So I finally get in for that appointment I messed up last week and missed (and I brought donuts today for my penance).  What was supposed to be a quick in/out adjustment like I've seen for the last few adjustments turned out to get quite interesting today.  I had a feeling something was up when the doc himself sat down to start doing all the worker bee RDA tasks like untie me and take the wires out.  Of course he goes straight for those front teeth.  And he's not super happy.  Ugh.  I am not even sure what he did to the wire.  Almost nothing at this point.  I think maybe just one bend in it to help extract that lateral incisor some more.  He wanted to see where it was at, but just by feel, he thinks it's ready to be out.  And based on the wiggle to my front teeth, his concern is growing there too.  He sneaks me in for a quick pano and decides to call my prosthodontist to pow wow and see what the game plan is.  Based on what I just saw on the pano, I have a feeling we're revisiting what is going on with these front teeth sooner rather than later.  My prosthodontist wants me to swing by to get some PA films and have him take a look at a few things and chat.  Took me 90 minutes to get over to his office in AM Bay Area traffic....sucked!

As soon as my prosth took the PA's and I saw the films pop up, I could tell where this was going.  Compared to last year's PA's, there is significantly more root gone on my 4 upper fronts.  Makes sense based on how  much looser they feel on me now.  And I shouldn't be surprised.  Seriously.... why am I surprised?  Or why does this seem harder and harder to have the discussions about all of this when I knew this was coming?  Maybe because having to actually do something about it is really not that far off finally, and unfortunately my hopes of MAYBE being able to hold on to 3 out of the 4 teeth for a while is just getting more and more crushed at each visit.  The prosth gets more and more pessimistic each time.  He really doesn't see any good long term (or even short term) prognosis of these teeth.  Even if I chose to try and keep them for a bit, I then risk them being continually loose and inflamed and it could prevent the osteogensis I need to support the implants and stuff that I need.  I definitely do not want to lose what already diminished bone that I have.  Catch is, now that my occlusion is class I, my upper and lower teeth touch a little bit (as they should), and that is just going to keep wiggling and be inflamed if I leave the teeth.  Also, if I replace just the right lateral incisor and wait on the other 3, then I risk uneven gum/tissue ware and recession and could end up with a whacked out looking gum line when we do finally decide to do the other 3 teeth (and we will have to do it.  It's not an if, it's a when...and they are saying the when would end up sooner rather than later anyway now).  So, there are risks vs. reward to weigh out here all around. Do them all at once vs. a few at a time? Do the implant supported bridge vs. all implants?  And depending on what I do, there is a greater risk to the aesthetic side of the house vs. functional with some things and vice versa if we go another way.  So, I had to tell my prosth today what is my primary area of concern-- function or aesthetics.  As it has been in this whole journey, I am not willing to sacrifice function for aesthetics, so I want that to be his main concern.  Obviously I don't want to look super jacked after this, but I am sure he's not going to do that to me and while aesthetically it won't be perfect, it will totally be just fine and dandy for me. 

So, my prosth, surgeon, and ortho will all put their heads together again and see what the best option is now and get back to me on everything.  Prosth asked me how much longer in braces, and I told him I was tempted to ask today but I didn't, so I don't know.  He seems to think I look pretty near done.  Like, braces could come off at any time.  So, he's more inclined to wait until braces are off to start all of this work since that will probably be happening pretty soon.  Same as last time after this appointment, I bawled in my car like a baby.  I have no clue why this doesn't get any easier coming to grips with the fact that I am losing these teeth.  It's a mixed bag of emotions.  I am sad over the act of losing the teeth, but also because of the reasons too.  I am angry about the reasons I am losing these teeth.  I usually keep it classy on this blog, but quite frankly, this is all bullshit.  I shouldn't be dealing with this, especially after having to deal with the mess of having to have this all redone.  I went on this journey to save my teeth and instead I've got this to deal with now, and most of it is all thanks to my first ortho and surgeon.  And it infuriates me thinking about that.  I really need to stop thinking about it because there is nothing I can do about it.  I can't change it and I can't do anything legally about it and nothing will come of it.  My first ortho and/or surgeon are not going to call and apologize.  They're not going to offer to help pay for me to fix their  mistakes.  So all I am doing is driving myself crazy for no reason if I continue to think about it, but I can't help myself.  Ugh.

So, for now next ortho appointment isn't for another 3 weeks.  My 6 month follow up with my surgeon isn't until August, but sounds like I'll probably be seeing him sooner rather than later to take care of these front teeth.  We'll see what they say when they call me with the news from their meeting on my case. 

I forgot to mention one good thing that came out of the ortho appointment--  I am stepping out of rubber band jail! Cleared to try going to nights only again.  He said it's OK if my bite slips back a tad.  He wants to give those front teeth a break and doesn't want to close them up any more at this point. 

