Re: 5 weeks post-op and midlines not lining up correctly.

[Guest guest]

Hi there,

Today's five weeks for me, too. The first week or two after

surgery I could tell that the midline was off by maybe a mm. The

doc put on bands to correct other deficiencies but they pulled the

midline back into alignment. Now a few weeks later they've

pulled it off again in the other direction, by maybe a half a mm.

But my point is that at this time in your recovery bands may do

the trick. Next time you see your surgeon make it a point to

discuss your concerns and ask specifically why he is satisfied

with the positioning. Always makes me feel better to know why

things are the way they are. Good luck,

> One of the problems my upper Le Fort and lower surgeries

was meant to

> correct was a midline assymetry, where the midline of the

bottom teeth

> was a good 3 - 4mm to the left from the top midline.

>

> Anyway, I'm now 5 weeks post op and healing up nicely, and

the surgery

> did a good job of correcting my open bite, but the midlines still

seem

> to be 1 to 2mm off. Each time I've gone in for my weekly

post-op

> checkups, though, my surgeon had assured me that everything

looked

> great, and that the midlines were perfect, even when I brought

up my

> specific concern.

>

> So I'm at the one time reassured that my OS thinks everything

looks

> great, and at the same time a bit frustrated. I mean, I'm not

blind.

> I can see that the midlines are off by a little bit, but my surgeon

> doesn't seem to think there's a problem. Did anyone else

notice

> assymetric midlines post-op, and was it something that could

be

> corrected with post-op orthodontic treatment?

[Guest guest]

Also, (pressed send too early!) that kind of problem can most

likely be fixed orthodontically as well. I have gaps where the

osteotomy was made, which leaves plenty of room for the OD to

move things where she wants them. Talk to your docs, explore

your options.

> One of the problems my upper Le Fort and lower surgeries

was meant to

> correct was a midline assymetry, where the midline of the

bottom teeth

> was a good 3 - 4mm to the left from the top midline.

>

> Anyway, I'm now 5 weeks post op and healing up nicely, and

the surgery

> did a good job of correcting my open bite, but the midlines still

seem

> to be 1 to 2mm off. Each time I've gone in for my weekly

post-op

> checkups, though, my surgeon had assured me that everything

looked

> great, and that the midlines were perfect, even when I brought

up my

> specific concern.

>

> So I'm at the one time reassured that my OS thinks everything

looks

> great, and at the same time a bit frustrated. I mean, I'm not

blind.

> I can see that the midlines are off by a little bit, but my surgeon

> doesn't seem to think there's a problem. Did anyone else

notice

> assymetric midlines post-op, and was it something that could

be

> corrected with post-op orthodontic treatment?

[Guest guest]

Hi!

I'm going on 6 months post-op Sept. 9th and my dental midlines are

only just starting to line up... Anyway, one reason I had the

surgery was also to correct assymetry in my upper and lower jaws. The

upper midline was over to the right and the lower was over to the

left. SO, after my surgery, structurally- skeletally, my midlines

were aligned. My teeth however weren't there yet. My ortho couldn't

put my teeth in exactly the projected correct position prior to

surgery because my arches were adjusted including an upper palate

split, so it has been a matter of correcting things after the

surgery. When your surgeon says that your midlines are fine, maybe he

is refering to the bones since that is what he is primarily concerned

with.... and your ortho would be concerned with your dental

alignment. Maybe you and he are just misunderstanding each other. In

any case, your ortho should definitely be able correct that and I

would imagine 1 or 2mm isn't a big deal at all. That's what post-op

ortho fine tuning is for . When I expressed my concerns to my

surgeon, he assured me that my bones were exactly where they needed

to be and that I just had a lot of post-op ortho awaiting me. Uhg!!

