Metal Mouth Message Board

I have a question about mandible surgery. I am dazed and confused.

I am 52 years old. I have had braces for the last 1 1/2 years. I had SARPE last summer. It was successful. My orthodontist wants me to get mandibular surgery. I have an underbite.
I have been going to a very reputable hospital for orthodontic surgery and consultation.
I have been there 2 x for molds, measurements and XRays. Each time they submit all my records and materials to a Conference of Oral Surgeons on the East Coast.
The first time they suggested the orthodontist move my teeth slightly.
The 2nd time, they came to the conclusion that my bite was off by 2 millimeters.
My orthodontist says it is off by 8 millimeters.
I went for another consultation on Monday, and they checked everything. I was mentally prepared to set a date for the surgery.

Their recommendation was that for 2 millimeters, I should not risk the surgery. They said that because of my age, there was a chance that the jawbones would not break or heal properly. I will have to spend the night in the hospital and have my jaws wired shut for 8 weeks.The surgery might not even be successful.

My orthodontist says I have a “Sunday biteâ€

Yikes, that sounds difficult. The only suggestion I can offer is to get another opinion, if you can.

I don't see why your age should be a big deal... especially since you already had SARPE and healed just fine. However, if your bite is really only 2mm off, that seems like a very small amount, that could probably be dealt with orthodontically. Either your ortho or surgeon has their measurements worng, and I would seek another independent consultation.

Was surgery ever mentioned as a possiblity in the initial plan? Yes, if there is too much anterior-posterior descrepency then you must settle for a 'compromised' result unless you go through surgery, and the compromised result is often much less stable. I, for one, had a compromised result the first time in braces and there are many others here who are in braces the 2nd time around because of replase over time. Since you are so pleased with your results now, another question for your ortho might be how much and how soon for your bite to start to replapse.....?

I would ask both parties their opinion of why there is such a descrepency between their findings, and also get another opinion from a different Oral Maxofacial surgeon group.

BTW, Having your jaws wired shut at all is pretty rare these days-much less for 8 weeks. I also don't see why your bones won't heal properly as long as you are healthy!

News: the orthodontist is furious. The hospital resident made a mistake. I do need the surgery. They never looked at my records, although they say they did.

I trust my orthodontist. (In a way I am relieved because I always thought we were in agreement)
More to come when I know more. I don't know the specifics of my crossbite. My ortho says I have a dual bite: one that is correct when the braces are on. When the residents measured me, I told them that.
It all makes sense, since up until last week everyone was in agreement about the 2nd surgery, even the insurance company had given the go-ahead.
The problem is that the resident who wrote the letter to my insurance company, and who performed the first surgery, has since moved on.
I have seen 3 residents since. All agreed up until the last one.
My ortho has called the chief of surgery, who is going to talk to the resident, who is going to actually look at my records and call me back.
I know, should I trust these people to cut me?
They are the same ones who did the first surgery and did an outstanding job. We essentially have to tell them what to do and put everyone on the same page.