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Question 55 - How often is revision surgery necessary plus nerve problem?

From: J.A.

Hi,

I am going to have revision MMA surgery since my bite did not come together correctly and is too open to tear food. The orthodontist said it is to far apart to repair with braces.

How often is revision surgery necessary, and why does this usually happen?

Could this be my fault. I thought I was following the eating guidelines properly. Also, while the revision is being done, the surgeon will repair the two nerves (possibly using a nerve graft) that were broke apart during the initial surgery. However, he is not optimistic about the nerve repair being able to restore feeling. The initial surgery was a little over two months ago.

J.A.


Response Provided by Dr. Kasey Li
Feb. 12, 2010

There are just too many variables in causing malocclusion and I won't be able to go over them, especially not having examined you. Revision surgery may be required, but is uncommon. At two months out, there is a fair amount of scarring so moving the jaws would not be easy, but not impossible. Restoring the nerve is another story. I hate to tell you but if the nerves were cut, the likelihood to be able to identify the nerve(s) within scar tissues AND be able to repair the nerves through a mandibular osteotomy site-very little access AND to use a nerve graft all point to extremely challenging and very unlikely to succeed.

A fair number of patients have come to me for nerve repair following injury from wisdom teeth removal and the results depends on how severe the injury, timing, skill of the surgeon. From your history, I would simply ask your surgeon to provide ONE patient that was successful that he/she has repaired the nerve the way he/she described to you.

Good luck.
KKL




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