My midlines (in my teeth) postop were off by about half a tooth( more

than 1 or 2mm) -the left side of my upper jaw was totally off

regarding the positioning of my teeth. So, for the past few months,

I've been wearing a rubber band on that side to shift all the teeth

over by half a tooth. Never fear, after a few months, they are

finally in place and we are fine-tuning the front including getting

the midlines of my teeth aligned. Definitely discuss this with your

ortho and he can give you an idea of what he needs to do/will do to

perfect your teeth and bite post op. I made my ortho see me early

just to reassure me for some of my concerns! They are there to

maintain a dialogue with you regarding what is happening with your

mouth and their plans for your treatment. Since you've spoken with

your surgeon, make an appt. now with your ortho. Anyway, your ortho

will be the best reassurance, but hopefully this will help! At least

in my case, ortho has been able to correct the midline misalignment

and lots of other things too. It IS frustrating though to read about

people postop who have perfectly aligned bites right out of surgery!

Sigh.... I wish!

Good luck and keep us posted,

Katja

> One of the problems my upper Le Fort and lower surgeries was meant

to

> correct was a midline assymetry, where the midline of the bottom

teeth

> was a good 3 - 4mm to the left from the top midline.

>

> Anyway, I'm now 5 weeks post op and healing up nicely, and the

surgery

> did a good job of correcting my open bite, but the midlines still

seem

> to be 1 to 2mm off. Each time I've gone in for my weekly post-op

> checkups, though, my surgeon had assured me that everything looked

> great, and that the midlines were perfect, even when I brought up

my

> specific concern.

>

> So I'm at the one time reassured that my OS thinks everything looks

> great, and at the same time a bit frustrated. I mean, I'm not

blind.

> I can see that the midlines are off by a little bit, but my surgeon

> doesn't seem to think there's a problem. Did anyone else notice

> assymetric midlines post-op, and was it something that could be

> corrected with post-op orthodontic treatment?

[Guest guest]

My midlines are off, but nobody -- including me -- is worried about

it. As my ortho and surgeon explained to me, if you have different

size teeth upstairs and down, and have lost different numbers of

teeth in the two jaws, the midlines may not line up. If everything

else works fine, I decided, I'm not worrying about the midlines. They

match up with my face, but my teeth are about one tooth off. Come to

think of it, my surgeon was clearly careful about it. I went to watch

them do one of the preparatory procedures on the models, and he kept

coming back to my face with that piece of dental floss, to check

where the midlines were and how they'd match up.

Since you're worried about it, though, why not tell your surgeon

and/or ortho what your concerns are. If someone tells you things line

up, and you don't think they do, speak up, ask for a mirror, and

point it out directly.

That said, though, it's not unusual for midlines to be off post-op

and get corrected, generally with the use of elastics. I do know of a

couple of folks, though, who've elected to have another round of

surgery in order to get the midlines just so.

Cammie

> One of the problems my upper Le Fort and lower surgeries was meant

to

> correct was a midline assymetry, where the midline of the bottom

teeth

> was a good 3 - 4mm to the left from the top midline.

>

> Anyway, I'm now 5 weeks post op and healing up nicely, and the

surgery

> did a good job of correcting my open bite, but the midlines still

seem

> to be 1 to 2mm off. Each time I've gone in for my weekly post-op

> checkups, though, my surgeon had assured me that everything looked

> great, and that the midlines were perfect, even when I brought up

my

> specific concern.

>

> So I'm at the one time reassured that my OS thinks everything looks

> great, and at the same time a bit frustrated. I mean, I'm not

blind.

> I can see that the midlines are off by a little bit, but my surgeon

> doesn't seem to think there's a problem. Did anyone else notice

> assymetric midlines post-op, and was it something that could be

> corrected with post-op orthodontic treatment?

[Guest guest]

what does your ortho say? my midlines were perfect pre-surgery and

post-surgery were off by about 2mm too. my ortho said it wouldn't be

a problem to correct and sure enough 3 months post op they seem to

finally be lining up perfectly again. i'd speak to your ortho too as

he's the one that will be performing the ortho treatmeant and not

your surgeon.

Sara

> One of the problems my upper Le Fort and lower surgeries was meant

to

> correct was a midline assymetry, where the midline of the bottom

teeth

> was a good 3 - 4mm to the left from the top midline.

