Author Topic: IMDO????  (Read 21863 times)

Lazlo

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IMDO????
« on: October 18, 2012, 02:01:21 PM »
Hi,

I came across this doctor in Australia who is a maxillofacial surgeon, but he also performs "IMDO" which is intermandibular distraction osteogenesis. The idea is that instead of a bi-max or bsso you make a small cut in the bone and it is lengthened with a device 1mm or so each day and then at the end of a few months it is taken out and the bone grows in to fill in the gap. Apparently there is little pain and virtually no trauma associated with surgery. You do need some orthodontic treatment after to just straighten out the teeth but it seems a much, much better option than traditional surgery. I did notice in the video also that the patients who have had IMDO instead of bi-max look much better in their after pictures. Has anyone looked into this or talked to their surgeons about it? Seems relatively new. I am scheduled for bi-max next year but I think I would much prefer this.

Before and After Orthognathic Jaw Surgery Overbite Underbite Profilo Braces

Lazlo

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Re: IMDO????
« Reply #1 on: March 20, 2013, 05:00:57 PM »
Hey people,

it's been a tough day going down even further this terribly confusing hole of jaw surgery. The surgeon I consulted here gave me a fairly bleak view of what could actually be accomplished through this surgery and he told me how having thicker skin and soft tissue and a smaller or more delicate bone structure is kind of like the worst case scenario for noticeably trying to manipulate the aesthetic outcome of the surgery.

I know many of you have been speculating about what causes all of this and when it's best to intervene in the process for young children to optimize their jaw/bite outcomes and I think I've come to some fairly stable conclusions about all of this.

First, many of us have speculated why we may have jaw issues. The answer is simple --our jaw bones didn't grow in the optimal positions. Either they grew too much or one side grew more or less or whatever. That's why our teeth are crowded or spaced. Whatever the reason, most often its just genetics. I know a lot of you think it's something that happened to you as a kid, and in some cases it might be, but more often it's just genetics --inherited --but regardless it doesn't really matter. What matters is when and how to actually fix the problem.

Second, I think I can say with some certainty now that traditional orthodontics is an entirely BANKRUPT and corrupt enterprise and moreover is scientifically unsound. Orthodontics doesn't address the problem at the root, it just tries to make do with what you have and this results in a cascading effect of producing all sorts of other problems, most often at the expanse of you facial aesthetics. Extractions, retracting teeth, etc. etc. are all just very poor techniques and do not address the root of the problem which is the jaw bones themselves. You must induce them to grow properly and most often then the teeth will take care of themselves.

Third, you might not be genetically programmed for whatever reason to have strong symmetric jaw bones, but there is a way to induce them to actually grow. You might still need some minimal orthodontics to straighten things, but not nearly the amount of harmful and long duration manipulation currently used.  If you read the following series of explanations on this site you can see that this doctor, who I've posted about before, takes a fairly radical counterposition against orthodontics to solve the problem. He basically argues that if you get the jaws to grow then you don't need the manipulation of the orthodontics.

Just read each of the subheadings and it all makes perfect sense. Grow the jaw bones, then straighten the teeth as needed, not the other way around.
I'm beginning to realize that the jaw surgery first/then braces as practiced in Europe in some places and in Korea is also a better alternative than the traditional braces then surgery approach as well. But ideally having distraction at a formative age would be the gold standard.

For most of us here this knowledge has come too late, but maybe there are people with kids out there reading this stuff and you can benefit. Seeing in fact how problematic the asymmetry I have and how unpredictable the outcome will actually be from my jaw surgery was a difficult thing to realize today.

I don't really know why distraction is not recommended as ideal for adult patients, but it doesn't seem to be offered except in extreme cases.


http://profilo.com.au/jaw-distraction-surgery/.aspx












Lazlo

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Re: IMDO????
« Reply #2 on: April 26, 2013, 09:26:28 PM »
yeah all these articles who that DO has a slight edge over surgery or is on par with jaw surgery in all respects as these tests were for sensory disturbance and relapse rates. But what is significant here is that DO gives you  a much more controlled growing of new bone and also that it can produce new bone without graphs or foreign materials  and so can lead to stronger results if more bone or advancement is needed. Moreover, all such tests are biased and they may be in the interests of maintaining the status quo. Think about it, DO is a HELL OF A LOT more work for the doctor daily guiding the distraction etc..

ppsk

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Re: IMDO????
« Reply #3 on: January 19, 2017, 02:57:02 AM »
Bumping this to say, as I live in Australia i am going to do a video consult with Dr. Coceancig, and I will ask him about IMDO and report back here.

