After the underbite correction with braces the midline is off

Q. My daughter is 18, she originally had braces to straight her teeth. Last year she was braced again in preparation for surgery LeFort I to correct an underbite. All has gone well except her midline is off, 4 or 5 mm. The orthodontist says it is fine and won’t do anything. My daughter is so depressed. She hates this worse than the underbite. Is there anything we can do? Please give me some advice, after all she has been through, three years in braces and difficult surgery she won’t smile and cries all the times.

A.

I sympathise with the problem. As you will both have been through so much you want a perfect result. It seems that this is a long way from  what you wanted. However repeating the surgery would generally not be advisable and so you are left with making the best of this situation.
Appearance is very personal and ideas of attractive vary from one person to another. In principle I would prefer the appearance of a corrected facial profile with a shifted centre line to the other way round.
You could veneer the front teeth to give the appearance of correcting the profile or try another orthodontist.
However it seems likely that some form of comprimise will be required to get an acceptable result within a budget and time in the dentists chair.

Dr Rob Tennet
www.e-dentalpractice.co.uk

Dr Rob Tennet St Johns Dental Practice 18 Bennett’s Hill, Birmingham, B2 5QJ Web: www.e-dentalpractice.co.uk
April 13th, 2009 at 08:47 PM
Pat Says :

Thanks for the reply. Just to up date you – the swelling went down, after ten weeks with slow progress we had a week where it went down dramatically. Then the brace came off – suddenly the midline looked alot better, still a bit off centre but not so much. She now loves the result. I think she was struggling with the changes – the midline was off and there was swelling but I feel the main problem was psychological. If anyone asked me for advice about this sort of operation I would seriously suggest counselling as it is hard for a teenager to cope with such a big change in their appearance.

Thanks for the help.

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