Splints after jaw surgrey

[JimmyTheGent]

Are splints an outdated concept in jaw surgery?   Should one avoid surgeons still using this method?

[marcus3415]

No they are not outdated. Bite splints are usually a good idea to help the patient's bite adjust to the new position (it is quite the change to the masseter and condyes!)

Rule of thumb: Bite splints for Lefort 1 that is a single piece are usually kept in for about 7-10 days.

If you have a multipiece lefort, it is usually up to 4 weeks then an expander afterwards.

[Bobbit]

Are splints an outdated concept in jaw surgery?   Should one avoid surgeons still using this method?

What is the reason why you thought that the appropriate use of splints in jaw surgery was outdated ?

some of the splints made using 3-D printers are pretty nifty.

[JimmyTheGent]

I thought I read a few people say that some of the top jaw surgeons were no longer using them.  I think I read that the doctors at NYCOMS no longer use them.  I could be wrong.

[marcus3415]

It's a surgeon preference. I was pretty happy that my surgeon used it because I can imagine my muscles and jaw would have gone crazy without it. It has to get used to the new position

[Dharma]

My surgeon did not use them for my MMA.  He says he uses them for particular orthognathic cases but no longer for MMA, particularly when pre-op occlusal is good (like mine was).  Per his report, he and other surgeons have noted that the before/after occlusal success has been similar with or without splints.  Considering this in light of the significant costs in terms of patient comfort, ability to communicate, etc, more and more surgeons are foregoing them, apparently.   I'm not sure this has been formally studied at this point. 

   

[chynee]

My surgeon and orthodontist both told me I’m definitely going to have a splint. Could just be case by case?

[marcus3415]

chynee if youre having your top jaw expanded you will most definitely require a splint

[chynee]

chynee if youre having your top jaw expanded you will most definitely require a splint

I don’t think I am, but I don’t know all the right terminology. My width is correct and the models line up perfectly. They are doing my maxilla in one piece.

[JimmyTheGent]

Thanks everyone for the responses.  Which ever way makes it easier to breath and puke is what I would prefer.   

[Dharma]

Ya, bout that...

Even without the splint, vomiting (or even feeling like you are) with your teeth banded shut and your nose clogged with blood feels like you're being waterboarded...

So much fun.    

[JimmyTheGent]

Ya, bout that...

Even without the splint, vomiting (or even feeling like you are) with your teeth banded shut and your nose clogged with blood feels like you're being waterboarded...

So much fun.   

This is what I am so afraid of!!!! 

[april]

This is A&G's take on surgical splints (from 2010 interview)

DR. CHUDASAMA Do you use intraoperative
splints to find the correct occlusion during orthognathic
surgery?

DR. GUNSON Two splint types are used with
orthognathic surgery—intermediate and final. We
use intermediate splints during double-jaw surgery
to orient the mobilized mandible to the unoperated
maxilla. The intermediate splint is made before
surgery on a semiadjustable SAM articulator,*
using the Great Lakes** model block to assure
movement accuracy within .25mm. The model
block is used because standard measurements,
whether made directly on the casts or on the
articulator, are grossly inaccurate (mean 2.5mm).

We do not use final splints. Our experience
has shown that bite correction is not as accurate if
a final splint is used. There are 13 steps in making
a final splint, all of which can produce error in the
final occlusion. Having tooth-to-tooth contact
immediately after surgery also results in a more
stable and intercuspated occlusion. Most significant,
transverse surgical expansion is less stable
when a final splint is used.

[Dharma]

Thanks Bee.  Yup--thats it.

When I stated that my surgeon didn't use splints, I meant what A&G are calling "final" splints here.  Intra-operative splints appear to be a requisite part of double jaw surgery--everybody uses them as far as I know.  I'm not sure how else you could effectively get things moved/lined up appropriately when actually making the movements.   

[chynee]

Thanks Bee.  Yup--thats it.

When I stated that my surgeon didn't use splints, I meant what A&G are calling "final" splints here.  Intra-operative splints appear to be a requisite part of double jaw surgery--everybody uses them as far as I know.  I'm not sure how else you could effectively get things moved/lined up appropriately when actually making the movements.

Interesting. I’m not sure if my surgeon was referring to intermediate or final. He just told me at my next appointment he’s going to take models so he could make a splint. Now I’m going to ask!