Thursday, February 10, 2011

Oral Maxillofacial Surgery

How Did My Face Measure Up?
My oral maxillofacial surgeon is Dr. Leonard Kaban at Massachusetts General Hospital. Before meeting up with him, some of his colleagues did a bunch of pictures, measurements, x-rays, and scans.

<--- What adjectives do you like to hear when people look at your face? I got "moderately convex." That's ok. At least my face isn't severely concave.

In my profile x-rays (below), you'll see in the first one that my profile is relaxed and my (endearing) overjet is hanging over my lower teeth like a prominent dental awning. In the second film, they asked me to jut my lower jaw as far forward as I possible could. (Then they told me to "try harder.") Notice the diameter of my trachea indicated by the red crossbar. My airway is significantly closed off by my recessed jaw and opens when I move it forward. I've even learned to do this now. When I take a deep breath, I move my jaw forward and I can breathe easier.

What is the Medical Term for F#@ed Up?
As one of the fellows measured my facial landmarks with odd tools and dental floss, he mumbled distances and comments to an assistant who took notes. "Mr. Shull presents with hypothelorism and diastema," he stated indifferently.

"Just so you know," I interjected, "I know what those words mean and I'll try not to be offended. (A little medical humor on my part). But, I was surprised by the first. Hypothelorism is abnormally close-set eyes and diastema is a gap between the two front teeth.

Knowing I'm a speech pathologist, he added "Oh, you must've learned those terms in your Craniofacial Abnormalities class." Wow. Really? Ok. Then I really was offended... a little.

The Plan(s)
During my follow-up with Dr. Kaban, he presented three options. The first step in each required getting braces (done) and the extraction of some impacted wisdom teeth. The goal of the braces is to move my teeth so my bite will align post-surgery. He also wants to open my narrow upper arch and move my upper teeth as far forward as possible to reduce the distance my jaw will have to be displaced. In essence, increasing my overjet. To which I replied, "I'll look like a rake!" Yeah, I got nothing. I suppose it's good to have surgeons without senses of humor.

Once my teeth have been sufficiently moved forward, they will break my lower jaw (and probably upper jaw) and move them forward and set them in place with titanium screws. 


  1. Hey I just came across your blog as I was searching wisdom tooth extractions. I just had 4 wisdom teeth extracted and I am also having double jaw surgery and genioplasty for an open bite, crossbite, underbite. I have a blog on blogspot as well.
    How long will it be until you have the jaw surgery. I was told I have to wait 6 months for my bones to reform where the wisdom teeth were removed. I've also had sleep apnea in the past that has improved on its own, it comes and goes.

  2. I need to have braces for awhile to move my upper teeth as far forward as possible to diminish the need to move my upper jaw. So, I'll be waiting 18 months before my bilateral sagittal split osteotomy (BSSO).

    I'm jealous of your pain-free wisdom tooth extraction. I think they did mine with a garden weasel... entering through the back of my neck.

  3. Wow! The internet is amazing for person to person help situational situations! I'm getting my BSSO in 2012, we'll definitely have to compare notes.

  4. @Noho1960 Have I mentioned that my central incisor diastema is nearly resolved? Are you going to be jealous when my face is the size of a mardi gras head?

  5. sorry to hear about the long wait. I did my time in the past though. I had braces and 4 premolars extracted about 10 years ago which didn't really help my bite but somehow attempted to compensate for it. I feel like I was really lucky with the wisdom teeth. Best of luck!

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