Am I still in crossbite?

[ben from UK]

I bet orthodontists and even surgeons are trained, or maybe they probably learn through experience, to use language carefully. If my ortho advises me to get a revision because my bite is not perfect, and then I suffer nerve damage in my upper lip, and I later find out my bite was “good enough” and there was no revision that NEEDED to be done, he would be screwed and potentially liable to lawsuit.

So instead of saying directly “you have a transverse deficiency,” they might say “I know YOU have concerns about the transverse.” That way they can never be accused of leading the patient, only responding to the patient.

True. That goes more or less for any kind of business, but even more for this kind of stuff with high risks.

Though in the end, it doesn't really matter. Either someone has the skill or he doesn't. And you just don't know beforehand if someone has it or not. And even if someone has the skills, it doesn't exclude the fact that even the best can make a mistake, or that his aestethic view doesn't correspond with that of the client. In a sense, beauty is subjective. A surgeon might be satisfied with a result, while a client is not. Fact is, some surgeons are better than others. I would say, based on experience: 90 percent are s**t, only 10 percent are good, but every one of them think they are the best.

[ODog]

True. That goes more or less for any kind of business, but even more for this kind of stuff with high risks.

Though in the end, it doesn't really matter. Either someone has the skill or he doesn't. And you just don't know beforehand if someone has it or not. And even if someone has the skills, it doesn't exclude the fact that even the best can make a mistake, or that his aestethic view doesn't correspond with that of the client. In a sense, beauty is subjective. A surgeon might be satisfied with a result, while a client is not. Fact is, some surgeons are better than others. I would say, based on experience: 90 percent are s**t, only 10 percent are good, but every one of them think they are the best.

Haha exactly. In summary, s**t is complicated, and surgery is imperfect. I do agree that beauty is subjective ONLY when a person is far enough away from the aesthetic ideal but they may have a unique look that isn’t typical, but that isn’t bad either. In that case, you have to work more on subjectivity WRT what would look good for that particular patient and toss out objective standards.

[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?

I had surgery with Dr. Gunson in Santa Barbra and my lower jaw is too far forward.

[ODog]

I consulted with Caminitti finally, he said it’s a minimal edge to edge bite on one side and he personally would be satisfied with this bite. He said he grades occlusion out of 5, and said he would give me a 5/5. When I pressed him on that he said okay fine 4.9/5.

He wouldn’t do a revision under any circumstances and advised me to stay away from anyone who he says they can improve my bite further. Although, again, he did say it was a bit edge on edge and a slight open bite on one side. But the bite itself occludes and meshes fine.

So it is what it is. I don’t think anyone would do a revision on me. I’m consulting one other surgeon.

[kavan]

I consulted with Caminitti finally, he said it’s a minimal edge to edge bite on one side and he personally would be satisfied with this bite. He said he grades occlusion out of 5, and said he would give me a 5/5. When I pressed him on that he said okay fine 4.9/5.

He wouldn’t do a revision under any circumstances and advised me to stay away from anyone who he says they can improve my bite further. Although, again, he did say it was a bit edge on edge and a slight open bite on one side. But the bite itself occludes and meshes fine.

So it is what it is. I don’t think anyone would do a revision on me. I’m consulting one other surgeon.

I think what he's conveying is that a bite does not have to be perfect Class 1 to be 'ok' or functional. One of Wolford's proteges once told me that Class 1 does not necessarily convey perfect occlusion because there is class 1 malocclusion. Also, that Class 2 and Class 3 occlusion does not necessarily mean 'malocclusion' because there can be Class 2 and Class 3 occlusion where the occlusion is good.

Basically, a deviation from 'perfect' occlusion does not automatically default to an assessment of malocclusion. So, it sounds like the doctor is validating that you don't have perfect occlusion but the occlusion you have would not be considered malocclusion.

[ODog]

I think what he's conveying is that a bite does not have to be perfect Class 1 to be 'ok' or functional. One of Wolford's proteges once told me that Class 1 does not necessarily convey perfect occlusion because there is class 1 malocclusion. Also, that Class 2 and Class 3 occlusion does not necessarily mean 'malocclusion' because there can be Class 2 and Class 3 occlusion where the occlusion is good.

Basically, a deviation from 'perfect' occlusion does not automatically default to an assessment of malocclusion. So, it sounds like the doctor is validating that you don't have perfect occlusion but the occlusion you have would not be considered malocclusion.

Yeah, exactly. It doesn’t mean the bite shouldn’t have been made better with the surgery since well, I’m going through this whole thing so may as well make the bite as perfect as possible. But it does mean the mild discrepancies don’t really have any functional significance, I guess.

[Dogmatix]

I consulted with Caminitti finally, he said it’s a minimal edge to edge bite on one side and he personally would be satisfied with this bite. He said he grades occlusion out of 5, and said he would give me a 5/5. When I pressed him on that he said okay fine 4.9/5.

He wouldn’t do a revision under any circumstances and advised me to stay away from anyone who he says they can improve my bite further. Although, again, he did say it was a bit edge on edge and a slight open bite on one side. But the bite itself occludes and meshes fine.

So it is what it is. I don’t think anyone would do a revision on me. I’m consulting one other surgeon.

Did he say anything regarding the stiffness, speech etc?

[ODog]

Did he say anything regarding the stiffness, speech etc?

Said it’s nerve damage and that removing screws/ plates won’t do anything. He actually described the speech issue exactly as I had in a post here, trouble with m,b,p’s like in Bell’s palsy. Has to do with not feeling your lower lip, knowing it’s position, etc.