For those of you who do not know, “orthognathic” is derived from the greek words “ortho”, meaning straight, and “gnathos”, meaning jaws. Orthognathic surgery is surgery performed on the bones of the jaws to change their positions.
So how did all of this start? It started about seven years ago, when I was speaking with my general dentist after a routine cleaning. I had been having some minor issues with TMJ dysfunction, and was not pleased aesthetically with my lower teeth, despite having worn braces for several years as a child. He referred me to an orthodontist, who I went to visit.
After taking molds and x-rays, the orthodontist presented me with two options. The first was a combination of orthodontics (braces) and lower jaw surgery. The second option was orthodontics only, but he would need to tilt my lower teeth forward which could increase the probability I would need some bone grafting done in the future, which would not be the optimal solution. He referred me to an oral surgeon, and I went for a consult.
To make a long story short, the oral surgeon submitted the procedure to my insurance, and they denied coverage. My orthodontist fitted me with a splint to ease my TMJ dysfunction and minimize clenching and grinding when I sleep. The splint to me was incredibly uncomfortable because it held my jaws in what was an “unnatural” position … although that is where my bite actually fit together the best. What I have learned now is that I have been most likely “posturing” my lower jaw forward for many years, even though this led to my bite not fitting together properly. The splint was really just a temporary “fix”, but it certainly did not address the root cause of the problem. I was not at a point in my life to consider paying for surgery out of pocket, so I moved on.
Now fast forward about six and a half years. Over time, I have developed crippling migraines and significant pain associated with my TMJ dysfunction. I can hear grinding in the right TMJ joint, and my left TMJ pops when I open my mouth wide. At times I get a sharp pain in my ear, but I have also found out this has nothing to do with infection, but is most likely a result of my TMJ dysfunction as well. After another routine dental exam in May 2007, my dentist again mentioned that technology has changed much over the last several years, and gave me another referral to the orthodontist. He referred me to the same practice, but a different orthodontist this time … one that my husband had recently been to and would be getting his braces on within the next few weeks.
They were quick to get me in for an appointment just two days later, and in mid June took some molds, x-rays and tomos. In mid-July, I had my consult to go over my treatment plan. I was only presented with one option this time, which was orthodontics combined with both upper and lower jaw surgery. My treatment coordinator showed me my tomo (a cranial scan that shows the joints from different angles), and I was able to see the significant deterioration of my right condyle.
The condyle is basically the bone connecting your mandible (lower jaw) to your skull. Where these connect is called the tempomandibular joint (TMJ). It is similar to a ball and socket … the ball being the condyle and the socket where it connects to your skull, known as the fossa. A healthy condyle is rounded, whereas my right one has been worn flat from the constant grinding. This happens because my occlusion (bite) is not balanced. By correcting my malocclusion (bad bite), my jaw will be in balance which should reduce my TMJ dysfunction. I also was showing wear on my lower incisors, which eventually could lead to tooth loss.
So … my journey begins. After seeing the deterioration in my joint over the last several years, I had decided that with or without insurance, I was going to pursue to correct this … after all it is my health and I own it!
1 comment:
Hi Stephanie,
My name is Caroline from Montreal, Canada. I am 33 years old. First, I want to thank you for your blog. It's really well done!
I am getting the same surgery (bimax) in 3 weeks. I have had my braces for 11 months. I have a class II malocclusion. For 10 years now, I feel cracking in my right TMJ every time I open my mouth and my left TMJ is popping out when I open wider but I have no pain, only discomfort. My condyles are still in good shape. My surgeon has informed me that the surgery would not necessary correct my TMD, it would be mostly to correct the alignment of my jaw and the slight facial assymetry.
My question to you if you don't mind...were you told by your surgeon that the bimax surgery would correct your TMD? Did it?
My orthodontist seems quite positive about improvement that the surgery would bring to my TMJ. I guess it does make sense that a wrong alignment of the jaws creates tension on the TMJs.
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