So, January was relatively uneventful orthodontically. I traveled quite a bit for work, so that made the month fly by. I had a couple of migraines, but not alcohol induced. They were most likely hormonal, given the timing. I guess I need to be more diligent about taking my magnesium again. On February 2nd, I had another orthodontist appointment. Got a powerchain all the way across the top, and no longer on the bottom. Elastics only on the right side at night. Here is a progress pic from that appointment:
The following day, I had an appointment with my OS. Everything looked good, except my ROM, which I expected. I was only at about 30 mm, and I don't think I've progressed much more since then. So, I am not released yet from his care until I get up to at least 40 mm. I have a follow-up appointment for May, at which time I hope to be to where I need! I will be working on it daily, as I am afraid that if I don't I will loose it. He doesn't want me to do tongue retractors or put anything physically in there, for fear I could damage my teeth. So, stretching exercises it will be.
At some point in February, I thought I had a piece of food stuck in between my tooth/band on my upper left side, so I started digging with a toothpick. Well, I don't have the feeling back in my upper gums, so little did I know that I was actually picking at my gums. I made a mess out of them, and with the band around the tooth, it didn't allow it to heal very well, so it is still a bit of a mess. Things should get better now, though.
One week before debanding, I had a DOUBLE power chain put on my upper teeth, one below the archwire and one over top of it. That was fun. While putting it on, one bracket popped off my upper right tooth. We got the bracket repositioned and back on, and wouldn't you know, the other bracket popped off the upper left tooth. Geez! The objective of this torturous dual powerchain configuration was to close the gaps next to my upper canines. Soon after the visit, the one on the left was closed. But the stubborn one on the right persisted, and I was incredulous that I would really get my braces off yesterday. So, skeptically, I went to my debanding appointment.
I am not going to sugar coat it. It was a painful experience. With the feeling starting to come back in my upper gums, everything is ultra-sensitive. I used to love brushing with my sonic care, and even that was not a pleasant experience any more. The vibration against the brackets is annoying. The wierdest part, when sanding off the glue, the feeling is criss-crossed along the gumline above my top front teeth. My bottom teeth didn't like the pressure when taking off the lower brackets, either. I felt bad for the hygienist. She was trying so hard to be gentle, but I felt like somewhat of a baby. I usually have a pretty good threshold for pain. But, I got through it, and I was willing to endure ANYTHING to get those babies off. Before getting the brackets off, she put a double power chain on the upper front teeth to close the remaining gap. It opened back up after taking off the chains, but the tooth is mobile, so the retainer will put it in its place.
I need to forewarn those who have bands on their back teeth. Although I felt I've kept very good hygiene throughout this process (except for the weeks post-op when I wasn't allowed to brush), there was a very disturbing stench when taking those bands off. Luckily, the hygienist wears a mask, otherwise I would have fully expected her to gag.
Since debanding, I do have to admit I have been obsessively narcissistic, looking in the mirror incessantly at my new shiny teeth and bite. "This isn't my mouth!" I exclaimed when I had my first look. The results, using the words of my orthodontist ... "Perfect".
So, now that I have completed the majority of this process, I feel that it is high time to give due credit to the amazing team of professionals that have gotten me to this point. I have added a list on the left side of this page that includes a hyperlink to my OS, OD, and dentist. I wouldn't have started on this journey if it wasn't for my dentist, Dr. Villwock, referring me to see an orthodontist. From there, Dr. Lin, my OD, took over and diagnosed me with vertical maxillary excess with mandibular AP hypoplasia. Dr. Lin referred me to Dr. Parmar, my OS, who is the most empathetic surgeon I could ever ask for! Combined, they have provided me with a result far superior to what I could have ever envisioned. I am so grateful for their expertise, patience, and professionalism. I wouldn't change a thing about any part of my treatment. I was and am truly blessed. And, I could never forget everyone at their offices who were always my biggest cheerleaders, along with my family, friends, and of course all of my fellow ortho bloggers! Cindy, Lisa, and Traci at Bellevue Family Dentistry have always been wonderful to me, and especially through this process! The countless number of techs at Orthodontic Specialists who worked on me and always had positive and encouraging things to say. And the receptionists at Bay Oral office who I got to know very well since I was there once a week for oh so many weeks post-op while waiting for that exposed plate to heal over. Sorry if this sounds like an Oscar acceptance speech, but I am forever grateful to everyone involved in this process, the results have been truly amazing. Now, when I place my hands on each TMJ and open my mouth, I no longer hear the cracking in the right joint and feel the popping out of the left joint. I can actually see my bottom teeth when my teeth are together, and at the same time I can feel the back of my upper teeth with my tongue! There are so many functional differences, not to mention the relief that I am not continuing to wear down my joints. The cosmetic improvements were a very positive side-effect. This was all so worth it.
