Am I still in crossbite?

[Post bimax]

Molestrip managed to fix his (pretty bad) AOB orthodontically.

I had AOB and orthodontics as a teen which was fixed and subsequently relapsed (pretty sure my jaw was done growing) so I’m guessing that’s why the ortho suggested JS instead of trying again.

[DRIVVEN]

No I haven’t talked to him about it, I see him next week. To be fair though Dogmatix, I shouldn’t even need a revision. We’re talking about chances of nerve damage being increased. I’m sure you would feel the same way after your surgery if your bite is not class 1.

I have to tell you, its the worst bite.  I had class one to start with and now my finished bite looks like this. I dont know if i could a handle a revision, so i am looking at things such as the DNA appliance and the ALF to see if i can get any room. My teeth are chipping away.  I dont even know where to start. Sadly, lawyers and lawsuits dont fix bites—that would take years. I am an attorney, and i cant practice because my teeth smack together 24/7.

[ODog]

Is that your front top and bottom teeth clacking together? I don’t have that, it just appears that my teeth are contacting prematurely on the sides. That looks awful. How did it happen?

[Lefortitude]

Is that your front top and bottom teeth clacking together? I don’t have that, it just appears that my teeth are contacting prematurely on the sides. That looks awful. How did it happen?

She had a complication mid-surgery which required a change in plan, leaving her in a bad situation.  I wonder if it would have been better to stick to the original plan, or if a different practitioner would have done it differently to yield a more favorable outcome.

[ODog]

In case anyone's interested, I did indeed have a crossbite after the surgery. I know it sounds crazy but you start to second guess yourself when nobody is telling you the truth. My surgeon told me there is no transverse deficiency there, and my ortho was very indirect/ cryptic, so I really didn't know for sure, especially with regards to how much ortho could improve the bite. Even a second orthodontist I consulted told me to wait 6 months to let things settle. No hard, clear answers.

Now recently, according to my orthodontist, finally he just came out with it and said I was in a crossbite on the left side after surgery but now (at 5 months) with elastics, I'm more edge-to-edge. I think my right side is ok; maybe not perfect but its certainly not a crossbite and teeth are meshing nicely on that side. The upper arch is certainly wider than the lower on that side.

Still unsure what to do about the left side that's now edge to edge. Is it even healthy to forcibly tilt the teeth outward into proper position? Could this cause gum recession down the road? Relapse? If the orthodontics doesn't improve things further, am I going to grind my teeth down eventually? I was already a grinder before. Having my teeth mesh adequately has alleviated that somewhat but it's probably still / will be an issue.

I type out this whole post but the truth is, I already know the answer. The techs who adjust my wires always ask when my surgeon consult so I can get a second opinion on the bite. They already know things won't be fixed perfectly with orthdontics.

I guess I still don't know what to do. Is it worth going through another surgery to move one side of my jaw outward 2 mm? The fact that I still have to worry about my crossbite after all this just seems really stupid, to be quite f**king honest.

On top of that, I've been informed by another post here that my surgeon is retiring (no longer accepting new patients).

[ODog]

On a positive note, now that all of my swelling is gone, it looks like I was advanced the right amount. After the surgery I was wondering if I should have asked for more advancement, but now the the swelling above my upper lip has dissipated (paranasal), I see that I came ever so close to straddling that line into chimp-lip territory. Further advancement would have done absolutely nothing aesthetically and probably would have make me look worse.

[Dogmatix]

In case anyone's interested, I did indeed have a crossbite after the surgery. I know it sounds crazy but you start to second guess yourself when nobody is telling you the truth. My surgeon told me there is no transverse deficiency there, and my ortho was very indirect/ cryptic, so I really didn't know for sure, especially with regards to how much ortho could improve the bite. Even a second orthodontist I consulted told me to wait 6 months to let things settle. No hard, clear answers.

Now recently, according to my orthodontist, finally he just came out with it and said I was in a crossbite on the left side after surgery but now (at 5 months) with elastics, I'm more edge-to-edge. I think my right side is ok; maybe not perfect but its certainly not a crossbite and teeth are meshing nicely on that side. The upper arch is certainly wider than the lower on that side.

Still unsure what to do about the left side that's now edge to edge. Is it even healthy to forcibly tilt the teeth outward into proper position? Could this cause gum recession down the road? Relapse? If the orthodontics doesn't improve things further, am I going to grind my teeth down eventually? I was already a grinder before. Having my teeth mesh adequately has alleviated that somewhat but it's probably still / will be an issue.

I type out this whole post but the truth is, I already know the answer. The techs who adjust my wires always ask when my surgeon consult so I can get a second opinion on the bite. They already know things won't be fixed perfectly with orthdontics.

I guess I still don't know what to do. Is it worth going through another surgery to move one side of my jaw outward 2 mm? The fact that I still have to worry about my crossbite after all this just seems really stupid, to be quite f**king honest.

On top of that, I've been informed by another post here that my surgeon is retiring (no longer accepting new patients).

It's a tough call and hard decision. The entire purpose of surgery is to create a good bite, and when you go through the entire process and don't get this, then this objective is not met. As I understand you had orthodontic preparation prior to surgery, in that case the surgery should be considered the last part of the treatment and near as perfect occlusion after. In case of surgery first or early, the surgeon may have to make assumptions of post operative orthodontic work, but not when proper preparation has been made.

