Surgery then braces?

[Heavyweight]

Dr. Alfaro in Spain, who has a good reputation, performs orthognathic surgery on patients with minimal pre-surgical orthodontics. This also seems to be fairly common in Asia.

Do any of you guys have opinions on this? I think it's a great way to save time and allow patients to enjoy their new appearances sooner, but I'm not sure if "shortcuts" should be taken in orthognathic surgery.

Here's where Dr. Alfaro talks about it on his website: http://en.institutomaxilofacial.com/orthognathic-surgery-facial-deformities/protocolo-surgery-first/

Here are two case studies: http://www.institutomaxilofacial.com/wp-content/uploads/2011/06/Surgery-First-in-Bimaxillary-Orthognathic-Surgery.-JOMS-2011.pdf

[neferkitti]

Dr. Alfaro in Spain, who has a good reputation, performs orthognathic surgery on patients with minimal pre-surgical orthodontics. This also seems to be fairly common in Asia.

Do any of you guys have opinions on this? I think it's a great way to save time and allow patients to enjoy their new appearances sooner, but I'm not sure if "shortcuts" should be taken in orthognathic surgery.

I don't know. My first concern with the shortcut is immediate post-operative occlusion and stability. The articles states that the patient without braces wore a surgical splint for only two weeks post-op. Maybe she had a perfect occlusion at this point, but I would think that any instability of that bite would lead to healing problems. They may choose their candidates carefully, but I have my doubts that this has broad application. Just speaking from personal experience, so there's that bias.

[stevek216]

I'm not sure if "shortcuts" should be taken in orthognathic surgery.

I'd agree with this, I think there's just a market for people who might do that, whether it's a riskier surgery or not, because people don't want to deal with upwards of a year in braces, exacerbating their bad bite before surgery.  I think in the long run though, it's probably worth it to go with the tried and true methods.  My orthodontist and surgeon insisted on having the teeth in nearly their final positions before the surgery.

Also, if you're having your jaws wired shut, I'm guessing it'd be harder to do that without braces to hook the wires and hooks onto.  Probably not a big deal, but still.

[trigeminalneuralgia]

im about to cave in and get braces, i get them really cheap thru work