I had my pre-surgery appointment at the University of Pittsburgh Dental School today with Dr. Ochs and his Chief Resident, Dr. Parker. Neil went with me again, (Thanks for lending me Neil again Katie!) which was great because any time I didn't have an answer to something I just looked at Neil. The appointment took about 2 hours. It started with the paper work describing the surgery and everything that could possibly go wrong. That was fun. Then I met with Dr. Parker and he explained the surgery to me, shaved down one of my upper canines so that it would fit in place after the surgery, took measurements of my bite, two sets of alginate impressions, a wax bite impression, and a plastic bite impression.
Next we took the "before" surgery photos of my mouth and front and side profile. Then Dr. Parker put these dots (see photo below) on my face for the CBCT scan. He put the wax mold back in my mouth and I had to sit very still for 50 seconds while the machine worked it's magic.
I think the CBCT scan is the coolest part of this process. With the CBCT scan they are able to make a 3D rendering of my skull. They then do digital versions of the surgery to practice the movements of the jaws and find the best alignment for function and aesthetics. A copy of the scan is sent out to a company that 3D prints the jaw bones so that they are able to bend the brackets that will hold everything in place prior to the surgery. Amazing!
Dr. Ochs came back in at the end of the appointment to answer questions and look things over. I was lost in dental jargon here, but he checked my bite, said a lot of fancy things, handed me a mirror and asked how I felt about the way my upper jaw looked. I was confused because I wasn't sure what he was after but basically where he was going with it was that he may NOT have to do the upper jaw. He said they will do two surgery plans: one for both jaws, and one for just the lower jaw. If it looks like the movement to the upper jaw won't be very significant then he will just bring the lower jaw forward. He said he doesn't like putting his patients through more pain if the end result isn't significant. He was happy with the work my Orthodontist had done since he was able to bring my front teeth down and create a good arch. Prior to braces my overjet was 11 mm which is pretty big. I think it's 7mm now if I remember right.
When he first saw me he thought I would definitely need both jaws re-aligned since it was so severe. I've mentally prepared for having both jaws done but if we can just do one I'll be ecstatic! The LeFort 1 osteotomy is pretty invasive. They have to cut into your sinus region and you can't blow your nose for a long time or you can cause a bad bleed. The recovery is a lot slower for double jaw surgery too. My friend just had a similar surgery involving the lower jaw and not the upper and is doing great! She is my hero right now! :)
I should know in a week or two what plan they decide on. I'm fine with either, but will be praying for just the lower jaw (BSSO-Bilateral Sagittal Split Osteotomy) so I can be back on my feet sooner. Cross your fingers for me! Thanks for reading!
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