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Asymmetry: Condylotomy or BSSO?

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  • ryanmurray311
    Hey everyone. This is Ryan. Basically I have slight asymmetry due to one side of my jaw being 4 mm longer than the other. Not too big of a descrepency. I ve
    Message 1 of 5 , Jun 1 1:30 AM
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      Hey everyone. This is Ryan. Basically I have slight asymmetry due to
      one side of my jaw being 4 mm longer than the other. Not too big of a
      descrepency.
      I've seen a few surgeons and jaw specialists and they all seem to say
      different routes to take as far as surgery goes for my treatment plan.
      One surgeon recommended I have a condylotomy to relieve tmj pain and
      discomfort, another said upper and lower to fix a cant with a BSSO and
      Leforte wedge. Another said nothing, and another said braces alone.
      I'm really confused and wonder if anyone else has a similar problem.
      If you had asymmetry, what type of surgery did you have exactly? Has
      anyone benefited from a condylotomy and does it fix asymmetry?
    • davgin25
      Ryan you are the first one we have seen on here who has had Lauren s problem! Lauren has surgery last Friday so is 7 days post-op today. She had her left
      Message 2 of 5 , Jun 1 5:58 PM
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        Ryan you are the first one we have seen on here who has had Lauren's
        problem! Lauren has surgery last Friday so is 7 days post-op today.
        She had her left condyle grow longer over the course of the last 5
        years or so (she is 20 y/o). For the last 2+ years she has been
        suffering daily headaches, with pain on a level of 4-7, with 10 being
        unbearable. We finally found out through an MRI of her TMJ that her
        right disc (cartilage) was completely off her TM joint and was in a
        little ball and deteriorated. The left disc was also out of place but
        was still attached. Our orthodontist said that whenever you have two
        unequal lengths of the jaw bone, one side is going to take the brunt of
        the chewing etc. So at last we felt we found the cause of her
        headaches, as her headaches were right above this joint. Lauren had a
        crooked smile, with more gum showing on one side than the other. She
        had 6 mm removed from her left condyle, her discs put back in place
        with Mitek anchors- this was done through her ear opening. Then she
        had her jaws fixed as they wouldn't have matched up after cutting down
        the condyle. The surgeon explained that this was not considered
        cosmetic as she couldn't have eaten afterwards. She had the BSSO and
        LeFort 1 done. I don't believe you can get the cant fixed just by
        cutting down the condyle. The whole upper and lower jaws needed to be
        realigned. Lauren had braces already and had a nice smile and a good
        bite but over the course of time, the uneven jaw wore down her right
        TMJ so it is slightly arthritic and the disc came off. I would think
        that with time this could happen to you. You could take your chances
        that the condyle is done growing. There are 3 conditions that cause it
        to grow, one in which it overgrows and then stops and then 2 others in
        which it keeps growing. In order to stop the growth they have to cut
        the top of the condyle down.

        You can see her pre and post-op photos on this website under "photos".
        She is on the first page under .Lauren surgery photos. She also has a
        blog which has some descriptions of her conditions and info about her
        surgery. It is at www.theysaysilenceisgolden.blogspot.com

        Hope this helps you in some way. Good luck with your decision. Write
        back if you have further questions. Keep us posted on the site!
        Blessings,
        Lauren's mom, Ginny



        --- In orthognathicsurgerysupport@yahoogroups.com, "ryanmurray311"
        <myrrh1@...> wrote:
        >
        > Hey everyone. This is Ryan. Basically I have slight asymmetry due to
        > one side of my jaw being 4 mm longer than the other. Not too big of a
        > descrepency.
        > I've seen a few surgeons and jaw specialists and they all seem to say
        > different routes to take as far as surgery goes for my treatment plan.
        > One surgeon recommended I have a condylotomy to relieve tmj pain and
        > discomfort, another said upper and lower to fix a cant with a BSSO and
        > Leforte wedge. Another said nothing, and another said braces alone.
        > I'm really confused and wonder if anyone else has a similar problem.
        > If you had asymmetry, what type of surgery did you have exactly? Has
        > anyone benefited from a condylotomy and does it fix asymmetry?
        >
      • minirascal2002
        Hi Ginny, I have also had orthognathic and TMJ surgeries but my problem was kind of the opposite of Lauren s. My condyles were underdeveloped and misshapen so
        Message 3 of 5 , Jun 1 7:47 PM
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          Hi Ginny,
          I have also had orthognathic and TMJ surgeries but my problem was kind of the opposite
          of Lauren's. My condyles were underdeveloped and misshapen so it caused my discs to
          dislocate starting when I was 8 or 9 years. Back then, in the mid-70's, however there were
          no treatments for TMJ. My orthodontist at the time actually told me I was faking it so he
          couldn't work on my braces. I finally started getting treatment as a teenager but that was
          limited to arthrocentesis, physical therapy and splint therapy. There were no acceptable
          surgical treatments at the time. I had my first surgery at age 35. I ended up having total
          joint replacements two years ago at 38 which is young for artificial joints but there was too
          much damage to my joints already.

