Am I still in crossbite?

[ODog]

Hey guys,

My upper jaw surgery was to bring the jaw forward, down, and widen it to fit over my lower arch, so I had a 3 piece lefort done. In terms of my progress, I just got a new top wire put in to begin the segmental step down of the front 4 teeth to close the remaining anterior open bite.

My current, preop, and 6 months preop smile: https://imgur.com/a/xIhKQCN

Just to give background on why my 6 months preop bite is worse than my preop: It was how my ORIGINAL surgeon wanted my bite Decompensated (maximally exposing the open bite, and I guess it looks like the cross bite is worse than my preop?) When I chose another surgeon, he wanted me in braces and started working with my orthodontist so I switched to that from Invisalign and as time went on I noticed my open bite closing which confused me. I thought the goal was to maximally decompensate to maximize the movements? When I asked my Ortho about this he just said “It won’t affect the surgery or anything.”

So anyway, my question is, does it look like my upper jaw could be have been made a bit wider?

I guess this is surely a “good enough” result, so I guess I’m wondering if IDEALLY my  surgeon could have expanded the upper jaw some more so as to not rely so heavily on post-surgery orthodontics to align the bite.

When I look at other before-afters the upper teeth seem to noticeably vertically and transversely overlap the lower teeth, which is what I was expecting with my bite.

[Lazlo]

yeah definitely, your upper jaw needs to be wider. what does your ortho say? you should sue.

[ODog]

I think my ortho knows it. He just doesn’t want to say it directly. So when I said “is this the maximum the arch could have been expanded, he said “Well make your smile wider with braces.”

When we were discussing my open bite, I asked him if the upper jaw was good, and he said “I think he did a really good job with your profile.” Which is his way of insinuating something with my upper jaw was not done right.

Do you really think suing is really an option? Tbh my crossbite was actually THE most solid indication for the surgery, that along with making my upper jaw longer. I feel like both of those were not focused on as much as improving my profile. 

EDIT: I’m starting to think my upper jaw wasn’t expanded at ALL and only looks wider because it was brought forward.

[GJ]

Not only does it look like a crossbite, but it also looks edge to edge. There's a good chance you're going to grind down or crack your front teeth now due to that positioning. You're life will be ruined with that bite, and you're likely looking at a lot of $ in dental  restoration as the teeth break down from it. It looks like classic traumatic bite. I agree cases like this are sue-worthy. You should not be responsible for the decreased quality of life and dental fees you'll incur.

[ODog]

Not only does it look like a crossbite, but it also looks edge to edge. There's a good chance you're going to grind down or crack your front teeth now due to that positioning. You're life will be ruined with that bite, and you're likely looking at a lot of $ in dental  restoration as the teeth break down from it. It looks like classic traumatic bite. I agree cases like this are sue-worthy. You should not be responsible for the decreased quality of life and dental fees you'll incur.

I had many injuries cracking my front teeth as a child biting into things. I also grind my teeth A LOT. . So this is extremely concerning to read given all I went though with this operation. I thought the crossbite was the number 1 concern about my jaws and that it was an obvious thing to fix. In fact the only functional concerns that I had regarding speech and grinding were probably exclusively due to the narrow upper jaw, and this was not fixed.

GJ, are you saying braces cannot fix the edge to edge bite? I don’t really have money for a lawyer but I guess my next step is to consult another surgeon and get confirmation that my crossbite wasn’t fixed. If that’s the case I’ll meet with a lawyer and see what my options are.

Should I carry on with the orthodontics or put things on hold?

[Lazlo]

You should get an opinion from another ortho and you should sue. Your case was not handled according to what the goal should have been. You definitely have a case I would say.

[PloskoPlus]

You need a revision. I very much doubt that braces can fix this. An edge to edge bite is the worst possible bite.

[ODog]

You should get an opinion from another ortho and you should sue. Your case was not handled according to what the goal should have been. You definitely have a case I would say.

Thanks Lazlo. I am going to look into this asap.

[GJ]

I had many injuries cracking my front teeth as a child biting into things. I also grind my teeth A LOT. . So this is extremely concerning to read given all I went though with this operation. I thought the crossbite was the number 1 concern about my jaws and that it was an obvious thing to fix. In fact the only functional concerns that I had regarding speech and grinding were probably exclusively due to the narrow upper jaw, and this was not fixed.

GJ, are you saying braces cannot fix the edge to edge bite? I don’t really have money for a lawyer but I guess my next step is to consult another surgeon and get confirmation that my crossbite wasn’t fixed. If that’s the case I’ll meet with a lawyer and see what my options are.

Should I carry on with the orthodontics or put things on hold?

You don't need money to sue in malpractice cases. If the lawyer thinks you have a case, they take it, and then they take a % of your winnings in court.

Again, who is to blame for your quality of life decreasing and the dental bills you're likely to incur from that bite?

A solid bite is the #1 goal of surgery. You'd have to have another doctor explain why that didn't happen here and why your surgery falls outside the standard of care. That's the hard part. But I'd get your records, see what went wrong, then call around. That's what I would do. It's your life and your decision. I'm very concerned about that bite. To me, that falls outside the standard of care. If your surgeon is willing to do revision for free, that's a possibility instead of a lawsuit.

Who was your surgeon?

[ODog]

You don't need money to sue in malpractice cases. If the lawyer thinks you have a case, they take it, and then they take a % of your winnings in court.

Again, who is to blame for your quality of life decreasing and the dental bills you're likely to incur from that bite?

A solid bite is the #1 goal of surgery. You'd have to have another doctor explain why that didn't happen here and why your surgery falls outside the standard of care. That's the hard part. But I'd get your records, see what went wrong, then call around. That's what I would do. It's your life and your decision. I'm very concerned about that bite. To me, that falls outside the standard of care. If your surgeon is willing to do revision for free, that's a possibility instead of a lawsuit.

Who was your surgeon?

Ok thanks for explaining. I’ve emailed my Ortho and waiting on his response. I will look to consult other doctors this week and get my surgical movements  faxed to me. I am concerned about the bite too, believe me, that’s why I made the thread. This is not acceptable to me.

I PM’d you the name of my surgeon. I feel uncomfortable with the idea of getting a revision with him at this point.

How long should I wait before seriously consider the idea of going under the knife again? Should this happen ASAP? Will my lower jaw have to be repositioned? Because I already have major lower lip numbness from the bsso.

[ODog]

You need a revision. I very much doubt that braces can fix this. An edge to edge bite is the worst possible bite.

Thanks Plosko. Why is it the “worst bite” to have?

[GJ]

Thanks Plosko. Why is it the “worst bite” to have?

Don't you feel it?

Your teeth are very likely to crack with that bite.

[PloskoPlus]

Don't you feel it?

Your teeth are very likely to crack with that bite.

Teeth are probably still numb.

[PloskoPlus]

Surgeons typically have a get-out clause of relapse. "It was all great when we finished surgery, but the patient relapsed, and we have no control over that."

[ODog]

Surgeons typically have a get-out clause of relapse. "It was all great when we finished surgery, but the patient relapsed, and we have no control over that."

I did take X-rays 2 weeks after surgery. But I’m not sure if that shows anything. I think I took in office photos at 3 or 4 weeks but again I couldn’t open my mouth wide so I doubt it could serve as visual proof.