Let us know what you decide to do. Have they offered you a revision?

[CCW]

Is it even healthy to forcibly tilt the teeth outward into proper position? Could this cause gum recession down the road? Relapse? If the orthodontics doesn't improve things further, am I going to grind my teeth down eventually? I was already a grinder before. Having my teeth mesh adequately has alleviated that somewhat but it's probably still / will be an issue.

No. Yes. Yes. Possibly. Dental widening isn't stable in adults and it should've been done surgically. There's not much your ortho can do now.

[ODog]

No. Yes. Yes. Possibly. Dental widening isn't stable in adults and it should've been done surgically. There's not much your ortho can do now.

Sorry I didn’t see this reply. Thank you for the straight answers. Jesus I am being heavily manipulated then. I am going to ask for a revision. I have no choice.

[ODog]

This is my bite now at almost 6 months post-op. Orthodontist said I’m edge to edge on one side now (cross-bite before), the other side is good.

What do you guys think? Worth a revision?

https://imgur.com/a/RXYaC5e

You’ll notice my right canine is shorter and flatter than the left. I noticed that before surgery; I didn’t have that wear and tear even two years ago when I started braces. So my grinding is obviously excessive enough to wear down teeth - and in a short amount of time to boot. So it’s not ideal for me to live with a cross bite

[Dogmatix]

This is my bite now at almost 6 months post-op. Orthodontist said I’m edge to edge on one side now (cross-bite before), the other side is good.

What do you guys think? Worth a revision?

https://imgur.com/a/RXYaC5e

You’ll notice my right canine is shorter and flatter than the left. I noticed that before surgery; I didn’t have that wear and tear even two years ago when I started braces. So my grinding is obviously excessive enough to wear down teeth - and in a short amount of time to boot. So it’s not ideal for me to live with a cross bite

I don't think I can contribute anything more than you already know about your bite or situation. These pictures look far better than the ones you've showed earlier. To my untrained eye, I don't see any clear crossbite or edge to edge on the canins as it was before, but if you say it's there, maybe it's better shown on professional pictures or at another angle. Are they offering you a revision, or would you have to struggle for it? It's bad how surgery left you with a crossbite that take 6+ months to work away, it should only be minor adjustments post op. But now you've gone through it and if they can fix it, it must be nice to get away without more surgery, but I also understand that you didn't got into this for almost a good bite. You say that you've grinded on your canine, but can it be that they've fixed it so it doesn't happen any more now?

[ODog]

I don't think I can contribute anything more than you already know about your bite or situation. These pictures look far better than the ones you've showed earlier. To my untrained eye, I don't see any clear crossbite or edge to edge on the canins as it was before, but if you say it's there, maybe it's better shown on professional pictures or at another angle. Are they offering you a revision, or would you have to struggle for it? It's bad how surgery left you with a crossbite that take 6+ months to work away, it should only be minor adjustments post op. But now you've gone through it and if they can fix it, it must be nice to get away without more surgery, but I also understand that you didn't got into this for almost a good bite. You say that you've grinded on your canine, but can it be that they've fixed it so it doesn't happen any more now?

Yeah my bite looks fine now but like you said this was supposed to be achieved with bone movement not tooth movement, so it’s not going to be stable. Crossbite fixed with ortho is never stable long term, as CCW said.

So question is should I get the surgery now to avoid future relapse. Maybe I can just get the surgery again when I’m older. The benefit of doing it now is they’ll do the revision for free if I pushed for it.

[DRIVVEN]

Is that your front top and bottom teeth clacking together? I don’t have that, it just appears that my teeth are contacting prematurely on the sides. That looks awful. How did it happen?

Yes i am edge to edge, the top teeth are veneers and they have been modified so i dont bang in the front but they hit at canines now, its miserable

[Dogmatix]

Yeah my bite looks fine now but like you said this was supposed to be achieved with bone movement not tooth movement, so it’s not going to be stable. Crossbite fixed with ortho is never stable long term, as CCW said.

So question is should I get the surgery now to avoid future relapse. Maybe I can just get the surgery again when I’m older. The benefit of doing it now is they’ll do the revision for free if I pushed for it.

There will never be a better time to have surgery, than now. So saving it for later sounds like a bad option. Either now, or never.

I'm actually having similar movements done. Angling the canines out to allow the mandible to come forward without getting a crossbite. Gunson also included this in the preop adjustments for me on his consultation. So it can't be totally unreliable. So I don't think you should get totally caught up in the instability horror stories, even if there's of course reasons people say it. Actually all teeth in both upper and lower jaw are unstable alone. Class II patients often have div II bite because nothing stops them from tilting inward etc. The stability comes from good occlusion and interaction between the lower and upper jaw while biting etc. I don't know, but if they get the bite to fit, it might be stabilizing it self?

I guess neither your surgeon or orthodontist is pushing or entertaining the thought of a revision? If they were you would probably already had it done. This is the problem with this field, you have 2 professionals who are supposed to look after you, but still you need to get advice here, and I'm certainly not the best one to know what to do. The only thing I feel strongly about is if you're gonna do it, don't wait.

[GJ]

There will never be a better time to have surgery, than now.

Why?
The surgery is primitive. You have think it will get much more exact and cheaper in the future as technology improves. E.g. distraction, when it can move accurately in all planes and be performed by precise robots, will destroy current techniques.