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What is the purpose of a 2 piece le fort I? Surgery Saturday!

(11 posts)
  • Started 5 months ago by bracedblogger
  • Latest reply from ocmama2four
  • 2 Members Subscribed To Topic
12

  1. bracedblogger
    Member

    I'm having surgery Saturday and my procedures include: 10.5 mm mandibular advancement with slight rotation and 2.5 mm maxillary impaction/2 piece le fort I. I am curious what the purpose of a two piece le fort I is? I think it's just to help the teeth/bite fit properly together but I'm not entirely sure. My orthodontist told me that it may widen my smile by 3 mm or so. The surgeon is widening the back of my upper jaw, I believe. This was just decided yesterday after the mock surgery. The back of the jaw will be widened and "spread apart" by 3-4 mm or so.

    Thanks for your help!

    Tara

    http://www.tara-jaws.blogspot.com

    Double jaw surgery on 12/17/11. BSSO mandibular advancement of 10 mm; two-piece le fort 1 with 3 mm impaction and maxilla brought forward 1 mm.

    http://www.tara-jaws.blogspot.com
    Posted 5 months ago #

  2. Hose.A.Jaw
    Member

    The purpose of the 2 piece is to give the surgeons a greater degree of mobility in stabilizing your bite. All too often, the upper and lower jaw do not properly align by moving the jaws in only one axis. By using a 2 piece, they were able to make sure that there is proper contact between all of your teeth after the surgery, usually by widening the palate. It is very good that they determined this during the mock surgery. Sounds like you are in really good hands.

    I recently had a 3 piece. Due to certain complications in my mouth, they weren't able to utilize a 2 piece. Do they tell you if you would have to wear a palatal splint during recovery?

    http://hoseajaw.wordpress.com/
    Posted 5 months ago #

  3. bracedblogger
    Member

    Hose.A.Jaw - yes, you are correct, my surgeon said it was to "stabilize" my bite. I just didn't fully understand. Thanks for explaining this to me! I don't understand though how that might change my face/appearance at all but my Ortho says it might widen my smile and help with the area around my mouth a little. Not exactly sure what that means. I guess at this point I just trust them to do what is best. Yes, I will be wearing a splint after surgery. Is that for stabilization also?

    Posted 5 months ago #

  4. Hose.A.Jaw
    Member

    bracedblogger, I really don't think that you will notice a bad difference, only good! I'm not sure about your case, but usually they only have to slightly widen the palate. I would trust what your Ortho says. They spend a lot of time in school learning about facial aesthetics! Maybe he means your face will look more balanced?

    The splint is to hold the pieces of your palate in place during recovery. You wouldn't want for your palate to move back to where it was and have to do the surgery again!

    Posted 5 months ago #

  5. ocmama2four
    Moderator

    I know you looked at my blog but look at the entry called "ready for surgery". I posted pics of my molds from my mock surgery. You can see what the procedure does to your jaw. Still now sure how he did it though because the roof of my mouth is still intact. He said he did it from above the roof of my mouth when my jaw was detached and he was trimming the gummy smile off. My surgeon aso said my ortho is going to put a bar in the back of the roof of my mouth when my splint comes out to stop regression. He said it will stay there a year or two.

    I had a 2 piece LeFort 1 that widened my upper jaw 3-4mm, my upper jaw was shortened by 6mm to reduce my gummy smile, pushed back 3mm and tilted up in the back. My lower jaw was pushed back 3mm. Surgery was December 1, 2011
    http://www.jennsjawsurgery.blogspot.com
    Posted 5 months ago #

  6. bracedblogger
    Member

    ocmama2four - I hope I don't have to wear that thing in the roof of my mouth! No one has said anything to me about it. You are looking fantastic btw!!!

    Thanks to all of you for your informative post on the 2 piece le fort I, I feel I get it now!

