Author Topic: After a failed double-jaw surgery, I want to hear some opinions!  (Read 9650 times)

molestrip

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Re: After a failed double-jaw surgery, I want to hear some opinions!
« Reply #15 on: August 09, 2015, 09:45:00 PM »
No need to repeat CT then. I mistunderstood your comment. Surgeons and orthodontists use CBCTs these days, ask for one of those and you don't need to be so anal about radiation.

Deformities are not black and white. People are sometimes born with them but never diagnosed and they might not even be visible outside imaging. Even so, many times I suspect the body self corrects in development. Asymmetries tend to be common with growth deficiencies or long face syndrome. Things that interfere with the normal well tuned development process. Still, the whole principle of dental-alveolar movements suggests that malocclusions are common in nature anyway, though perhaps not to the same degree we find it in humans today. That you molars came in crooked suggests a skeletal deformity. I'd say crowding but you don't have that clearly. Growth is non-linear and big shifts can happen in short windows, though it's typically not the case that people's environments shift quickly. Joint wouldn't be visible from CT unless they imaged there, which they probably didn't. Needs a separate CT and MRI to evaluate the soft tissue. Not sure about the nerve, CT may be able to pick it up, MRI tends to be better at soft tissue I think. Both may be impaired by the presence of your plates now.

What you are describing about the healing process is typical for this surgery. It's the inherent risk of the procedure and, you just got unlucky. It's just surprising considering that your movements were not significant. Evidence of the respect this surgery deserves. I've seen many cases of even certain named famous surgeons mentioned on this board of stuff like this happening. Basically, a plate shifts and throws them all out of balance. People usually stop documenting at that point, I don't know if they live with it, commit suicide, or repeat without documenting further.

SirUserName

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Re: After a failed double-jaw surgery, I want to hear some opinions!
« Reply #16 on: August 09, 2015, 10:43:56 PM »
Again, I'm talking about going through earlier photos of me (toddler, stuff I've found from about 10yo) - I didn't have this at all. The teeth themselves might not have been perfect, as many before they go through orthodontics, but the midline shift wasn't there and I didn't have the (however subtle) underbite I've ended up with. Regarding the molars - well, as far as I know, they don't come out well or at all for most people, but I think mine have already broken out of the gums by the age of 15, so I don't know whether they've caused some problem with their (at least some of them) tipping over the rest of the teeth while I was still in my growth phase. When I went through the orthodontics, he first used this "palatal expander", but that was only for the maxilla (I don't know if that's possible, but as the doctors from my surgery decided I rather had a retrusive maxilla, I wonder whether the expansion have caused a widening but also a shortening of the maxilla?).

And regarding the TMJ - I actually just received the diagnosis of the laboratory I had my CT taken at, and it probably sheds some light, but I'm not sure of everything's meaning (translated from Hebrew): it says "There is a substantial narrowing of the TMJs, more at the left" (the side I suffer from clicks and poppings at), "Erosive changes are shown at the left mandibular condyle", "Right mandibular condyle is shown normal", "The glenoid fossa is shown intact", "The ramus mandibula and the mandibular canal are shown with no unusual findings".

molestrip

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Re: After a failed double-jaw surgery, I want to hear some opinions!
« Reply #17 on: August 10, 2015, 09:52:39 AM »
My molars didn't have problems. I remember my parents debating whether to get braces because my case was borderline, little crowding.

Sorry to hear about your TMJ problems :( They're not uncommon, estimates up to about 60% of the population subclinically and 20-30% clinically (patient reported) at some point in life. Many surgeons don't bother with such studies because there's nothing to do about it. Fix the maloclussion and the TMJ stablizes. Unfortunately, when jaw surgery fails patients are often left with joint problems because the joint attempts to remodel to the new norm. You may have an ongoing process right now so addressing this sooner is better and in that respect, repeat surgery definitely beats out orthodontia.

SirUserName

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Re: After a failed double-jaw surgery, I want to hear some opinions!
« Reply #18 on: August 10, 2015, 10:12:38 AM »
Well, I've just sent this diagnosis to the surgeon, but I'll see him tomorrow again anyway so I'll ask his opinion on this situation. I actually wondered whether each surgery could get it worse, because I don't what actually resulted in this.