Second surgery update & gap update

Front view - 2/3/11



Left side - 2/3/11



Right side - 2/3/11

**Surgery Update**

On Wednesday, I had a big teeth day. I went to the orthodontist twice—once to get my wires off and then back again for my adjustment—and to my dentist for a cleaning.

When I saw my orthodontist in the morning, I showed him the x-rays from the oral surgeon. He assured me that my roots would line up again and we also discussed my options for the second surgery. Basically, I could try and use orthodontics to move my teeth so that they fit together, however, the teeth would not be aligned. My feeling on this—as I mentioned in my last post—is that I didn't go through all this to STILL have misaligned jaws when it's all said and done. I left it with the orthodontist that he would chat with the oral surgeon about my concerns and get back to me.

Next, I headed over to my dentist's office. My hygienist was excited to see the progress on my teeth and couldn't believe how much my smile has come together. I mentioned my conversation with the orthodontist and she agreed with me that I might as well get the second surgery. My dentist didn't want to comment one way or the other, but said I was in good hands with my oral surgeon and orthodontist (both doctors he's known for years).

So, after my cleaning I headed back to the orthodontist for my adjustment. My orthodontist told me that he chatted with the oral surgeon and that they felt the best plan is to just do surgery on the lower jaw. The surgeon would bring the lower jaw back, align it with the upper jaw and then do a genioplasty (chin job). The genioplasty is necessary since I would basically have no chin once the surgeon brought the lower jaw back and straightened it up. With my SARPE completed, I was told that the upper jaw is done. My only disappointment is that I was excited about the possibility of a turned-up / less prominent nose from having the front jaw brought forward. I suppose when the jaws are aligned and my chin is in the right place, it will make everything looked balanced so maybe a one jaw surgery is for the best. I think I'll just have to chat with the oral surgeon about it when I get closer to game time.

At that point, the orthodontist said, "OK, sorry to do this to you, but we're going to make you look worse for a while. Before you have surgery, we have to give you an underbite." I have already noticed an underbite forming, but it's really only apparent when I move my lower jaw over and attempt to line up my midlines. Although an underbite is nothing to get excited about I figure 1) I won't have it that long and 2) it's better than an 11mm gap. I have about 4mm of space left and at this rate I should be ready for surgery in June.

The ortho assistant put powerchains on the top and bottom teeth and also put these super-high molar pads on the bottom teeth that cause me to slur my speech a bit (though not as bad as the expander). My understanding is that the purpose of the molar pads is to prevent my teeth from hitting each other while the front teeth back are moving back. With the groundhog just having seen his shadow, I decided that lavender powerchains were appropriate for Spring.

**Gap Closing Update**

The pressing issue on a SARPE patient's mind is, how long until that dreaded gap closes? Well, my gap has sort of shifted all over the place so basically total space closes at 1mm per month. At this point, my gaps are not very noticeable so I would say that at about 2 1/2 months after braces I felt more comfortable and by 5 months of braces the gaps are barely noticeable. Of course, some people have much smaller gaps and their teeth close much more quickly. I saw one blog where the front gap closed in 6-8 weeks. So, my advice is not to get too hung up on how fast the gap closes. For the most part, no one even notices. My friends didn't realize I had the gap since I covered it up with wax. Plus people are generally more concerned with their own appearance. So, my advice is go out and have fun and don't let a gap get you down.