    Posted 5 months ago #

  7. ocmama2four
    Moderator

    Thank you and you're welcome! :) I was only told the night before my surgery when I went in for my presurgery ortho appt to make sure I didn't have any broken brackets. It was news to me and never mentioned before. The good thing was they mentioned I might get my braces off sooner than they thought with the bar thing added. They kindof changed everything because my mock surgery had a totally different outcome than they expected. Glad he did the mock surgery so he wasn't figuring it out for the first time while he was in my mouth. I will know more when I see my ortho on Mon. He isn't going to do anything, just look at my mouth.

    Posted 5 months ago #

  8. bracedblogger
    Member

    Hi all - my surgery was Saturday and the surgeon said it was one of the most complex cases due to several factors. I had a lot going on and the movement was significant. My lower jaw was advanced 10 mm and I have 2 plates and 16 screws in the lower jaw. The upper jaw was brought forward 1 mm, impacted 3 mm, and widened 7 mm in a 2 piece le fort I. The widening was much more than I had expected. I am wearing a splint so I can't see my teeth but was told the widening was in the back of the palette. Will I have a gap between my teeth? Also, what is the difference between a SARPE and a 2 piece le fort and is one preferred over the other? Is 7 mm a lot of expansion? How will this impact functionality and aesthetics? Up until 3 days prior to surgery, the plan did not include widening my palette. That was decided by my oral surgeon and orthodontist once the mock surgery was performed.

    Are there more risks associated with a 2 piece le fort and/or due to the amount of widening I had?

    Thanks for any info you can provide! I've been in a great deal of pain these past few days and haven't posted much. I think the worst days are hopefully over (today is Day 4). Any tips for a speedier recovery feel free to share! My face feels so tight, and parts feel like it's on fire (lips mostly). My jaw also aches from time to time. And the swelling and stuffy nose are super uncomfortable. I'm sure this is all normal though at this stage.

    Best,
    Tara
    http://www.tara-jaws.blogspot.com

    Posted 5 months ago #

  9. ocmama2four
    Moderator

    Totally understand about you pain. My upper jaw and jaw joints have a constant dull pain, especially where they widened my jupper jaw. I would think 7mm is a lot. From your movements I think you are going to look so beautiful. So excited for you! I would ask about their concerns with regression. My surgeon said he wanted to prevent it with me by putting that bar across the roof of my mouth and my 2 piece wasn't as big as yours.

    Also, the sarpe is a minor surgery done way before your jaw surgery. My dr never gave me the option of sarpe. Didn't ask why.

    My face was sooo tight for the first 2 weeks at least. It felt like my skin was stretched across my skull and stapled down. My face feels so much looser now. I can do a little laugh and smile without feeling like my skin is ripping from my face now.

    I loved carmex for my lips because they were painful due to huge swelling. They are finally going down now.

    I have my humidifier on all day for the stuffy nose.

    All that you have described is similar to what I went through. Good luck with your recovery and I hope it goes quickly.

    Posted 5 months ago #

  10. bracedblogger
    Member

    Ocmama2four - ok, so is this the "bar" you're referring to - let me see if I can describe my splint... You know how a tooth whitening tray (or Invisalign) looks like a U shape? Well my splint looks like that but it has a piece of plastic crossing over horizontally in the back of it, from left to right molar. Is that the "bar" you are referring to which should help prevent regression? If not, I'm definitely a bit worried because I definitely don't want to risk screwing up my bite and having to go through this all over again! I see my surgeon on the 28th and I'm definitely going to bring this up. Thanks for sharing with me!

    Also, when I run my tongue over the roof of my mouth, I don't feel any stitches up there. Were all expansions made under the soft tissue only? I am curious more for keeping the surgical site clean. Although, I haven't actually looked inside my mouth yet to find the other stitches that I know are in there. I'm too scared!

    Finally, do you know when you can expect the pain to go away especially in the jaw joints? I hate this feeling. Are you on pain meds still? I'm trying to ween off but if it's going to be several more weeks of pain, I might as well just give up and keep taking them.

    Posted 5 months ago #

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