Thought about it recently and I totally should have updated with a Vlog to show how things look debraced!  So, here's one now.... don't mind the ridiculously short haircut my hair dresser decided to give me unexpectedly....and the tired face.  I've been up since 2 this morning and the last two nights combined I have not slept more than 8 hours.  #ThanksShiftWork 

A few tidbits not in the video-- I got a thank you card from my surgeons office for the thank you gifts I gave them.  It's always funny when somebody gives you a thank you for your thank you, but I can relate since I usually do the same thing!  Anywho, if anybody from Dr. Karas's office reads this blog, thank you for your thank you for the thank you! ;)

Speaking of my surgeon, I wanted to talk about a few words he had with me last week. I think it's important to talk about for other patients both preop and post op.  I mentioned to him that I am still trying to get used to my new face/smile (which he said give a year to settle in to, which I totally was already going to do and then some) and how difficult the process is of doing that.  Think about it.  You had this face shape and teeth your whole life, and then they knock you out and re-arrange it in a few hours and sometimes people look seriously way different.  I don't think my change is as drastic as some others, but it's still not the face I saw for 33 years every day, and different is hard, even if it's a little different and even if it's different in a good way.  He immediately said something that makes sense though, so for anybody else going through this and having a hard time, he said just look at is as if your jaws had grown right to begin with, this is how you would have looked.  His goal is to get me to that place had I not had the jaw grow all wonky on me.  And it's totally true.  I find now that I look more like my younger sister, who for the most part is a proportional class I skeletal and dental.  I would say the hardest thing for me personally right now is everything almost looks fake to me, but I think it's just because I am not used to it at all.  My smile looks way too wide to me, and my teeth feel huge. I think that is because I used to have little chicklet teeth and I was all gum (you can glance as some of those pre op shots in the before/after treatment comparison page in the side menu).  I'm sure I'll get used to it though.  And for other patients who may be reading this and having a little bit of a hard time with the changes through all of this, take my very wise surgeon's advice-- give it time and allow this to become your new normal.  Even good change is still change and you'll need time to wrap your brain around it.  Like everything else in this journey, it won't happen overnight.

Anywho, here is the Vlog.  Again don't mind the ridiculous haircut and my tired and out of it self!

In the world of bets/poker, this is not the bet I would have set out to make in all of this... but it is what it is.  I had my appointment with my maxfac today.  I got the scans done of my teeth, pano, 3d xray.  As I said in my last post, I was cautiously optimistic about maybe getting better news on my upper anterior teeth.  Notice I said cautious. I definitely wasn't betting the farm on it, so this isn't devastating to hear that the news isn't good.  If anything, it's just solidified what they were already thinking.  Tooth 7 has nothing left in the bone.  Teeth 8-10 have a little bit of anterior surface left on the root, but in the 3d scans you can see the lingual side where it's gone.  Not only is the resorption going strong on the roots there, but also the bone is starting to see resorption too.  THAT is exactly what we're trying to avoid and why these teeth need to go sooner rather than later. I need to get them gone before I lose bone that is critical to the implant process being successful.  So, any fantasy I had going in the back of my mind of possibly being able to keep these teeth is now put to rest.  RIP tooth fantasy.  ::sigh::

So....the ante upped of a few more teeth....I've talked in a few blog posts about how I thought my lower incisors also looked short to me on films.  Always scratched my head though as to why nobody really brought them up as being in trouble and figured maybe I was just being a paranoid patient.  I took the opportunity today to finally ask about them, and sure enough, they're in trouble.  Ugh.  They kind of wanted to deal with the uppers first before jumping on to the lowers, but the lowers have seen significant resorption too.  I only have the 3 teeth down there instead of 4 because I got one extracted as part of my surgical/ortho plan, but as of now at quick glance, the one in the middle is in bad shape.  Same as the top, it's lost the bone and root on the lingual surface of the tooth.  The two incisors around it are a little better off, but not much.  We'll probably be revisiting those two down the distant road, with the middle one needing to be revisited after the uppers are done.  FML.  So, the grand total cost of doing all the jaw/ortho business here is now at least 5 permanent teeth.  All front teeth.  That is a tough pill to swallow, but it's going down easier as time goes on and I am getting my brain wrapped around what is going on and what is to come in treatment with all of this.  But it still sucks.

So, I got the CBCT, new pano, new ceph, and an iTerro scan to plan the prosthetics I'll wear during the implant process.  We were running pretty behind so the pano got taken as I was walking out and I didn't get a chance to hear how the bone healing looks and all, but quick look and some intra oral pics for records and my surgeon said my bite is fantastic and all of the scar tissue and stuff is healing nicely.  I do want to check with him on the bone healing though since that was an issue for me after my first surgery.  I haven't been back on my road bike or anything yet and I am taking things REALLY conservatively so I don't have a fall and mess anything up.  It's totally not worth it at this point!

I stopped at my orthodontists office on the way back home for my appointment to pick up and get fitted for my retainers.  I am wearing a traditional old school hawley on the bottom because it needed a fake tooth bonded in the space of my missing molar, and then the clear essix on top.  I can get the essix for the bottom after the implant is done there and we don't need to hold the space any more.  All I know right now the hawley is NOT fun.  It's kind of bulky and gagging me. Ugh.  I am sure I'll be getting the top retainer updated sooner rather than later depending on what happens after these teeth are extracted.  I really hope all of that doesn't end up being a total mess!

Since this was kind of my final active ortho/jaw appointments today, I bugged my docs to take a pic with me.  So, now you get to put names to faces!  These guys really did save my bacon in the situation I was in coming out of my first round of treatment.  

