First, I wanted to get braces at age 15, because I thought my teeth were “too forward”. I consulted with 2 orthodontists who both said I needed to have my 4 bicuspids extracted. I went to a third orthodontist who gave me 2 options after he saw the required X-Ray: either to extract or not to extract. If I extract he said, I will have room for my wisdom teeth when they erupt. If not, I have to remove them surgically before I get the braces. Unfortunately I chose bicuspid extractions, even though all my teeth fitted in my mouth, and I just had a bite problem. I got braces for 4 years; first my lower jaw was brought back and then my upper jaw, both by wearing headgear (J-Hook), then the orthodontist used elastics. I need to mention that he pushed my front teeth back a little, and advanced my molars forward a little in order to close the gaps but I don’t know if this is a good thing or if it diminishes the damages done. I hope you can clarify this point :)
Now I’m 25, and I have one wisdom tooth erupted (it’s perfectly healthy and fits well in my mouth), one erupting and the other 2 are starting to show. Also I think I have no TMJ, no headaches, no sleep disorders, so in general no health problems. However, my tongue does not fit well in my mouth and it bugs me sometimes, even though I quite got used to it… also, I do not like how my profile looks as I think it moved from a class I to a class II profile (I compared before and after pictures after doing an online research). When I bite my upper jaw does not meet well with my lower jaw, meaning that I have to push harder for my lower jaw to come forward (overbite?...) and I find that my smile is narrow. I used to have a wider smile. My nose which already has a bump is more prominent and the bump looks bigger. My lips are less full than before the extractions. See, my problems are mostly from a cosmetic viewpoint…
I have a few questions:
-If I want to reverse all these unwanted effects, is it necessary to replace the 4 bicuspids in my case, or can my jaws simply be moved forward to return to a class I profile without recreating spaces and getting implants? I mean can all teeth be moved forward without creating TMJ problems?
-Will my face and profile look like before? Will I look good from a cosmetic point of view?
-What kind of appliances apply to my case?
-Is it necessary to use expansion in my case?
-Do I need to be in full brackets the whole time of treatment?
-I understand from one of your replies that sometimes when the upper jaw is moved forward the lower jaw tends to move forward naturally. Can this be applied to my case even though headgear was used on my lower teeth?
-Is it an option to use invisalign?
-How long will the whole process take?
Sorry for the load of questions… :)
I thank you a lot in advance for your time and your help.
Suzie B.
b - things start shifting as we grow older.it just the way life is.teeth wont shift again of course if one has permenent retainers placed on the back of the teeth but thats it.invisalign is for minor teeth straightening.i would go see an ortho for a consult.we all have to get re aligned here and there as we age if we have the cash,lol.
ReplyDeletetooth975 - You had typical bicuspid extraction treatment where bicuspids were pulled and the front teeth were retracted. This results in loss of lip support and a dished-in profile. When the spaces created by this treatment are closed, almost all is the result of the front teeth moving posteriorly and very little from molars moving forward. And YES, molars moving forward would definitely be a plus but unfortunately such movement is almost always insignificant because multirooted molars are VERY difficult to move and takes much more time to do.
ReplyDeletePulling the upper jaw and the lower jaw back usually causes posterior-superior displacement of the condyles which in turn will cause anterior displacement of the articular disk whenever your teeth come together. This causes the jaws to click and pop. You are 25 now but you are not out of the woods yet. TMJ has been known to develop in patients as old as in their mid 30's. You can self diagnose TMJ by inserting your pinkies into your ear canals with the soft portion forward and opening and closing. If you feel no clicking then you do not have TMJ; if you do feel clicking then you have a TMJ disorder. Pain and the other symptoms often associated with the disorder may come later; it will all depend on how well your body handles stress and trauma. You may just be lucky enough to be one of the few females who will not develop a TMJ disorder.
A cephalometric analysis and full orthodontic workup including a model analysis will need to be done before any of the questions you asked can be answered. Not being able to actually see you in person and assess your profile also makes it impossible to answer your questions. I can only tell you that the normal way to reverse the effects of bicuspid extractions is to reopen all the spaces and use implants to restore the gaps. When an entrapped mandible is released, the mandible often comes forward on its own and how much is uncertain but in adults it is usually minor. Usually a functional appliance (like Twin Blocks) will be needed to move it to a Class I after the maxilla is properly situated again. What appliances will be used will depend on the orthodontist's experience and expertise as each patient is an individual case.
Invisalign cannot do any of this.
Expect a treatment time of no less than 2 years. A cephalometric analysis will show the severity of your problems and what will need to be done. I apologize for not being more specific but only very generalized treatment plans and procedures can be given online since the patient is not physically present and the necessary records are not available.
Although I have not done so, I have attended TMJ seminars where the orthodontist have maintained the 4 bicuspid extraction situation and moved the upper and lower jaws anteriorly to correct a TMJ disorder. From this one can assume that partial facial profile improvements also resulted. You cannot just move teeth alone, entire jaws must be moved.