So, I am sure you want to see pictures of my naked teeth! I'll start off with a picture of Dr. Lin and I, freshly de-braced!
Below are my before and after photos. The befores were taken in June, 2007, and afters in March, 2009. I now introduce you to my Class I bite!:Front view, no smile. Notice the lack of lip incompetence! No more puckering of the chin when my lips cme together. Also, the nose has changed. I didn't think I wanted my nose to change from this surgery, but I definately think I like my new nose better!
Front view, smile. No more gummy smile! I no longer need to posture my jaw forward so I don't have a double chin!
Right profile. I have a chin! Nuff said. Also, look at the difference in the angle of my upper lip. Dramatic difference.
Front teeth, closed. My lower teeth are now visible ... no more deep bite!
Front teeth, slightly open. Dramatic difference in the crowding of the lowers.
Left and right occlusion. Check out that Class I relationship. No more overjet or overbite. Very swollen gums from lots of torture, but an extremely satisfied patient!!
Upper Arch. Check out how much it widened and rounded out.
Lower Arch, a picture is worth a thousand words.
For retention, I have a fixed lingual retainer on the bottom, and an essix retainer on the top. I am to wear the essix day and night for 3 months, until instructed otherwise. My gums are too swollen at this point to get floss in at my gumline on my lower teeth, so I need to allow the swelling to reduce and work on that with some oral pix. I plan to give my mouth a rest for a while, and next year I need to have one of my molars crowned due to a large filling, and will slowly get my metal fillings replaced by composite ones.
I will post again soon with some of my reflections on this whole process. I still follow all of your blogs, and look forward to your updates. Hopefully, my blog will serve to educate future orthognathic surgery patients as your blogs have educated me! In the process, it has been incredibly therapeutic and I have created a diary of my journey along the way.
In addition to the wider airway, there is a dramatic difference in the soft tissue around my chin in the above x-ray. When I got my plate removed last Thursday, I mentioned to Dr. P that I haven't had any migraines. He mentioned that coventional wisdom points to my now stable occlusion and less load on the joints, however he also has been reviewing some recent research on airway and I believe he said fibramyalgia. Basically, these studies show that there is a correlation between pain and small airway. When the airway is opened, the patient many times doesn't experience some of the pain they suffered from before. This could also be something that is helping to reduce my migraines, in addition to to my TMJ's being much more stable now. The piece I don't really understand is why I used to get migraines when I drank alcohol, and now it seems that alcohol does not trigger a migraine for me anymore. I was hoping for my migraines to be reduced with the surgery, but I honestly didn't think they'd be eliminated completely because I never thought it would prevent me from getting one when I drank. In the end, I guess I don't need to understand it, I am just elated that they have been almost non-existant! I just hope it stays that way!
Here is my panoramic x-ray, so you can see all of my hardware. You can also see the gaps in my bones from where my mandible was advanced.
I will post more pics of my teeth and bite later this week. My teeth were somewhat sore after my ortho appointment today, I don't know if it is because that space is already trying to close up, or because I was really aggressive with chewing today. I am hoping my ROM will start to increasing at a faster rate now that I am only in bands at night. 
