Report from the Surgeon and Braces Update

I got something in the mail today from the surgeon I visited last week. It's just the sort of thing I really like -- a list of things to google!

Allison is a 17 year old referred for the evaluation of a malocclusion. On the basis of a clinical examination and analysis of diagnostic records, the patient's diagnosis includes:

1. Maxillary constriction
2. Mandibular AP excess
3. Class III malocclusion
4. Bilateral cross bites
5. Missing lateral incisors 7 & 10
6. Chin deficiency

The skeletal malocclusion is producing function problems and has had an effect on the patients medical heath including: limited mobility, difficulty incising solid foods properly secondary to a sparse occlusion resulting in masticator muscle complex compensation. The dysfunction of the masticatory muscular envelope is secondary to the jaw mal-positioning and misalignment of the dentition. These problems cannot be treated with orthodontics and physical therapy alone, and if they continue can result in premature loss of the dentition, myofascial pain, TMJ dysfunction, and GI symptoms. Significant clinical and cephalometric findings include maxillary constriction resulting in bilateral crossbites, excessive mandibular AP projection, steep mandibular plane angle, and a long lower face height.

The following treatment plan is recommended:

1. Pre-surgical orthodontic therapy (Level and align arches)
2. Surgery to include
1. Maxillary Lefort I
2. Mandibular ramus osteotomies
3. Genioplasty
3. Post-surgical orthodontic therapy to finalize occlusion

On the "Pre-surgical orthodontic therapy" (ie, braces) front: I have gone from swallowing everything whole to eating nearly normally in the last three or so days. Unfortunately, I have also already lost a bracket. This is not a trend that should continue, especially considering that I will be away in Europe for the next two weeks!