Beginning treatment next month with TAD's & open bite sp

Message

#1 Post by **sjs8906** » Wed Jun 16, 2010 4:25 pm

Hello! My name is Jade and I am 22 years old. I am due to begin treatment next month after years of putting it off! I had braces for 3 years (ages 12-15) but had issues with my orthodontist the entire run and my teeth didn't turn out quite as I had planned.

My new ortho found that I have:
-Anterior open bite
-Bilateral posterior crossbites
-Molars do not fit together properly
-Class II skeletal pattern (overbite)

He said that mine is a tricky case and made me an appointment to come back for a 2nd evaluation so he could have time to come up with some options for me. At the 2nd evaluation he first presented me with the option of jaw surgery which I really didn't want, so I declined.

Instead, he is planning to use:
1) Anterior open bite splint with TAD's in the maxillary posterior (expansion screw as part of the open bite splint) - approximately 8 months
2) Full upper and lower Damon braces (added when splint is removed)

Estimated treament time is 28 months and the cost is $6680. My insurance will pay up to $1500 but ONLY until age 23. I only have a year until 23 so their schedule of payment (monthly, quarterly, etc.) will determine how much I get. But I was expecting them to pay nothing so anything is good!

I go in July 7 to have impressions made and July 22 to have the TAD's and bite splint put in.

Since I have had braces before I felt that I knew what to expect and was not at all nervous, but now that I know I will have to get TAD's I am actually very nervous! I'm scared that the TAD's will hurt...although my ortho said that putting them in should be painless!

Also - I don't know much about the open bite splint. Does anyone know anything about that or the expansion screw? Is that something that you have to tighten yourself?

Anyway...just wanted to introduce myself...and I'll end with pictures!

#2 Post by **sjs8906** » Wed Jun 16, 2010 4:27 pm

...aaand the pictures didn't work. Sorry about that

#3 Post by **Clo** » Thu Jun 17, 2010 8:27 am

Hi Jade,

welcome here !
Some time ago, I was quite active here. From time to time, I still come here to read about cases that interest me. Why? Because after a long time in braces, I ended up with a major anterior open bite and a nonexistent occlusion. My treatment ended now a year ago, but to this very day, I still have the TADs, in fact bone anchors. Because maybe I will also start a new treatment. Now, because I also didn't want a jaw surgery, I did a lot of internet searches to find a good and reliable solution. When I read about your coming treatment, I remembered this method :

http://www.angle.org/doi/full/10.1043/0 ... 2.0.CO%3B2

Maybe the splint you mention is something like on figure 5. It is a system that makes it possible to pull up the upper molars using 2 TADs on the outside above the molars. After all the searches I did, this method is probably the best to intrude molars and therefor close an anterior open bite. I did not have this splint thingy, but I had the surgery to place those bone anchors. I immediately want to tell you it looks scary but is really not that bad. It may hurt a bit after they are placed, but that gets better very quickly. Now, since you also need expansion, I think the part that is under your palate might be more like a RPE (rapid palate expander). I know there are different ways to do this, but it wouldn't surprise me if the parts on your molars would be like on figure 5 and the part that connects those is like a RPE. Anyway, there will be some kind of expansion screw and hooks on the outside part of the molar splint to be able the pull the whole thing up.

My story is still here on the boards :

http://archwired.com/phpbb2/viewtopic.p ... sc&start=0

On page 1 you can see the start, on page 7 the result, with the open bite. So, you see, I also had issues with my ortho(s). They gave me a very bad and open bite.

Because there are not many members here who get a non-surgical treatment to close an open bite, it would be great if you would tell your story in the section "Our Braces Stories". Because a story that describes a treatment that successfully closes an anterior open bite would be a very interesting read. That is exactly what I wish for you !

#4 Post by **sjs8906** » Thu Jun 17, 2010 12:01 pm

Clo - thanks for your reply. I read through your story with shock at all you have had to go through! If you do decide to begin treatment again, I really hope things turn out better! Although I don't feel that I have had to endure as much as you have, I can empathize with you. My first run with braces was not the most pleasant experience. My ortho seemed to be just blindly trying whatever he could, and with my insurance at the time I didn't have the option to try another orthodontist. After 3 years I was going in for what I thought would just be an adjustment, and he decided to take the braces off. And that was it - I had straight teeth but a terrible bite. Since then my teeth have moved even more from not wearing my retainer and now it's just a mess.

The method that you referred to is exactly what my new orthodontist is planning to do. The device in figure 5 is nearly exactly the photo my ortho showed me. Like you said, he hopes that attaching that to the TAD's will pull up the upper molars and thus close my open bite. He felt that this would be the only option besides surgery. He didn't urge me to choose the surgical route and seemed hopeful that this method would work, so I really hope that it does.

I will definitely begin my braces story when I get the TAD's and expander put in. I'm so nervous about it all ... I actually dreamed last night that everything went wrong!

#5 Post by **Clo** » Fri Jun 18, 2010 8:33 am

Thanks !

First, it was only a dream. The advantage of this intruding method is that you have nothing to lose. The worst case scenario is that it just doesn't intrude your molars. But much more probable is that it will work completely or partially. Anyway, all going wrong won't happen.

I find it unacceptable that orthos consider well aligned teeth but a terrible bite a final end result. Obviously, first comes a good bite. If also aligning well is possible, great, but the bite is most important. Even more, the best retainer you can have is exactly a good bite. I find it kinda unethical that an ortho let a patient leave with a bad bite. Because when he/she knows a bit his/her thing, he/she must also know that such a patient will encounter issues sooner or later. Anyway, I really hope your present ortho is more skilled.

I did put my treatment on hold. Because I had no hope anymore. But if I would start again, I would also get that appliance like on figure 5. I already saw an ortho who would try that. That is the reason why I still have those bone anchors. So, soon I need to decide whether I'll continue or will have the bone anchors removed.

This article I referred to is serious stuff, not some advertisement of some system by some ortho. It proves that this is a good method to close an anterior open bite, if it is not excessively bad.

Obviously, I am interested to read about your experiences. I really wish you the best of luck !