found a better before/after of that Wolford condylar resorption teen. girl

[x]

ive heard conflicting reports on these kinds of surgeries by doctors. one told me that surgery performed before the bones harden is generally discouraged and it is best to wait until maturity. it is difficult to predict how the bones will grow and breaking them and putting it all back together may mess up future growth. others have told me surgery should be performed as early as possible (6-7 ideally) if a growth disorder is diagnosed, and i was told the effectiveness of orthodontics in dealing with abnormal growth is exaggerated and sometimes has the opposite effect. the issue is parents of a child who is said to have developed growth problems are given two choices by orthos - surgery or braces.

most parents - when given the choice - will choose braces over surgery because surgery is seen as incredibly invasive and risky. and of course many orthos present the two treatment plans as if they are on the same playing field. shameful.

Vertical maxillary hyperplasia

Maxillary vertical hyperplasia or maxillary vertical excess is defined as excess in the vertical growth of the maxilla which may or may not result in an anterior open bite.13 This deformity can be corrected during the growth period with fairly predictable results. The vertical growth of the maxilla will continue after surgery in the same proportion as before the surgery,14 but the postoperative occlusal outcome will probably be preserved. The facial growth vector will continue downwards and backwards. Le Fort I osteotomy is not recommended as it may compromise the anteroposterior growth of the maxilla.3

http://www.scielo.br/scielo.php?pid=S2176-94512012000100019&script=sci_arttext

[pekay]

Vertical maxillary hyperplasia

Maxillary vertical hyperplasia or maxillary vertical excess is defined as excess in the vertical growth of the maxilla which may or may not result in an anterior open bite.13 This deformity can be corrected during the growth period with fairly predictable results. The vertical growth of the maxilla will continue after surgery in the same proportion as before the surgery,14 but the postoperative occlusal outcome will probably be preserved. The facial growth vector will continue downwards and backwards. Le Fort I osteotomy is not recommended as it may compromise the anteroposterior growth of the maxilla.3

http://www.scielo.br/scielo.php?pid=S2176-94512012000100019&script=sci_arttext

basically what that^^ says is until the person is done growing, correct?

[x]

basically what that^^ says is until the person is done growing, correct?

yes, essentially that the 'redirecting growth' does not happen via surgery.

it will maintain a proper occlusion in the case of vme though, but facial aesthetics are still compromised

[CK]

yes, essentially that the 'redirecting growth' does not happen via surgery.

not for all forms of abnormal growth, case #5 for example. article needs to be proof-read, males patients are referred to as shes. the surgeon was explicit surgery prior to growth is warranted in many cases. article doesn't say any surgery done prior to adulthood cannot defend against the direction of growth. only mvh as far as i can tel.

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not for all forms of abnormal growth, case #5 for example. article needs to be proof-read, males patients are referred to as shes. _____ was explicit surgery prior to growth is warranted in many cases.

source?

[CK]

source?

read the article. nowhere does it say any surgery cannot treat abnormal growth before adulthood, only vertical maxillary hyperplasia.

[x]

read the article. nowhere does it say any surgery cannot treat abnormal growth before adulthood, only vertical maxillary hyperplasia.

it treats the same way it would in adulthood, the article concludes it should be indicated in cases only where it's causing psychological distress or progressive issues (like condylar resorption)

[CK]

it treats the same way it would in adulthood, the article concludes it should be indicated in cases only where it's causing psychological distress or progressive issues (like condylar resorption)

youre right, but.

Professionals should understand the uniqueness of each individual case and be aware that some patients with facial deformities need to be subjected to surgery during growth in order to ensure for such patients function, aesthetics and a psychological attitude in line with their normal development.

article doesn't say surgery in adulthood is necessarily better than prior to growth just less risky, second/third surgeries might be needed (not always) but i dont think everything is as cut and dry as the article implies. surgeons with 30+ years of experience and responsible for recognizing long face syndrome have told me straight up intervention early in childhood can halt severe development problems later in life, and lead ultimately to a better aesthetic and functional result. the real issue is recognizing and eliminating the causes if they are induced by the environment.

[x]

youre right, but.

article doesn't say surgery in adulthood is necessarily better than prior to growth just less risky, second/third surgeries might be needed (not always) but i dont think everything is as cut and dry as the article implies. surgeons with 30+ years of experience and responsible for recognizing long face syndrome have told me straight up intervention early in childhood can halt severe development problems later in life, and lead ultimately to a better aesthetic and functional result. the real issue is recognizing and eliminating the causes if they are induced by the environment.

well the implication of the part you quoted isn't that you're suddenly gonna start growing cheekbones when your jaws moved forward, or that they aren't going to fall back into the same pattern they were already in; it's that the natural aesthetic improvement of surgery will help them fit in with their peers. It's why a second surgery is almost always indicated, because the first is a holdover to help kids get through adolescence.

environment is a different ballgame.

[CK]

well the implication of the part you quoted isn't that you're suddenly gonna start growing cheekbones when your jaws moved forward, or that they aren't going to fall back into the same pattern they were already in; it's that the natural aesthetic improvement of surgery will help them fit in with their peers. It's why a second surgery is almost always indicated, because the first is a holdover to help kids get through adolescence.

environment is a different ballgame.

lol obviously. every case is different and it's difficult to define a standard. i think we will learn more as time goes on, for quite awhile growth wasnt even considered which is why orthodontists have been able to get away with claiming they can redirect jaw growth.