Anyone ever hear of anyone getting more teeth removed for more advancement?

[jawsaw]

I know it sounds crazy but I would definitely give up two more bottom teeth for room for some more advancement of my mandible. Has anyone ever heard of this or any other method to squeeze out a little more room for more advancement during surgery number 2.

[Peter6789]

I know it sounds crazy but I would definitely give up two more bottom teeth for room for some more advancement of my mandible. Has anyone ever heard of this or any other method to squeeze out a little more room for more advancement during surgery number 2.

I am thinking of the same. It seems possible: extract teeth in the front area to get space to bend back front teeth in the mandible, gives more overjet for BSSO forward movement.

Question is probably to find a doctor who has experience with this kind of treatment.

It could be an idea as well to use dental implants in the back of your mandible after all the surgeries to get an additional molar back there.

[thinkingme]

http://ovortho.com/jaw-surgery/. I heard bro.

[Tezcatli]

It is not uncommon but I wouldn't do it, I like my teeth.

The other options would be advancing your maxilla more or getting a mandibular expansion beforehand. Very few doctors do mandibular expansions though, it is like SARPE but for the lower jaw.

[thinkingme]

U cant expand mandible easy. Mandible is not like maxilla u can damage tmj. Its very less doctor do it and generally fail.

But u can expand arch. If u can tip ur teeths out.

[jawsaw]

Just to clarify; I had lower bicuspids removed for bimax. I had the procedure and although I like the results, it is quite obvious that I should have had a larger advancement to further open my airway.

I am wondering if anyone have heard of having two more teeth ON THE MANDIBLE removed for more advancement. Four teeth in total removed from mandible only, not maxilla.

[Lazlo]

Just to clarify; I had lower bicuspids removed for bimax. I had the procedure and although I like the results, it is quite obvious that I should have had a larger advancement to further open my airway.

I am wondering if anyone have heard of having two more teeth ON THE MANDIBLE removed for more advancement. Four teeth in total removed from mandible only, not maxilla.

no and your lower jaw would be f**kED if you did that. this whole thread is idiotic.

[jawsaw]

You seem to have an unfounded fear of extractions. My jaw would be exactly the same. The only thing that would be different is that my lower incisors wouldn't protrude as much. the length from my chin point to ramus would remain unaffected. My jaw might be affected if I had my last molar removed. That, from what I understand could result in bone loss over time.

Instead of insulting my question why don't you offer alternatives?

I just had a surgery that I have been waiting years and years for, and I am disappointed with the resulting airway. I am sort of bummed. Forgive me for trying to brainstorm alternative solutions.

[Lazlo]

Sorry, didn't mean to make you feel bad.

Could you maybe just lengthen with more of a genioplasty?

I can understand why you would need extractions to lower jaw for lengthening but the jaw also shrinks a bit at the extraction sites so it is counterproductive.

[Lazlo]

wait are you doing this for cosmetic reasons more or for the airway?

If for the airway I think it's simply a matter of bringing the upper jaw forward more, no?

[kjohnt]

Yeah an equal bimax advancement would open the airway just fine. 

If for cosmetic because the mandible still appears retrusive relative to the maxilla, your mandible would have had to have been pretty short originally if you've already had lower extractions and think you could do round two.  I'd like to see a current lateral ceph radiograph.  Depending on how deep your labiomental fold is, a genioplasty may be the better way to go.  But if your lower incisors are still tipped outward to "fit" into the arch, it's basically extractions or arch expansion.

Also know that in some cases people opt for one lower incisor to be extracted if there is crowding but two premolars seems like overkill.  This results in a mid-tooth instead of a midline but I doubt anybody would ever notice. (edit - only for lower teeth obviously)

But no, I've never yet heard of four bottom teeth being extracted.  That's not to say it hasn't happened or isn't an option.

[kjohnt]

Oh yeah and another option is CCW rotation depending on current occlusal plane.

[jawsaw]

Mainly for function. Bimax is probably what I will have to do, again. It is unfortunate because the mandible is the problem, not the maxilla. It is unfortunate because once again I fear of how I will look with more advancement of the maxilla.

Ideally I NEED ccw, but, like I said before, that is not an option because of flat occlusion.

As it stands now, I could probably use some impaction. I think it should have been impacted during my first surgery. Is it true that advancement of the maxilla causes MORE gum show? Would I be better off with impaction if my maxilla is advanced further to mitigate some of the gum show caused by the advancement?

[PloskoPlus]

Mainly for function. Bimax is probably what I will have to do, again. It is unfortunate because the mandible is the problem, not the maxilla. It is unfortunate because once again I fear of how I will look with more advancement of the maxilla.

Ideally I NEED ccw, but, like I said before, that is not an option because of flat occlusion.

As it stands now, I could probably use some impaction. I think it should have been impacted during my first surgery. Is it true that advancement of the maxilla causes MORE gum show? Would I be better off with impaction if my maxilla is advanced further to mitigate some of the gum show caused by the advancement?

If you have a truly flat occlusal plane then you won't get much more gum show from advancement.