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Dentistry/Reversal of Le Fort 1 osteotomy

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QUESTION: Dr. Teig,
I read your response to "Lisa" on 6-29-2006 who asked if there was a way to reverse a Le Fort 1 osteotomy.  Like Lisa, I have been extremely dissatisfied with this surgery.  You told Lisa hers could probably be reversed (hers was 4 years prior).  Mine was 25 years ago and I am now over 60 and have osteopenia.  Is there any hope for me? I know it would a painful process but I'd be willing to go through it.

ANSWER: Marty -  If you truly have osteopenia, a revision of the jaw relationship would be difficult.  Recut bone might be difficult to heal and that could create more of a problem. I wish I could be more positive, but if you were my patient, I would probably suggest that surgery to redo the upper jaw should be avoided.  Sorry.

If you have more questions, feel free to contact me again.

---------- FOLLOW-UP ----------

QUESTION: Dr. Teig,
If the osteopenia is only minimal, would you still not recommend it?  I can't stand the way I look. How bad does the osteopenia have to be before it's too late to do a reversal?  You say it would be difficult to heal,  but what if I were willing to have my jaw wired shut for an extended period?

Answer
Marty - If the osteopenia is minimal, it is probably possible to do the surgery, but my suggestion is to have your surgeon speak with a specialist who assists in the treatment of osteopenia.  That specialist might be a rheumatologist or an endocrinologist who along with your physician and oral and maxillofacial surgeon determine if you bone is of a proper density and has adequate blood flow for bone healing.

So find a board certified oral and maxillofacial surgeon and tell him of your osteopenia. Let that doctor work with the other specialists to make the determination.  I wish you well and hope you are a candidate.  

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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