It is possible in adults, He has two public patients on his website that had this, one was 23 and the other was significantly older, I'm not sure but looked to be in his late 30s.

Its worth stating that IMDO is only done in Australia, by Coceancig. It is not the same as other DO methods published online. I'll be sure to ask him the finer details of what makes it different, but I believe the key difference is right there in the name: Intermolar Distraction Osteogenesis.

Its also worth noting, the younger man who had this also had a genio performed. So the DO is not a magic bullet, it seems to be very capable of making large movements in a 3D manner, but for an ideal aesthetic outcome you would probably still need some form of bony contouring. I imagine you would also need some form of maxillary expansion before as well.

But this is just me talking out of my ass, I will find out.

JimmyTheGent

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Re: IMDO????
« Reply #4 on: January 19, 2017, 07:20:35 AM »


This result is amazing.  There is only one surgeon in the world who does this??? 
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

JimmyTheGent

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Re: IMDO????
« Reply #5 on: January 19, 2017, 07:24:19 AM »
and this!!!!

The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

ppsk

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Re: IMDO????
« Reply #6 on: January 19, 2017, 07:32:59 AM »
This result is amazing.  There is only one surgeon in the world who does this???

Yes.

IMDO is Coceancig's baby and legacy it seems.

Other surgeons do distraction osteogenesis, theres quite a lot of literature published on it, but this particular method of inter-molar distraction is novel I believe.

JimmyTheGent

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Re: IMDO????
« Reply #7 on: January 19, 2017, 09:20:06 AM »
Yes.

IMDO is Coceancig's baby and legacy it seems.

Other surgeons do distraction osteogenesis, there's quite a lot of literature published on it, but this particular method of inter-molar distraction is novel I believe.

I can't believe no other surgeons are interested in learning this.  I have sleep apnea and if I could be cured of it and have results half as good as the dude I posted I'd be on top of the world! 
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

JimmyTheGent

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Re: IMDO????
« Reply #8 on: January 19, 2017, 09:22:13 AM »
I didnt read everything associated with IMDO, is numbness also avoided using this procedure?  Id imagine if they also did a sliding genio you would have a chance at some numbness but I wonder if the IMDO itself causes any?
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

Lefortitude

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Re: IMDO????
« Reply #9 on: January 19, 2017, 10:13:37 PM »
This is amazing! would be worth the trip to australia if it was legit


Lefortitude

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Re: IMDO????
« Reply #10 on: January 20, 2017, 01:04:13 PM »
Why is it amazing? Wouldn't a standard bsso be better.

if its legit, lower down time, less invasive, physically stronger etc

Bobbit

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Re: IMDO????
« Reply #11 on: January 20, 2017, 04:23:43 PM »
and this!!!!



Pardon me.  But there is a huge amount of photoshopping in those before & after pictures.
There is an ethical issue when doctors post those kinds of non-representative / photoshopped pictures. 

There is only one purpose to that sort of thing - -  an intention to mislead the potential patient.

ppsk

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Re: IMDO????
« Reply #12 on: January 20, 2017, 06:03:02 PM »
Pardon me.  But there is a huge amount of photoshopping in those before & after pictures.
There is an ethical issue when doctors post those kinds of non-representative / photoshopped pictures. 

There is only one purpose to that sort of thing - -  an intention to mislead the potential patient.

would you like to qualify this?

I dont see any obvious photoshopping other than that which is necessary to have a clean presentation.

Bobbit

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Re: IMDO????
« Reply #13 on: January 20, 2017, 06:08:42 PM »
would you like to qualify this?

I dont see any obvious photoshopping other than that which is necessary to have a clean presentation.

No... really,  there is no qualification needed.  For example,  the slope of his forehead above the eyebrows is different, and not as "slopped" backwards.   That was the starting point for me.   

ppsk

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Re: IMDO????
« Reply #14 on: January 20, 2017, 09:32:46 PM »
Also, look at his gonial. The after has more definition which I don't think this operation alone would bring out. Lighting could explain this though.

If the procedure works as described, then it would definitely bring out the gonial as it is growing the jaw in 3 dimensions. People with poor gonial definition lack width in the mandible.

Also as the jaw gets longer and wider the amount of slack in the skin will be picked up. Just as a lefort 1 can reduce eye exposure, which is not an expected effect if you were just playing around with anatomy models.

EDIT: I just want to clarify, i'm not jumping to the defense here. I just don't see any telltale signs of photoshopping, you guys are bringing up facial changes from a procedure that........changes the face. Normally you'd see some pretty obvious tells, like blurring on the skin or odd or lack of shadows in expected locations.
« Last Edit: January 20, 2017, 10:13:31 PM by ppsk »