And that's that.  My braces are off!  I am still walking around feeling kind of out of it.  I am pretty certain I am in shock.  Even driving home from my ortho's office I was so out of it that my collision control on my car had to kick in and stop me when somebody stopped short in front of me and I was slow to react.  But, it's a good kind of shock.  It's just surreal to be at this place now in all of this.  Like, I am sitting here with my lips at rest not being forced closed for the first time in my life!!! Even though I had amazing revision doctors who I knew were going to do their damn best to patch me up.... I just didn't think it was realistic to expect results like the ones I have, no matter how good the doctors I got were.  Check it out!

It just doesn't feel real to me.  These can not be my teeth. This can not be my bite and skeletal profile now.  It's just so surreal.  I mean, it should be surreal.  Looking at my smile/face now and seeing that I don't look at all like me from 3 years ago.... that is a mind screw.  It's a lot to wrap your brain around and process. I wasn't even expecting to feel shock.  Excited/anxious?  For sure.  And I was definitely anxious.  But thankfully I think it was for nothing.  Those front teeth I was so worried about?  They feel MUCH better than I thought they were going to feel.  So good that now I am pretty sure pulling them right away is NOT what I should do, and instead I am going to advocate a wait and see on them for now.  I don't think they're much worse than what I had when I got my braces off in between my first and second round of treatment.  Well...except for tooth 7.  That is my derpy tooth, and that one is for sure a goner.  The other 3 though, I was pleasantly surprised.... and relieved!!!  So, phew!  A big weight off of my shoulders, but now we'll see what my surgeon says when I see him on Weds for my 6 month follow up and consult with 3d xray for the implants.

And just like that, my active ortho/jaw journey is ending.  That is surreal too after having it dominate my life the last 3.5 years.  I had to email my ortho after I got home today and let him know I wasn't jumping up and down excited because I actually left his office in this weird shock I am in still.  It's so hard to describe.  I also linked him to this blog if he hadn't seen it already.  I think he was trying to get me more excited before leaving and was looking for preop pictures to show me to put it in perspective and he had trouble pulling them up at the chairside computer.  Well, I've got a page for you for that! Ha!  And trust me, I always have this in perspective.  Constantly aware of how far I've come (probably more aware than him since he didn't see what I originally started with), and ALWAYS thankful for where they've taken me through this revision process.  Hopefully he didn't mistake my quiet shock for ungrateful dismay, so I emailed him and said thanks again. 

See my surgeon on weds for my 6 month check up and next appointment to pow wow over the implant situation.  I am not getting my hopes up, but I am secretly hoping the consensus on these anterior teeth changes for the better! 

I've made a final treatment comparison/summary page.  I'll be sure to update it when I get final records and my cbct this week: 

Before/After treatments comparison and final thoughts

Well, really it was the last non-adjustment adjustment.  Nothing was done, which I was expecting.  Ortho just wanted to get a final looksie at everything and hear from me how everything feels still.  Everything has felt pretty settled the last 6 weeks or so and there have been no major changes.  He checked my bite and looked really excited and happy.  I think he's happy about his work and genuinely happy for me and getting to where we are now after the mess we started with.  I felt really bad, but he could sense I wasn't as excited.  He asked why, and I politely told him it's just a weird place to be in finally.  I have a mixed bag of emotions.  Part of me is waiting for some awful trick to be played on me by the powers that be.  For my bad luck to resurface and find out something else is wrong, something else needs to be done, the braces will have to stay on.  The other thing is I really am dreading feeling the looseness of my front teeth in all of their glory without the security blanket of the arch wire keeping them stabilized.  He understood and said it will all be OK.  He reminded me that yes, we have quite a bit more work to do, but we have come a VERY long way from where we started.  He's right, and I am always aware of that and try to look at the bright side and be thankful for all of that, but with the restorative phase now knocking on the door, it's tough to NOT be aware of what is to come.  As always, I am sure all of my doctors understand.

So, that is it. Technically my last (non) adjustment and in 13 days, I come back to get debanded.  I really did feel so many things at once walking out of the office.  Part of me wanted to cry, another part of me was anxious, another part excited.  I know this will be worse at the debanding appointment.  Who knows, maybe I'll get to see my full results and feel more excited about it, but I am sure there will be some tears. Probably happy tears, but there will be some tears. We'll cross that bridge when we get to it in a few weeks.

On a totally different topic-- I went out of town to work an airshow with the weather service.  Super awesome opportunity as an aviation enthusiast and outreach person for my office, but I was also dreading the talking and my jaw.  This was going to be the first outreach event I've done since surgery, and it's a HUGE one.  I seriously non stop talked for 4 days straight, and I definitely felt it. I packed heat packs to bring with me.  I also brought wine and vicodin, but luckily I just needed heat packs and lots of advil.  I wasn't in a ton of pain, but just general soreness and mostly stiffness.  Like I had to keep stretching and massaging throughout the day. I probably looked like an idiot doing it, but oh well.  While I was in Wisconsin for this show, I happen to run in to a long time online jaw surgery friend.  It's so awesome when we get to meet up and put faces to these online names we've gotten to know! 

So, that was way cool and one of the highlights of my trip!  Hopefully we can meet up again next year and maybe this time I'll let her talk more. I babbled on and on because I was running off of 5 hours of sleep over two nights combined (and admittedly a little hung over too) and I tend to just blubber on to basically stay awake. lol 

That's that for the next 13 days.  My next update I will be brace free!!!!!!!!