>

> Anyway, I'm now 5 weeks post op and healing up nicely, and the

surgery

> did a good job of correcting my open bite, but the midlines still

seem

> to be 1 to 2mm off. Each time I've gone in for my weekly post-op

> checkups, though, my surgeon had assured me that everything looked

> great, and that the midlines were perfect, even when I brought up

my

> specific concern.

>

> So I'm at the one time reassured that my OS thinks everything

looks

> great, and at the same time a bit frustrated. I mean, I'm not

blind.

> I can see that the midlines are off by a little bit, but my

surgeon

> doesn't seem to think there's a problem. Did anyone else notice

> assymetric midlines post-op, and was it something that could be

> corrected with post-op orthodontic treatment?

[Guest guest]

Hi,

I had a Lefort 3-piece on June 28th and noticed also that my midline

did not line up properly. I was informed by my OD that he was trying

to achieve a functional bite versus my midline being perfect. The

banding is bringing my midline a bit closer, but it is still off

about 1mm. But on a good note, all my teeth now have contact which I

haven't had for years because of my open bite.

--Caboose

> > One of the problems my upper Le Fort and lower surgeries was

meant

> to

> > correct was a midline assymetry, where the midline of the bottom

> teeth

> > was a good 3 - 4mm to the left from the top midline.

> >

> > Anyway, I'm now 5 weeks post op and healing up nicely, and the

> surgery

> > did a good job of correcting my open bite, but the midlines still

> seem

> > to be 1 to 2mm off. Each time I've gone in for my weekly post-op

> > checkups, though, my surgeon had assured me that everything

looked

> > great, and that the midlines were perfect, even when I brought up

> my

> > specific concern.

> >

> > So I'm at the one time reassured that my OS thinks everything

> looks

> > great, and at the same time a bit frustrated. I mean, I'm not

> blind.

> > I can see that the midlines are off by a little bit, but my

> surgeon

> > doesn't seem to think there's a problem. Did anyone else notice

> > assymetric midlines post-op, and was it something that could be

> > corrected with post-op orthodontic treatment?

[Guest guest]

I had my surgery (upper, lower + genioplasty) about 5 months ago. Post

op, my midlines were not lining up correctly and I had to wear

elastics 24/7 for around 3 months. The main reason why your midlines

don't line up is because your muscles are accustomed to the imbalance

of your jaw (pre-op) and have developed to compensate for this.

Because of the imbalance in the jaw, most people tend to chew

predominantly on one side. Post-op you have to ensure that you start

chewing on the other side to develop those muscles and to get them

used to more chewing.

After about 3 months, I noticed that my midlines were starting to line

up and for the last couple of months I only wore elastics at night.

I just got my braces off 2 days ago and am very happy with the result.

Having said that, if I don't bite creating more pressure on my left

side then my midlines will be off by about 1mm - but again it's about

building up those jaw muscles so that they get used to your balanced bite.

> > > One of the problems my upper Le Fort and lower surgeries was

> meant

> > to

> > > correct was a midline assymetry, where the midline of the bottom

> > teeth

> > > was a good 3 - 4mm to the left from the top midline.

> > >

> > > Anyway, I'm now 5 weeks post op and healing up nicely, and the

> > surgery

> > > did a good job of correcting my open bite, but the midlines still

> > seem

> > > to be 1 to 2mm off. Each time I've gone in for my weekly post-op

> > > checkups, though, my surgeon had assured me that everything

> looked

> > > great, and that the midlines were perfect, even when I brought up

> > my

> > > specific concern.

> > >

> > > So I'm at the one time reassured that my OS thinks everything

> > looks

> > > great, and at the same time a bit frustrated. I mean, I'm not

> > blind.

> > > I can see that the midlines are off by a little bit, but my

> > surgeon

> > > doesn't seem to think there's a problem. Did anyone else notice

> > > assymetric midlines post-op, and was it something that could be

> > > corrected with post-op orthodontic treatment?