lip. I recently got a chin implant+neck lipo+sublabial filler to improve the retrognathism - it looks better but it didn't help with the length of my face (maybe I should have got a custom made one). The sublabial fold is still significant despite getting radiesse put in it.
According to all the reading I've done, traditional treatment of deep bite is - anterior intrusion (in the case of gummy smile) or posterior molar extrusion (in the case of short face, like me). HOWEVER, molar extrusion via braces is apparently not terribly stable in adults and will often relapse. It also rotates the mandible down (good) and back (bad) ie. makes the face longer but the overbite/retrognathism worse (which would be desirable if I was going to get the BSSO as my overbite at the moment is not that bad, even though my profile is!)
I want to get a BSSO to improve my profile, so am seeking experiences of people who also had deep bite and short face and needed extrusion of the posterior molars rather than intrusion of the anterior incisors to correct the deep bite. I would like both more vertical length and horizontal length but think it would be unlikely that I can extrude my back molars enough to still meet if I got a ramus BSSO to lengthen.
Questions
- to those who had a deep bite and an underbite, how did you do your extrusions, has is been stable, and did it result (as it is supposed to) in increasing the overbite?
- does anyone know if it's possible to get wilckodontics before a BSSO? The way I see it this would speed up the time in braces and also make the extrusion more stable, but does it mess up the jaw too much to get further surgery?
- has anyone had their deep bite corrected with crowns or segmental subapical osteotomy as opposed to regular extrusion using braces?
- has anyone used powerprox to speed up braces?
- has anyone with a lower lip significantly behind the upper lip had significant improvements without surgery? Custom facial implants can massively improve the jawline but I don't see them improving lip position
thanks all for any insight
