Questions for follow up with surgeon (so far)

Hope everyone had a Merry Christmas and wonderful holiday season with family and friends!!!

Surgery is now 3 months away for me. Can't believe how quickly it's coming up, getting nervous and excited! Will be glad when it is here and done to get on with things.

Here are some of the questions I have for my follow up appointment with the surgeon at the end of January. Some have been borrowed from other blogs (thanks!). At my initial consult last year he thought just lower surgery would be necessary and genioplasty could also be done if desired. I have had more extractions since my initial appointment which I think has improved my tooth to gum ratio (less gummy. Anyways, here are my question so far:

What do you recommend? Do you think my teeth (gaps) will be ready by March 28th?
How much overjet do I have now(measurement)?  
Asymmetry?
What is the most the mandible can be advanced (and that you have done)? 
How much movement (and what kind) do you expect?  
Will BSSO be sufficient to correct bite?
Does amount of movement increase risk of permanent numbness?  Age?
Discuss hardware used to stabilize. 
Is there anything about my jaw discrepancy that can't be corrected, or can only partially be corrected?  Previously mentioned open bite...front/back?
Can these things be corrected orthodontically?
Can I expect a perfect bite post-op/post-braces?
Any incisions to face or intraoral only?
About how long will the surgery take?
Will it be you or a resident performing the surgery?
Will I be banded or wired shut?  (previously said not wired) For how long?  
Splint? Surgical hooks?
Swellling...Ice good or bad? Manual lymphatic drainage (massage)?
What changes can I expect in my face?  Do you have software that can show me potential profile and front view pictures?
How will surgery effect lip competence?
How will surgery effect mouth breathing?
Does genioplasty increase chance of permanent numbness with increased traction on the nerve?  Opinion re: need for genioplasty?
Can I expect to be free of jaw related headaches after?  Jaw clenching?
What are my chances of relapse? What causes relapse?
Supply list?
Diet info? Vitamins (Calcium, D, B)? Protein powders?
Postoperative meds? Antibiotics?
Chronic nasal inflammation...post-nasal drip, swelling, breathing, prior injury to nose
Preoperative physical? When?
Should I stay in the city overnight? Inpatient? Day surgery and I live two hours away in another city.
Sleep positions postop?
When is first follow up office visit? Timing of other visits to plan for travel/work. 
Time off work?
Bleeding
Any long term risks? Hardware...
Cosmetic suggestions re: bonding canines post-braces, who to see?

Yikes, that's a lot of questions but I'm sure he's used to it.

If anyone has ideas for other questions to ask feel free to comment. Thanks!

Closing the gap...and making a new one

Hey there bloggers...sorry this post is a bit delayed.  We've been working on a renovation project so access to my PC for uploading pics has been limited.

I had another adjustment done in early December and my upper extraction gap is slowly closing. I now have a new one developing between my front teeth as everything shifts over; which I know is necessary but still annoying. Can't wait until they are all closed up! I have had the same arch wires for the last couple adjustments, just replacing the power chains so nothing too exciting to report.

I got a double chain on the lower arch between my central incisors. Bottom teeth were super sore when getting the power chains on..OUCH! They seem to feel a bit loose at times and wiggle/click a bit, hope this isn't bad, I forgot to ask at my appointment. I go back in a month so will have to try to remember to ask then.

I also got a message from my surgeon's office the other day to call back and schedule another pre-surgical consult since I haven't seen him since last February and my braces weren't even on yet at that time. I'm getting a bit nervous about the surgery but excited to have a normal bite when all is said and done. It will be nice to come up with an official surgical plan. At my first appointment he thought we could like just do the BSSO mandibular advancement and possibly genioplasty instead of having to have maxillary surgery as well. My surgical consult is booked for January 30, 2012.  Hope things will progress enough in terms of the gaps closing so that I am surgery ready come March...

Here are some new pics:

       UPPERS

Dec 2011 compared to Aug 2011

   SMILE

Dec 2011 compared to Aug 2011

 Midline is definitely improving

(seems slow to me but a lot has to move)

 LOWERS

Dec 2011

6th Adjustment

I had my 6th adjustment today, 4 weeks from the last one. There has not been a lot of movement since last months appointment. My ortho joked that I should stop drinking milk...lol! I got my upper power chain replaced with a wide chain instead of having an extra loop in the gap so hopefully that should create some more movement. The gap is still about 4-5mm.

My lower teeth are extra sore tonight, there is a new power chain on all the lowers. Tylenol and Advil are my friends tonight!!! It even hurt to chew rice at supper...

Here are the new pics:

 I love the new rounded arch shapes, you can see more teeth when I smile :D

Upper midline seems to be shifting slowly

             Here are a few of my overbite and profile:
(You can see why this cannot be corrected without surgery)

Bite closed from the side, uppers and lowers very far apart

 Bite closed, view from below, YIKES

Relaxed profile, can't believe I'm posting this one!! 

