some orthos' say 'jaw op' others disagree - who to choose?

[horriblebite]

When i first decided to try and do something, age 35 about my class 2 malocclusion I made the decision (for various personal/ health v risk ratio / cost reasons) that if jaw operation was only option, I would give up on the idea of treatment and forget about it. So i was overjoyed when ortho said she could help with fixed upper and lower braces to angle the front teeth (inwards i think). She arranged xrays to double check their 'was enough bone' (i presume this means if lower jaw is large enough) but was pretty sure there was and gave me a quote.
I got my xrays, but before taking them to her, sent copies to two orthos in the UK (i live in France) for second opinions. One said that he would not recommend fixing the problem with fixed braces alone as ortho was just trying to change teeth to effect the appearance of good bite, rather than create one whihc could lead to tmj later, and he would use fixed uppers and lowers and a bite plate as well as extruding some teeth..which th French ortho wasn't planning to do.
Back to French ortho armed with list of questions and ready to tell her what UK guy had said and ask her opinion on this...and she tells me that after seeing xray,she doesnt think there is enough bone after all and only jaw op (which i wont consider) will help. She said it would be dishonest of her to treat me because after a few years teeth would go back to original places (i did mention a retainer but she says it would not work) I asked about extrusion and she says she does not do this in adults because teeth eventually just sink back down. So jaw op only will do.
Back to UK guy ...he says that sometimes people with hammers feel they have to hit things and in his opinion French ortho is weilding orthodontic hammer...ie in his opinion jaw op is being offered without fully looking and gentler remedies.
To complicate things I sent xrays to a second Uk ortho (who happens to be French too) for an opinion, he says that he agrees with French ortho re extrusion being a waste of time in the long-run but that he can avoid a jaw op, by using mini implants to open up the gaps that closed after the extractions i had as a teenager..apparently when this is done in kids, it actaully makes small lower jaw worse as the gaps close after extractions making bite smaller and jaw can actually shrink around the teeth...this needs to be opened up again, he would use fixed braces and a bite plate or splint at night and whole thing would take 12 - 18 months as new mini implant things make whole thing quicker...these mini implants were mentioned on another thread and as far as i understand it, they actually are fixed into jaw bone but expand the bite much faster - the orth said they are inserted in his office and it takes 5 minutes. So now totally confused. I can't understand why, on looking at xrays, one ortho would suggest jaw op and others can say its avoidable.
I just wondered if any one out there had been told 'jaw op or nothing' sought second opinions, been offered non-surgical options and are glad they did so?
Very sorry for long post.

[stevon]

I had a very similar experience. I had 2 orthos tell me it was surgery or nothing. I had one say he could fix my issues by removing 2 teeth and I had 2 tell me that they could get me very nice, but not orthodontically perfect results with no extractions or surgery. After discussing it with all 5 orthos my feeling was that I definitely did not want surgery and if I could do it without extractions that would be optimal.

So I went with one of the no-extraction / no-surgery orthodontists. He has had to tip my lower teeth in slightly and my uppers out just a bit, but most of the movement he created with palatal expanders (2) and elastics. I am 3 days from having my braces removed and I am thrilled with the results.

IMO, it really a question of what you are willing to endure and what your end goal is. If you want "perfect" you may need surgery. In my case no untrained eye will ever know that my teeth are not "perfect". They look wonderful and everything works great.

[Lisa65]

I'm with Stevon and you on this. There is no way I would have agreed to a jaw surgery. Kudos to those who have, and who have had good results, but like you, I didn't care about perfection, I just wanted a nice looking smile. It sounds like your French ortho isn't prepared to try and get you a compromise result. I think sometimes they get so caught up in the pursuit of perfection that they can lose sight of what the patient wants.

I have a similar problem to yours - small lower jaw, class II, extractions as a teen which didn't help matters, and my ortho is doing the mini implant thing. It's taking a while and there's been some delays, but already my smile looks a million times better than before. I will still have an overjet afterwards, and one side will not be a full class I occlusion, but my bite will be functional and my smile will look full and straight, and that's what I wanted above anything else. If you want to get yet another opinion from somebody in the UK, my ortho's website is on my profile (click the link) and hopefully he can advise you.

[horriblebite]

Thank you Lisa, thats very kind.

[TigerLily]

I talked about my treatment in one of your earlier threads, I'll PM you my ortho's details to you (she's French but based in London).

[Dovechild20]

I agree with the above posters, but for me i dont want PERFECT, i just want to look nice for me, so i said no to the suggestions that i get my jaw broke and reset and to extract up to 4 teeth in the front.

I am nearing the end of my treatment and i love the results. Do I look like i could be a Crest White Strips model? No, but i look good FOR ME and that meant more to me than anything surgery could provide.

[horriblebite]

The words 'skeletal deep bite'were mentioned re my jaw yesterday when i sent the xrays to another ortho for another opinion, i googled info on non-surgical options didn't look too promising. Anyone else have 'deep skeletal bite' ..I'm guessing mine isnt exactly a borderline case as i had hoped.
What i dont understand is why some orthos, having seen the xrays, are offering me others routes...apparently skeletal deep bite can be spotted by a layman - if it's there and is something that only jaw surgery can 'cure' how come these guys are offering alternatives - I hope they are not failing to spot the skeletal case when looking at emailed xrays...the xrays are so detailed and numerous, surely they wouldn't miss something so glaringly obvious.