Relapse from jaw surgery

[berback]

I read an old post from Lazlo in which he said surgeons pointed out all autologous bone grafts resorb with time (such as rib, hip bone grafst) except for grafts taken from the skull. This was linked to relapse of jaw surgery.
Everything is screwed in place. I thought the bone graft would be replaced with your own bone. How can a relapse still occur with all the screws to keep things in place and if in time the bone grafts are replaced with your own bone?

[Rico]

masseter muscle is extremely strong muscle.

If a patient have isolated zygomatic arch fracture.. 2 surgeons has to set it back.. they use a lot of force to do it

watch from 1 minute  https://www.youtube.com/watch?v=SMtDPZ-_D3U&list=PLktFzwbR092AVQ9D39wZVp4faDSJEcXZY

and now believe me, some patients can rebreak (or bent) the strong connectiong during chewing

installing plates often is not necessary for such fractures... the muscles and bone edges keep it strongly.. it's specific structure

[Rico]

not good osteosynthesis = relapse possible.

but the point is to install as less plates as possible

many surgeons choose compromise.. if they want patient to keep plates they uses microplates in crucial points , which may not be sufficient
other surgeons just install strong mini plates in crucial point in order to remove them later

surgeon must be experienced to know how and where install plates.. it's about the forces  and how muscles works
not all surgeons can predict everything

 just showed example how facial muscles can be strong...

Also not all patients have "good" strong bones (loose screws)

[Lazlo]

I gotta tell you, I've met several middle age people who have had jaw surgery back when they were in college or young and they've all looked deficient to me, except for class 3's hve looked "okay" but the class 2's looked like there was significant relapse over time. Hopefully techniques now are much better but I don't know. It might be one of the dirty secrets of jaw surgery. There's so much differnce of opinion about when braces should be removed. Arnett and Gunson say 6 months to a year afteer surgery to prevent relapse, other surgeons say a few months. And then everyone does the grafting differently and uses different materials.

It was Dr. Cameron Clokie, former chair of the maxillofacial surgeons body of america that told me only bone taken from the skull doesn't resorb.

[chinnychinchin]

Would nasal breathing, correct tongue posture and elimination of an atypical swallow contribute to better long-term stability?

[Rico]

ah you meant relapse in long term..... I understood it in another way

[MrFox]

I was talking to someone today who claimed the relapse rate in jaw surgery is 50%...
He was not a surgeon and has his own agenda, I instantly distrusted him after this statement.

Nowhere online can I find any mention of the rate of 50 %.

I have seen quite a few people that had double jaw surgery years ago and haven't experienced relapse.

[needadvancement]

Does lack of retention by patients post surgery affect this?

[carlos30]

I was talking to someone today who claimed the relapse rate in jaw surgery is 50%...
He was not a surgeon and has his own agenda, I instantly distrusted him after this statement.

Nowhere online can I find any mention of the rate of 50 %.

I have seen quite a few people that had double jaw surgery years ago and haven't experienced relapse.

had to be someone from Mew camp.

[carlos30]

Mike Mew wanted to charge me hundreds of pounds to speak with my surgeon and make him question the treatment plan he was proposing for me, then charge more to give me an appliance post surgery to prevent relapse (which he claimed is far higher than surgeons like to admit)

 

that guy, I swear....

[boyo]

relapse rate is about 20%, more bone movement increases your chances of relapse, so will only doing BSSO without moving the upper jaw with it

[PloskoPlus]

I gotta tell you, I've met several middle age people who have had jaw surgery back when they were in college or young and they've all looked deficient to me, except for class 3's hve looked "okay" but the class 2's looked like there was significant relapse over time. Hopefully techniques now are much better but I don't know. It might be one of the dirty secrets of jaw surgery. There's so much differnce of opinion about when braces should be removed. Arnett and Gunson say 6 months to a year afteer surgery to prevent relapse, other surgeons say a few months. And then everyone does the grafting differently and uses different materials.

It was Dr. Cameron Clokie, former chair of the maxillofacial surgeons body of america that told me only bone taken from the skull doesn't resorb.

Maybe they had surgery before plate fixation became common.

[Rico]

i believe too it's connected somehow with plates fixation issue in some cases.
I also believe that plates should be removed in most cases

[PloskoPlus]

i believe too it's connected somehow with plates fixation issue in some cases.
I also believe that plates should be removed in most cases

For whatever reason plates are removed in Europe, but not elsewhere.

[Rico]

yes, but the logic thinking says "remove them if it's not complicated. its' foreign object. and the skull changes little with the time"