Excessive overjet - 31 year old - palate expander ? (photos)

Question

When I was 15 I was told I'd need lower jaw surgery, chin shaving, two upper incisors extracted and wear braces for two years. None of this occurred - I am extremely happy about this now. I will be seeing two orthodontists this month and I've done some research - looking at my teeth/mouth I'm guessing I will need a palate expander or rather I'm hoping. I absolutely refuse to have surgery or long term braces. What kind of treatment do you think I will require? How long do you estimate?

Robert L. Knudson, DDS · Answer

I would not recommend any extraction of teeth unless you would like to look more like the wicked witch of the west.   Your lips would drop in and your nose and chin would become more pronounced.  The jaw surgery thing is an option.  A rapid palatal expander pops apart the boney suture on the roof of your mouth but is really not necessary here.  Your upper back teeth are simply tipped in and need to be tipped out some to broaden your smile (think Julia Roberts).  You will always have some overbite without the surgery, but having a bigger smile can happen easily with invisalign or braces and about year.  The overbite (actually we call that "overjet") cannot be corrected nicely without the surgery/chin bob thing.  You have a nice profile now.  Making the "horshoe"  wider a la' Julia  is not a problem.

Mark Weiser, DDS · Answer

When I do my records, I order a lateral cephalometric xray and a tracing and analysis. This helps me determine if your lower jaw is deficient or the upper jaw is excessive or both.  This analysis will help determine your surgical and nonsurgical needs.  At 31, you have no growth left.  So, true palatal expansion isn't possible with out surgery. That doesn't mean that your arch form can't be improved.  If the upper arch is idealized, then the lower arch may come forward.  How much is unknown.

Excessive overjet - 31 year old - palate expander ? (photos)

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Excessive overjet - 31 year old - palate expander ? (photos)

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