First of all I want to say I'm very happy with my results, and not regret my choice of going through surgery (which was mainly, or to be honest, only done from aesthetic reasons...).

My operation included Lefort I for upper jaw and something similar to BSSO for lower jaw (called mandibular segmental osteotomy). I had Class III.

After the surgery was over my surgeon told me all the teeth in the lower jaw should be vital since they were careful not to expose anything (the lower jaw was more problematic in terms of perserving teeth viability because of the mandibular segmental osteotomy procedure, which is a little bit more risky).

Today I might have got some bad news though. About a week ago (this is 15 months post-op), while looking in the mirror, I've suddenly noticed that a certain front tooth in the lower jaw has a color which is a little bit different than the others (a little bit more transparent, or off-white, not sure how to describe it). I know that a dead tooth sometimes change color so made an appointment for the dentist immediately.

Today the dentist went through my teeth and said everything looks good. Then I've told him about my concern regarding that certain tooth. He said the color of that tooth looks ok in his opinion. I insisted that the color has slightly changed from what I remember. Then he agreed to do a "cold test" to make sure that the tooth is indeed vital. To his surprise, the tooth failed the cold test. And not only that, another tooth in the front lower jaw (which looks perfect in color) also failed this test !!

He took x-rays of these two teeth and said there is no signs of bacteria, but there is some indication that these two teeth are not vital...

In his opinion (and another dentist he consulted with) these two teeth are dead, and we need to do a root canal.

I guess even at 15 months post-op you can still discover something went wrong in surgery , though if to be honest, I guess losing the vitality of two teeth is not such a horrible consquence...

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Noam.

Two more thoughts I had:

1. I wonder why isn't it standard procedure to check (all) teeth viability after orthognathic surgery...

2. Although less likely, but it is possible to kill the tooth nerve during orthodontic treatment.

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Noam.

That's surprising in that it showed up over a year later. I would think the damage done during surgery would be apparent much sooner.

I've read that from the moment a tooth-nerve dies, to the moment the tooth start to change color, sometimes even years can pass. So theoretically it's possible those two teeth died at surgery, and I simply had no clue. Even after 15 months I still have some loss of sensation at lower jaw so maybe I've missed some hints of pain that otherwise would have been there too to hint for tooth-nerve loss...

I have an appointment with my jaw surgeon next tuesday, hopefuly she'll have something good to say. Otherwise I'm booked for two root canals...

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Noam.

ohno i hope things work out ok for you

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