Tuesday, March 26, 2013

Comprehensive pre-surgical consultation

About a week before surgery, the orthodontist placed the surgical hooks on the teeth.  Since I have lingual braces, she placed clear brackets on the outside of each tooth for the surgeon to use. 

I returned to the surgeon for final models.  At this appointment, they took another set of molds, cephlometric x-ray and panoramic x-rays, profile pictures including pictures with mouth closed, mouth at rest, mouth in full smile, to help the doctor determine how much he needs to impact the upper jaw. Then they used something called a face bow to replicate how the jaw opens and closes.  They stick one part in your ears, align another part with your eyes and bridge of nose and then you bite on a wax form on a plate to determine the “hinge” of your jaw joint so they know how your jaw moves.  From there, the doctor will make plaster molds and do a mock surgery to determine exactly what he will do during the surgery.  From this, he also builds a splint, basically a plastic retainer that represents the bite he wants to achieve.  During the surgery, he wires your teeth to the splint via the surgical hooks and then can properly adjust the upper and lower jaws to achieve a good skeletal relationship.  After performing the mock surgery, the surgeon decided that he would only need to do the upper jaw surgery which will reduce healing time and risk while still getting me a good bite relationship.  He told me that he was going to move the upper jaw forward 1 mm and up 6-7 mm.  The lower jaw would auto-rotate into a good bite without having the BSSO.

Surgical models

Surgical splint aka wafer

Facebow setup