So... had the big meeting with my orthodontist, and we have a plan. Finally, it just feels so good to have something laid out and know what is coming now and can start planning around all of this. So, the plan is much like what my prosthodontist was explaining to me about a month ago. They are going to take out my lower right incisor and close that space. Once they close it, it will bring my lower arch in and make my overbite and overjet a LOT worse. Worse in a good way though. It will give them more space to move my jaws where they need to go to be in a class I relationship finally. They are hoping to have the space to move my upper jaw back 3-4mm where it started, and the lower jaw forward another 3-4mm. They also need to impact me more and level out the cant my first surgeon left (about 3mm more gum/bone on my right side vs. the left), and also untwist the yaw she put in my bottom jaw. The cant and yaw will be the wild card in all of this. That will be the toughest thing to get perfectly correct. I told my team if they can put their best effort in and get close, I am OK not having it absolutely perfect but functional and good enough. Of course they responded with they are in this for the perfect result and will try their hardest. The coolest thing about all of this is how many eyes have been on my case and contributed to the planning. The prosthodontist (who has to drive an hour to get to the area where my surgeon and orthodontist are), orthodontist, and surgeon all met up on one of their off days to stew over my records and talk about a plan. Then my orthodontist took my records to a study group with 4 other orthodontists and they all weighed in on everything. The group was unanimous that the plan we are proceeding with is the best option. It just blows me away that this much planning has gone in to this. The 3d computer simulations of all the scenarios (removing a tooth vs. not removing it and seeing what the end results after surgery would be) was REALLY cool. It's definitely the result I am looking for.
So, I am scheduled now for Tues Jan 27th to go to the ortho and he is going to fit my upper molar bands on and full lower braces. They are only doing the lower for now, and will probably be like that through much of my treatment leading up to surgery. Ortho feels that my top teeth really don't need a lot of pre op work since they are set up already, and they just need to work on closing the space and bringing that lower arch in with the bottom appliances. He also said this is a good route to go since most of my upper fronts have the root resorption, and this will save those teeth from further unnecessary damage. I'll probably get the uppers right before surgery, and then he'll do the work post op to fine tune the bite and any tweaking on any upper teeth to get them in their final positions. I love that he is paying attention to the root issues (thanks, prosthodontist, for weighing in and being apart of the planning!!), because I got no attention to that the first time around which is why my 3 front teeth are in the shape they are in now. I never got all of this attention in the planning either. I am just kicking myself and really wish I had this the first time around! Anywho... I get the lower braces on, then go straight over to the surgeons office to get the lower right incisor out, and then back to the ortho to get the arch wire put in and I'll be on my way. I am NOT looking forward to this. Tues night is probably going to be miserable. Getting a tooth out and being stitched there AND dealing with the initial pain of having braces and an active wire going for the first time in 4 months... I am probably not going to be a happy camper, but no pain no gain and need to move forward this way.
I saw my surgeon after the ortho, and he reiterated the plan to me. He also took a look at the area in my left cheek where I suspected the screws are backing out. He took a look at my pano from Oct and said he can see on the xray that they are loose. Something about seeing dark area around the screws and it means the screws are loose and that is the hole/fresh bone that is left. Great. So, since it's just tender and a little puffy now with no signs of infection, he suggested leaving them as long as possible. If I can survive the year until revision (yes, a year, because my ortho wants to SLOWLY close that space so the roots of my teeth don't get damaged doing it quickly like my first ortho did), then he's just going to take all the hardware out then anyway and I could avoid the minor surgery where he would have to knock me out in his office and go in and get the plates/screws. I am not sure I can hold out that long. These things are already bothering me enough that on my more sore days I am waking up out of a dead sleep when I roll over on to my left side that is bothering me. It will probably get worse and eventually get infected if I had to guess. But, it's worth a try doing this if I can avoid yet another (all be it minor) surgery. So, anyway.... I was right when I noticed something wasn't feeling right in my cheek! Definitely always trust your instincts with this stuff!
So.. that's the plan! A week left to eat my favorite gummy candy. Bbbbooo! The break has been nice though. I think I am about 8lbs heavier thanks to the holidays and all of my sugar gummy binge eating the last month, but it's been great. Excited, and as always, a little nervous, to have a plan and push forward from here!
So, I am scheduled now for Tues Jan 27th to go to the ortho and he is going to fit my upper molar bands on and full lower braces. They are only doing the lower for now, and will probably be like that through much of my treatment leading up to surgery. Ortho feels that my top teeth really don't need a lot of pre op work since they are set up already, and they just need to work on closing the space and bringing that lower arch in with the bottom appliances. He also said this is a good route to go since most of my upper fronts have the root resorption, and this will save those teeth from further unnecessary damage. I'll probably get the uppers right before surgery, and then he'll do the work post op to fine tune the bite and any tweaking on any upper teeth to get them in their final positions. I love that he is paying attention to the root issues (thanks, prosthodontist, for weighing in and being apart of the planning!!), because I got no attention to that the first time around which is why my 3 front teeth are in the shape they are in now. I never got all of this attention in the planning either. I am just kicking myself and really wish I had this the first time around! Anywho... I get the lower braces on, then go straight over to the surgeons office to get the lower right incisor out, and then back to the ortho to get the arch wire put in and I'll be on my way. I am NOT looking forward to this. Tues night is probably going to be miserable. Getting a tooth out and being stitched there AND dealing with the initial pain of having braces and an active wire going for the first time in 4 months... I am probably not going to be a happy camper, but no pain no gain and need to move forward this way.
I saw my surgeon after the ortho, and he reiterated the plan to me. He also took a look at the area in my left cheek where I suspected the screws are backing out. He took a look at my pano from Oct and said he can see on the xray that they are loose. Something about seeing dark area around the screws and it means the screws are loose and that is the hole/fresh bone that is left. Great. So, since it's just tender and a little puffy now with no signs of infection, he suggested leaving them as long as possible. If I can survive the year until revision (yes, a year, because my ortho wants to SLOWLY close that space so the roots of my teeth don't get damaged doing it quickly like my first ortho did), then he's just going to take all the hardware out then anyway and I could avoid the minor surgery where he would have to knock me out in his office and go in and get the plates/screws. I am not sure I can hold out that long. These things are already bothering me enough that on my more sore days I am waking up out of a dead sleep when I roll over on to my left side that is bothering me. It will probably get worse and eventually get infected if I had to guess. But, it's worth a try doing this if I can avoid yet another (all be it minor) surgery. So, anyway.... I was right when I noticed something wasn't feeling right in my cheek! Definitely always trust your instincts with this stuff!
So.. that's the plan! A week left to eat my favorite gummy candy. Bbbbooo! The break has been nice though. I think I am about 8lbs heavier thanks to the holidays and all of my sugar gummy binge eating the last month, but it's been great. Excited, and as always, a little nervous, to have a plan and push forward from here!
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