I know my fellow bloggers are sympathetic...

'Til next time :)  Now for some more drugs then off to bed...

6 months (and a bit) later...

I can't believe six months has gone by already! Sorry about the lack of posts for awhile.  I've been busy with work, family, dogs and life in general.  Things are moving along nicely with my braces, still waiting for my lateral gap to close. I got a power chain added to the left side of my uppers to start closing it more quickly, more sore now :(  I have decided I like the silver powerchains as they stain less than the clear or whilte ones.  At my last appointment my ortho agreed to grind the hooks off the upper right canine bracket which has made my lip happier, but also gave me a strange rash, maybe the little bits of ceramic were irritating.  And hooray my lisp that showed up after the upper extractions seems to have resolved!!!  Glad that was only temporary, it was very frustrating especially at work, made me even more self conscious of my new toothless look. 


I can't believe how quickly my bottom "straggler" has moved into place.  I am noticing that my overbite is definitely getting worse and I was warned that they need to make it worse for now and the BSSO surgery will correct it, still annoying and starting to give me some TMJ pain.

 Here are some new pictures from Sept 2011: Six months in braces...

The deed is done!

My upper lateral incisors are officially gone...extractions were yesterday. I would have posted sooner but they looked kind of icky plus I had a sick and cranky kiddo. I will say I'm not a fan of the gap however my family, friends and coworkers have been really supportive which has made the transition easier. I know it's only temporary and will look the best in the long term!  The canines will still need to be reshaped and bonded after braces are removed and after I have my teeth whitenened...

On a more exciting note, my lonely unwired bottom tooth has now been connected and is on the move literally has moved since yesterday (ouch but YAY!!!). My lowers are more sore than the extraction sites! I also have a bit of a lisp now but think this will improve with time once I adjust to the extra space for my tongue now that the especially wonky upper tooth is gone.

Here are the latest pics:

Upper arch with extractions

 

Before braces photo for comparison

Lower arch, gap on right closed, left side smaller, all teeth strapped in...yipee!!!

Before braces photo for comparison

Smile with "the gap", excited to be able to correct my upper midline!

Decision made...

So I made my big decision and have decided to go with extracting both laterals. I'm not excited about the process but know the end result will be worth it! It's funny to me that I debated more about this than the jaw surgery. Now I'm waiting for my dentist to get back from vacation so I can hurry up and get it over with. They removed the spring on my upper arch and the space where the lateral is now seems to be getting smaller again which is good, less of a gap to close :)

As an aside, I was a little frustrated at my last appt with my OD. I know he's busy and sees a lot of patients but he often asks the same questions or does not remember important things about me. I asked him if i chose extractions how the upper teeth would move (would the front teeth move back or back teeth move forward?) and he went into answering about how the only way to correct my bite was for me to have jaw surgery...HELLO my surgery is booked for next March!!! I was really quite shocked, told him my surgery was booked already, if it happens again I will call him out on it but in the moment I didn't really know how to handle it. I just needed to rant about this, feels better already!

Anyways, that's all for now. My next post will likely be after my extractions once I get my appointments coordinated.

Need to make a BIG decision...opinions please!

Here's a quick update and then I'll share my dilemma with you...So I went in for my 2nd adjustment yesterday and things are progressing very well. I got new power chains on the bottom to close gaps (love the silver color), a new spring to make room for the unwired lower tooth and reshaped point off one upper canine.

Left

Right

Now, about my BIG DECISION...please share your opinion and be completely honest...

So I have been trying to decide about having my upper canines reshaped like laterals (since one lateral for sure has to be extracted). I mentioned to Dr. W that I am not happy with how gummy the spot over my lateral looks when I smile, I'm a type A and would really prefer symmetry...Here are some photos to give you a better idea:

Smile pre-braces

Recent casual photo, the gummy area is obvious

Front view

Upper arch

Sooooo my options are:

Option 1. Have the 2nd lateral extracted, best way to get symmetry and correct midline of central incisors. Best aesthetic end result as per the OD. sounds great right?.....BUT I'm so scared to have this tooth extracted as the gap will be HUGE for quite awhile and very visible. He didn't say exactly how long but I would guess a few months based on my other extraction gaps. Don't really want to look like a hillbilly, lol...I'm in a professional line of work too (health care) so I feel how I look matters. I realize this would only be temporary but once the tooth is gone I can't change my mind! The OD seemed very pleased I was considering this option. I asked about a fake temporary tooth (I think it`s called a pontic) but he said this wasn't an option :(

Option 2. Keep the 2nd lateral, have a procedure to cut away gum tissue (to make tooth appear taller) but won't quite resolve the gummy issue due to tooth height discrepancy. Uppers will remain asymmetrical and midline cannot be completely corrected.

I have until next Thursday to decide as he didn't want me to make a snap decision. But he needs to know so he can stop making room for the lateral if the teeth will need to be moved in the other direction...If it were you, what do you think you would do???