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Anyone have experience with MSE _After_ having LeFort?  

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Mr_Man
Active Member

I have an MSE screening appointment coming up soon, and I was wondering if anyone has been in or knows someone in my situation:  I've already had a segmented Lefort 1 to expand my palate, but am still deficient.

I began as a rather severe class III (quite deficient in both transverse and sagittal dimensions), leading to the LeFort done at age 19.  Although it made a big difference, I was still left with deficiencies in both dimensions that became somewhat worse over the years (as in relapse).  I'm left with an edge-to-edge incisor bite (even with strongly lingually tipped lower incisors) and approx 10mm difference between lower IMW (approx 48mm) and upper IMW (approx 38 mm).  Before my original LeFort, my upper IMW was about 25mm (I had almost a complete reverse scissor bite where I could practically fit my enitre upper arch inside the lower without jutting), and I had about 5mm negative anterior overjet.

I'm 43 years old now.

Although the upcoming orthodontic consult will answer this question, I'm trying to get an idea of how likely having such a previous LeFort would preclude me from being an MSE candidate.  I'm not worried at all about bone being too dense for suture splitting, given that I have rather thin bones. Specifically, one thing that I'm scared that could possibly prevent MSE from working are the plates/screws under my nasal spine.  It's hard to tell from the XRays, but it almost looks like a bit of one or more plate screws crosses over the midpalatal suture.  I hope my maxillofacial surgeon didn't actually do that!  I'd assume such surgeons are not supposed to do that, but what do I know?  If that is, in fact, the case, I'd desperately hope that I could undergo a simple procedure to remove the offending screw.  I'm not sure though if such a procedure exists or has ever been practiced.  At 43, I've grown tired of the aesthetic and functional problems (incl tooth wear and gum recession) of the class III that seems almost impossible to correct in my case.  MSE is a big hope for me, and after going through a lot of trouble just finding an orthodontist who practices MSE (good lord it was hard, living in western MD) and is willing to go through a consultation, I'd be devastated if I find out I'm precluded.

I'd be quite appreciative of any knowledge or experiences anyone else might have related to this situation.

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Posted : 16/07/2020 10:56 am
IwishIwasgoodlooking
New Member

Sorry I cannot be of any help, I was wondering the same, but have not yet found anybody in my proximity to consult with. Did you find the answers to your questions? If so, I would love to hear them.

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Posted : 08/08/2020 2:00 pm
Mr_Man
Active Member

No answers as of yet; my first consult didn't have answers (it was rather preliminary).  After xrays and my next appointment (in a few weeks), I should know more

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Posted : 09/08/2020 12:54 am
IwishIwasgoodlooking
New Member

I don't have the timestamp, but in this interview somewhere it is mentioned that MSE after lefort can be done https://www.youtube.com/watch?v=BMEJZJfUVMg.

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Posted : 12/09/2020 3:03 am