          That's wonderful and amazing that treatments have evolved so much in the last 20 years.
          I'm happy to see that Lauren is doing so well. Hopefully since she got treatment now, she
          should be able to avoid all the problems I have had. She may have some bad days now
          during her early recovery but it's better to get it all over with now than face worse
          problems down the road if she hadn't had the discs repaired. I wish her a continued good
          and uneventful recovery.
          minirascal-Karen


          --- In orthognathicsurgerysupport@yahoogroups.com, "davgin25" <davgin25@...> wrote:
          >
          > Ryan you are the first one we have seen on here who has had Lauren's
          > problem! Lauren has surgery last Friday so is 7 days post-op today.
          > She had her left condyle grow longer over the course of the last 5
          > years or so (she is 20 y/o). For the last 2+ years she has been
          > suffering daily headaches, with pain on a level of 4-7, with 10 being
          > unbearable. We finally found out through an MRI of her TMJ that her
          > right disc (cartilage) was completely off her TM joint and was in a
          > little ball and deteriorated. The left disc was also out of place but
          > was still attached. Our orthodontist said that whenever you have two
          > unequal lengths of the jaw bone, one side is going to take the brunt of
          > the chewing etc. So at last we felt we found the cause of her
          > headaches, as her headaches were right above this joint. Lauren had a
          > crooked smile, with more gum showing on one side than the other. She
          > had 6 mm removed from her left condyle, her discs put back in place
          > with Mitek anchors- this was done through her ear opening. Then she
          > had her jaws fixed as they wouldn't have matched up after cutting down
          > the condyle. The surgeon explained that this was not considered
          > cosmetic as she couldn't have eaten afterwards. She had the BSSO and
          > LeFort 1 done. I don't believe you can get the cant fixed just by
          > cutting down the condyle. The whole upper and lower jaws needed to be
          > realigned. Lauren had braces already and had a nice smile and a good
          > bite but over the course of time, the uneven jaw wore down her right
          > TMJ so it is slightly arthritic and the disc came off. I would think
          > that with time this could happen to you. You could take your chances
          > that the condyle is done growing. There are 3 conditions that cause it
          > to grow, one in which it overgrows and then stops and then 2 others in
          > which it keeps growing. In order to stop the growth they have to cut
          > the top of the condyle down.
          >
          > You can see her pre and post-op photos on this website under "photos".
          > She is on the first page under .Lauren surgery photos. She also has a
          > blog which has some descriptions of her conditions and info about her
          > surgery. It is at www.theysaysilenceisgolden.blogspot.com
          >
          > Hope this helps you in some way. Good luck with your decision. Write
          > back if you have further questions. Keep us posted on the site!
          > Blessings,
          > Lauren's mom, Ginny
          >
          >
          >
          > --- In orthognathicsurgerysupport@yahoogroups.com, "ryanmurray311"
          > <myrrh1@> wrote:
          > >
          > > Hey everyone. This is Ryan. Basically I have slight asymmetry due to
          > > one side of my jaw being 4 mm longer than the other. Not too big of a
          > > descrepency.
          > > I've seen a few surgeons and jaw specialists and they all seem to say
          > > different routes to take as far as surgery goes for my treatment plan.
          > > One surgeon recommended I have a condylotomy to relieve tmj pain and
          > > discomfort, another said upper and lower to fix a cant with a BSSO and
          > > Leforte wedge. Another said nothing, and another said braces alone.
          > > I'm really confused and wonder if anyone else has a similar problem.
          > > If you had asymmetry, what type of surgery did you have exactly? Has
          > > anyone benefited from a condylotomy and does it fix asymmetry?
          > >
          >
        • ceast36532
          Seems to me that the biggest problem you have is a difference of opinions amongst many experts. I can t be the one to resolve it for you, because I m just a
          Message 4 of 5 , Jun 1 10:14 PM
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            Seems to me that the biggest problem you have is a difference of
            opinions amongst many experts.

            I can't be the one to resolve it for you, because I'm just a lay person.

            As you note, 4 mm. is not a big discrepancy... i was told that my 5 mm
            movement forward is a quarter of an inch. My surgeon also decided to do
            a 3 mm. sideways slide. Neither made a visible difference, but both
            seem to have helped discomfort in my bite, and helped to save my teeth.

            I think if I were in your spot, I'd focus in on long-term results, and
            what the docs advise might be expected. It doesn't sound to me as
            though you have big-time cosmetic issues, but rather as though you have
            issues about function in the joints.

            My notion, strictly as a lay person, would be that you want the best
            help to resolve your issues of function and pain... I'd try to find the
            most experienced specialists available who are accustomed to dealing
            with joints, pain and degeneration... I know there are some in Texas,
            and in North Carolina, and there are probably many others in other
            areas of this and other countries.

            For sure, ask a pile of questions. Consult with dentists you trust, if
            you are fortunate enough to have some. Be slow to decide what to do,
            and weigh all the options you're offered. Long-term results are the
            main concern -- or would be, for me.

            It's not an easy set of problems, and you have my sympathies and best
            wishes. Be restored, though, in knowing that this set of troubles,
            unlike many others we mortal souls suffer, are unlikely to be lethal.

            Cammie
          • ryanmurray311
            Hello Lauren s Mom! This is Ryan again. I m 22 from Salt Lake City, Utah. I ve been reading all of your recent blog updates about Lauren s surgery and she
            Message 5 of 5 , Jun 2 10:24 PM
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              Hello Lauren's Mom!

              This is Ryan again. I'm 22 from Salt Lake City, Utah. I've been
              reading all of your recent blog updates about Lauren's surgery and she
              really seems to be doing great. I'm really interested to talk to
              Lauren about her experience with surgery. By the looks of it, we have
              very similar problems, even though Lauren's jaw asymmetry seemed to
              look a little worse than mine does. I've contemplated this surgery
              almost everyday for the past few years. It terrifies me but at the
              same time intrigues me. I never want surgery day to come and at the
              same time I wish it was tomorrow.

              Basically I just want to ask Lauren what type of surgery she had
              exactly and how big the jaw discrepancies were. The right side of my
              jaw is approx. 4mm longer than the left and there is a slight cant,
              very slight. I suffer from constant TMJ headaches and I can't stand
              not having my teeth come together properly. Because our cases appear
              to be so similar and you two seem willing to help and answer questions
              and concerns, I'd love to hear back from you. Is there an easier
              email I could reach you at?
              Best wishes
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