Here are some glamor shots from today. 

I hit 4 months post op on the 9th, and tomorrow was supposed to be my 4th post op adjustment, but stupid me had it on the calendar wrong and turns out the appointment was actually today and I was a no show.  Doh!  I feel like a shmuck, but oh well, what are you gonna do?  This is the only time I've ever no showed for an ortho appointment for either of my treatments.  My ortho's office is closing for a bit this week though, so their schedule is absolutely packed with everybody trying to squeeze in before the office goes on vacation, so now I can't get in until next week.  Womp womp wwwooommmpppp.  Kind of mad at myself though, because now I am stuck in 24/7 rubber band jail for another week.  I was hoping he'd let up on them with this appointment.

In all honesty, I have to start wondering a bigger question.  Not really when am I going to be out of the elastics, but when will I be out of the braces?  My bite is pretty damn solid now.  I honestly think there is very little left to do with my teeth.  I do feel like I am still a smidge more open on my right than my left.  If I had to guess, I think he's going to contour the teeth on my left a bit more to make the right side come together for that little final push.  It's seriously just a hair, but noticeable unless I clench my teeth together tight and force  my teeth to come together.  Otherwise things feel pretty good.  Whatever adjustment doc did to my teeth last time has stopped the uneven biting on my front incisors and I now finally have a "softer landing," that he's been talking about.  I wonder if he ever so slightly proclinated my upper fronts, but they don't looked flared out at all.  Whatever he did, it was super subtle and just enough to get those teeth in that sweet spot.  So since that improved, I've been able to be in my bands almost 24/7 still despite him giving me the OK to get the triangles off if I was clashing down too hard on those fronts still.  BUT... for the first time in 4 months last night, I fell asleep and didn't have my elastics in.  I definitely woke up and had an, "oh crap," moment.  But, all was well.  My jaws did not relapse over night.  I was still class I when I woke up. lol

My numbness is pretty much officially back to what I had left over from my first surgery.  Woohoo!!  That is a huge feat. It was almost guaranteed I was going to have additional numbness since this was a revision.  For once, I actually got the long end of the stick when it comes to something on this jaw journey!!  I would say 90% or so of my swelling is gone, and I have up and down days where I can see my nose is puffy. My opening has plateaued.  I am not sure what I am in mm, but I am still getting 3 fingers in comfortably.  Sometimes a little over that.  My right TMJ still feels stiff and kind of weird.  Still hoping the lingering stiffness and irritation is mostly from being in elastics 24/7 still.  And still hoping that disc eventually does settle down, but I'm starting to prep myself for the chance that I will now have some TMJ stuff going on over there permanently.  As long as it doesn't escalate in to significant issues with that joint, I can take what is going on if I had to.  I'll have to chat my surgeon up about it in Aug at my next appointment.  I might be seeing him before that though.  I'll probably start work with him for my first implant on my back missing molar.  Hopefully have that grafted and post in and set so not too long after braces come off I'll be ready for the crown on it.  And then that will just leave me with the 4 upper fronts to deal with after that.

I think I am getting used to my new smile more. It's starting to feel less foreign, and I have actually found myself rushing to take more pictures with my husband and stuff when we're out and about.  But why?  This is the weird part.  It's not because I think I am looking fantabulous and can't stop being in love with myself or anything, but because it's almost like I need to see it to believe it. A reminder that this is all real and, yes, it's still looking straight and class I and the other shoe has not dropped. It's definitely a weird feeling and hard to describe. I'm also getting more used to being able to bite in to certain foods, but at the same time I am still in awe when it happens and appreciate the new bite.  And on top of getting used to new things, I am still noticing new things too!  Few medical differences that are definitely appreciated this go around that are now clear to me- 1.) the fullness and muffled/diminished sound in my right ear is pretty much back to normal.  I guess my first surgeon offset my jaw so far on that one side that somehow it was pinching off something over there and muffling my hearing and making me have to constantly pop that ear; sometimes it was painful to clear.  2.) my nose no longer clicks.  After my first surgery, if I were to scrunch my nose or be clearing it a bit with the tissue and moving the cartilage around a little, I could feel it catching.  Like a piece of cartilage was off up in there or something.  It really gave me the heeby jeebies and I hated it, but that is officially gone.  So, I am guessing when my surgeon did the minor septoplasty to center the lower section that was deviated, he was able to correct whatever piece of debris or what have you that was floating in there and causing that clicking.  Hard to describe exactly how it was, but my nose just felt like it wasn't solid and a piece of it was freefloating and clicking. So glad that both of these things are GONE!!

So, now my ortho appointment is moved to next week. Hopefully I hear more about rubber band jail, possibly more on debanding, and then reconfirm that I can go ahead and get started on that implant with my surgeon.  Ugh, still can't believe I screwed this appointment up today! 

Anyway...here's to 4 months post op!