Dr Wolford believes that joint surgery is safe and reliable and has concluded that few others do it because they don't offer it. He also believes that joint pathology is responsible for relapse and is willing to operate on them even when asymptomatic. He claims that 25% of OSA patients meet this criteria. I had my MRI done elsewhere but it was only a few hundred dollars as I recall, covered by insurance. No other surgeon has been able to reproduce these results and he claims that is because they don't do CCW rotations. If he determines that you do indeed have defective joints, then he will likely refuse to operate unless the joints are included.
My impression is that CCW rotations have been performed by most surgeons now for over a decade, especially younger ones, and joint pathology is very common, affecting up to 55% of the population at some point in life (only about 30% clinically). What I have observed is that Wolford is more aggressive in advancements than most surgeons because he believes that since you're already taking the risk the airway should be fixed while you're at it, a position I strongly agree with. I've seen way too many gummy smiles fixed by single jaw surgery. Still, I would think that were his conclusions correct there would be consensus as other oral surgeons should be seeing it often too. Other oral surgeons sharing his philosophy, while rare, appear to be piggybacking on his publications rather than independent research and experience. TMJ surgeries are rarely performed and there have been few publishes follow up studies on outcomes. It's not hard to find failures but successes or word of them appears to be completely lacking. I conclude that no one really knows what the true outcomes of joint surgery are. Most patients chose to suffer in silence or seek care elsewhere (or simply die off even in the worst cases without attribution).
Wolford tends to get referrals from more complicated cases so I wonder if there's selection bias in the patients he operates on. He's noted, for example, that nutrient deficiencies are common in his cohort and perhaps those are the ones more likely to be referred to him. Like your mom said, eat your spinach! My respect for Dr Wolford stems not only from his willingness to help anyone but also that he does believe he is delivering the best care long term to his patients, of which there are probably many thousands by this point mostly quiet on the internet. His publications are also excellent, even with biases I mentioned.
