29 - carriere, surgery or else?

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29 - carriere, surgery or else?

#1 Post by cnmat »


After getting braces when I was 16, with permanent retainer glued, my teeth are now, at 29, back in a worse position than they were before. I have been tongue thursting (pretty much only on my left incisive) and my permanent retainer is still there (though I've learnt by one orthodontist that one of the 2 coiled wired making the retainer is broken). My left incisive is now so much forward that my lip is going under when I sleep on the back and pushes it even further.

I was offered lower jaw surgery for receeding mandibula at the time of my first orthodontic treatment but I had decided to go for braces.
Surgery is now back on the offer table by several orthodontists that I have seen in the past months but I'm quite scared of it and I'm not sure it's really worth the risk as I've no snoring/breathing or chewing problem. Yes, esthetically it would be better but I don't mind it that much as my lower jaw tends to go forward naturally (without then being able to bite at that point), and from what I've seen this is pretty much the position that the surgeon would bring it to, so it seems that it would only change my profile when I'm biting (at least that's what I concluded, maybe it would be better, not sure..) The only point is that I don't want to go for another orthodontics treatment in 10 years.

The same orthodontists have also proposed alternatively a simple Invisalign treatment that would realign my teeth and bringing it slightly back.
Another orthodontist has offered Spark clear aligners together with Carriere distalizer (at the same time, not one after the other, which was he said the advantage of Spark compared to Invalign, to allow for modifications in the aligners to be able to place the Carriere distalizer). But this would bring my upper teeth a lot backwards and I'm scared not to have enough place for my tongue (especially since I was tongue thrusting). It would also move some teeth that would enlarge slightly my bite but it doesn't seem that much space gained by that compared to how much space I loose by by upper teeth being moved backwards. (also saw this article https://carrieresystem.com/wp-content/u ... 2jcnBszQZ6 , which mentions that Carriere is not made for patients who present tongue thrust)
Also, after Carriere, my middle vertical line would not be aymore in the middle but slightly shifted towards left and I would need Inter Proximal Reduction to correct that (which I'm not a big fan of as I have perfectly good and healthy teeth appart from this orthodontics problem).
Another orthodontist told me Carriere could increase the crowding on my lower teeth despite a retainer.

To resume my case: Class 2 maloclusion (receeding lower jaw), ~6,3mm overjet, narrow palate, tongue thursting, now additionally lips pushing the teeth when sleeping on the back, no particular temporo-mandibular disorder (at least that I know of?), crowding of upper teeth and a bit of lower teeth as well.
Hesitating between surgery, simple alignment or bringing my front teeth back.

I'm a bit lost with all these different suggestions. Any help, advice, story, would be greatly appreciated :)

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