Author Topic: Possibilities of redo?  (Read 3834 times)

wishingjaws

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Possibilities of redo?
« on: September 24, 2012, 08:43:49 AM »
 I am new to this forum. I am desperately looking for a way out for my problem.
The first thing I need to mention is I already had a double jaw surgery in June but I am not happy with the results. It was somewhat anticipated but I did not expect it to be so off my expectation.

I live in the Netherlands and from my own experience and pre-surgery research, surgeons here are not particularly perfectionist, nor are they using even the newer technologies. The nice thing is all the fees including orthodontic treatments are paid by my insurance company because my case is a medical necessasity.  But that premium comes at the price of the outcome...

I've looked around on internet and surgical prediction with software was not heard of. I thought that was the fact I simply had to accept. So I went to a nationally renowned surgeon with 20 yr+ experience and I was operated without seeing a surgical prediction. He is a very patient and nice surgeon I must say. The reason I chose him is also because he is known to have more than average experience with underbite.

Medically I have an underbite plus an asymmetric face because the right half of my head is slightly bigger. My jaws are slightly tilted to the left and my occlusal plan is also tilted, left side being vertically higher. I also have some problems with my right TMJ. I can hear noise coming from it when eating. My maxilla is somewhat deficit in height and my upper lip is short as well. His treatment plan was to rotate my lower jaw a bit to the right and then fit my upper jaw on top of it to create a class 1 profile. (he said before the surgery it was as simple as putting the lid onto a tea pot). Well, that may be true but in my case both the lid and the tea pot have abnormalities...he also told me before the surgery my asymmetry would remain and I thought that was techically limited.

wishingjaws

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Re: Possibilities of redo?
« Reply #1 on: September 24, 2012, 09:03:06 AM »
The textbox became annoying with long texts. So I split my post.

So I went ahead with the surgery. The pre-op planning was done with a dental mod and a side-view x-ray. Curiously, he did not take a panoramic view before the surgery. Instead he used one of 9-month old. But in my percection, there was hardly any precise planning. He worked with his eyes. He literally told me, you may plan to the 0.1mm but the surgery has to be done by human hands. The offset may well be 1-2mm. I was eager to have it done and my parents were also urging me to have it finished. So I decided to give it try.

 The surgery went smoothly and in accordance with the plan and he said he rotated my lower jaw a bit to the right and moved my upper jaw a bit forward. He did not give me any number on the moved distance. It is worth mentioning that he only broke the right side of my lower jaw and left the left side intact.
 
Now 3 month post-op, my upper incisors do no show at all when in repose. I think the deficiency is even 1 or 2 mm. Still my lower incisors show too much. Whenever I open my mouth a bit, I look as if I were shocked. I have to work really hard in order to show more upper teeth and hide my lower teeth. My upper lip is just covering my lower lip when my mouth is closed when viewed from my side. The upper lip is protruding a bit because of the underlying braces but the lower lip is not pressed by the braces. Simply put compared with a normal person, my jaws were counter-clock-wise rotated pre-op when viewed from my right side and that condition was not solved by the surgery.

I am afraid once the braces are out I am left again with the impression of an underbite. My upper incisors can still hardly touch my lower lip in a natural position (it was impossible before the surgery though), which makes pronouncing /v/ and /f/ still a pain in the ass.

And last but not least the occlusal plan is still tilted...  


« Last Edit: September 24, 2012, 09:44:42 AM by wishingjaws »

wishingjaws

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Re: Possibilities of redo?
« Reply #2 on: September 24, 2012, 09:29:10 AM »
because my lower jaw is basically still in the same position, the profile of my chin remains more or less the same. I don't have a receding chin nor do I have the prominent groove you see on many post-op photos. My chin at this moment looks more or less like in the guy's pre-op photo.
http://www.drrichardjoseph.com/photos/111.php

I recently went to another surgeon (who is also a renowed professor) in the same country for a second opinion. He confirmed my tilted occlusal plane and upper incisor deficiency and he said only a redo can solve my issues. He said he would have planned the surgery differently. He asked me to think over it whether I really want a redo. On one had, I really want to have a redo to have all the problem solved so that I can begin my life at my 30. On the other hand, I am very hesitant to go though another procedure without seeing a good planning. And probably I've already used up the once-in-my-life free treatment option unless my previous surgeon is willing to reoperate on me. But he thinks my current profile is "near perfect"....

Every time I read stories from the US, I become envious of the advanced techs you can rely on. I am currently thinking about having a consult in the US to see if my problem can be further helped. But considering the high fee they charge, I will certainly have to get a job in the US, which will postpone the treatment by a few years.

Do you guys have any eexperience with redos? In my case, the surgeon did, to my understanding, very limited cutting and bonding, which is in a sense fortunate. I have only two tooth-size titanium plates on my upper jaw and 3 tiny screws on my lower jaw.