Power chain and new archwires

With renewed teeth and some happiness (I never feel happy to go to the dentist!) I went with my future wife to the clinic of Dr. Ibarra for the big appointment. In my previous visit a few days ago I had my teeth cleaned and a visual inspection of the progress.

By now the two brackets that were on my two crowns (back molars of lower jaw) had fallen over the past months. I live abroad so I could not visit him to have that taken care of.

The 2 fallen brackets posed no problem for the treatment because my lower jaw molars and teeth were almost totally aligned and with sufficient space. He chose to simply replace my lower archwire to a thicker wire (more force now) and cut the archwire so that the two crowns remained without brackets. Brackets don’t bond well with (porcelain) crowns even with more powerful glue as he had used.

The replacement of my lower archwire was very painful, pfew! stressful too! in the past months the two lower front teeth had rotated slightly, in fact for a few months I had not been able to pass floss between them due to their tightness. It was impossible to completely place the wire through the bracket so in the end to save my some pain he had to tie them. Looks as if it is through but well, saved me more discomfort.

My upper archwire was also replaced with a thicker one. This one is the last (and thickest) to be placed there while my lower jaw will still require a thicker one on the next follow up (December).

In order to close down the gap between the upper front teeth and align them Dr. Ibarra put on a “power chain” on my upper jaw. The “power chain” (see video below) is an elastic chain with loops that are put around each bracket to close space/gaps, they apply extra force. That first day was a bit uncomfortable but bearable and I noticed results that same day (the gap was closed!).

My power chain is transparent to make it discrete so for the purpose of this blog I am showing somebody else’s chains (in pink, see (a)). There is also a video of the application of a power chain (again another person).

Surgery Update: Meet your surgeon

On this same appointment (3rd) Dr. Ibarra introduced me to the surgeon that will do my orthognathic surgery. She is a relatively young woman with a lot of experience in more difficult cases.

We discussed my situation for about an hour in which they explained everything to me and let me ask a lot of questions about my worries (I have never had “major” surgery).

The panoramic X-Rays taken a few days ago showed all my teeth and their roots perfectly vertically aligned and this was quite a change! I hope to get copies of that later. They also showed me the plaster mold and I could see my upper jaw has also widened to make more space and become rounder, quite a nice change too!

There have been a lot of retraction too and I feel and see that I no longer have to force my lower jaw way forward in order to have my teeth meet each other.

Because I live abroad and can’t come often they decided it was better not to perform extractions now because they wouldn’t be able to monitor it or perform maintenance on the archwires that my stick out when the gap closes.

Also, the original plan (nov. 2008) was that I would have surgery on my lower jaw to enlarge it. During my earlier research I learned that there are two big nerves in that area which cause a lot of numbness & tingling for months and it presents a risk. I was (am) very worried about it so I discussed it.

They also told me that now that she has evaluated my case there were several (4) alternatives and it has been chosen to do the following:

• Perform the two extractions on the upper jaw during the orthognathic surgery.
• Perform surgery on the upper jaw instead of the lower jaw. This would involve shortening (pulling back) my front side which would change the profile of my face. They would do the cuts on the gaps created by the extracted teeth (bicuspids).
• Having done that they would then evaluate if that is enough. If not, then they would also perform surgery on the lower jaw to enlarge it. In this case the advancement will be shorter than the original assessment (9mm) and therefore involve less risks.

Naturally I was more worried to hear about surgery to my upper jaw, still worries me but I hope that the lower one can be left untouched.

My surgery has not yet been scheduled, that depends on the assessment made on the next follow up in December. However they estimate it could be around June 2010 (I don’t want to have that for my birthday!). If I was not abroad maybe even earlier!

Also, since I am scared about it Dr. Ibarra told me that even if I changed my mind and decide not to have the surgery the current results are still very good. In the meantime they will practice the surgery on the plaster (?) models they make of my mouth.

Power Cleaning on 3rd revision

The day came on June 13th, 2009 when I was at the waiting room of Dr. O.A. Ibarra for my 3rd revision after having braces put on on November 2008.

In my previous visit (Jan. 2009) I was told that probably I would have two teeth removed from my upper jaw to make some space and that was to take place now and I was worried about it. Also because in April I suffered a new back injury which has kept me with uncomfortable pain and incapacitation for quite some time.

Today was only a quick follow up of about 30-45 minutes in which he ordered another panoramic X-ray of my mouth to get an updated view of the current state of affairs.

My teeth were cleaned thoroughly with some sort of bicabornate (baking soda) sand blasting technique. It was cool! it was painless! and my teeth looked slightly whiter too as they had suffered some extra coloration during the past months! Naturally I had a stingy feeling on my mouth for part of the day.

According to my orthodontist the previous minor surgery I had on my gum to remove the fraenum healed perfectly. My upper frontal teeth were almost together but for about 1 millimeter.

The lower molars were almost totally aligned (I have been amazed about this change after 45 years!) and believe it or not even my upper teeth feel pulled back. My bite feels different.

On my next visit a couple of days from now I will be examined by the surgeon that will do my orthognatic surgery and have some things installed by my orthodontist.

His other colleague (dentist) did a retouch of the aesthetic reconstruction of my upper frontal teeth (two) given that they have done quite a lot of rotation and alignment. Now they look even more beautiful like they had never been before!.