SARPE + Bimax Questions (X-Rays provided)

[kavan]

If I was to just summarise I guess the SARPE would be in the interest of creating more room in my mouth (smaller buccal corridors) & setting the teeth up to be aligned later on down the line.

This is why I was asking about the other aesthetic implications, as they're more than welcome (well maybe not the nose thing but there's preventions/ solutions) but they were not the focal point during my consultation & so I did not ask about them.

Yes.

[beyondconfusedtbh]

okay so lets call these

Will fill out upper part of my cheeks a bit

Widen the base of nose & cheekbones*

Slight CW rotation of the maxilla*

side effects

Is there any way of pushing FOR the CW rotation? What bit of SARPE even causes this tbh


Also, while almost completely irrelevant to me I was curious about this procedure:

https://www.youtube.com/watch?v=S8TQa4c1D9g

Is this like a more dated sarpe? wtf are those things they insert in between the gaps?

[kavan]

okay so lets call these

side effects

Is there any way of pushing FOR the CW rotation? What bit of SARPE even causes this tbh


Also, while almost completely irrelevant to me I was curious about this procedure:

https://www.youtube.com/watch?v=S8TQa4c1D9g

Is this like a more dated sarpe? wtf are those things they insert in between the gaps?

Sorry. Can't advise you on how to push for something (clockwise rotation) where it's not clear to me you know what you are requesting and why. All I can suggest to that regard is that you confirm you want Clockwise rotation and demonstrate your reasoning for wanting it. When you know what you want and why, it becomes easier to discuss different displacement possibilities with the attending surgeon.

As to the VIDEO. SARPE and SARME are the same thing. In SARPE, the 'P' stands for Palate and in SARME, the 'M' stands for Maxilla. 'P'= 'M' as in different words for same thing.

HOWEVER, as to the video it is showing a 3 piece Lefort 1 to a recessed and narrow maxilla/palate. The things between the gaps are BONE BUTTRESS material so the openings made don't close.

[beyondconfusedtbh]

Once again I've been thinking about this in completely the wrong way.

So I want CW rotation (as another user pointed out) because my occlusal plane is a little too flat. I have NO IDEA why I didn't think to just ASK my surgeon about this as if it were some random uncontrollable outcome.

Sorry lol

[kavan]

You need to ascertain WHAT displacement(s) you are getting and not confuse yourself more with videos of what you might not be getting in your surgery such as the prior video. This video, is probably what you are getting. But only YOU can ascertain FROM your doctor what will be done in terms of displacements. https://www.youtube.com/watch?v=aNngGPuA4ho

[beyondconfusedtbh]

Thanks for your concern, yet again I probably mislead you by posting that video but rest assured I'm aware that I'm getting SARPE with a distraction device that I'll turn myself follower by braces --> power rails etc etc

My only concern came from the fact that I thought I MIGHT as a SIDE EFFECT get some CW ROTATION (although desirable), but as you pointed out my worry stemmed from me not asking my surgeon to fully explain his plan for the surgery.

tldr: I was focusing on the SARPE and not looking into what the proposed SARPE actually entailed

thanks again  

[kavan]

Thanks for your concern, yet again I probably mislead you by posting that video but rest assured I'm aware that I'm getting SARPE with a distraction device that I'll turn myself follower by braces --> power rails etc etc

My only concern came from the fact that I thought I MIGHT as a SIDE EFFECT get some CW ROTATION (although desirable), but as you pointed out my worry stemmed from me not asking my surgeon to fully explain his plan for the surgery.

tldr: I was focusing on the SARPE and not looking into what the proposed SARPE actually entailed

thanks again

Glad I was helpful. thanx

[beyondconfusedtbh]

Reviving this.

Since head tilt doesn't effect the actual shape of the skull I tried calculating the SNA angle (pic attached)

The mean value of this angle is 82+-2 degrees, I got ~68 degrees. So I have retrognathia of my maxilla and by extension my mandible also needs advancing. AKA my profile is not fine & there IS reason to have an advancement.

Please let me know if there's any gaps in my knowledge/ a flaw in my conclusion (especially if the S point I've used is accurate, had a hard time finding the sella.)

[beyondconfusedtbh]

To me it looks like my sella is strangely positioned when compared to the anatomical 'norm' & that could be skewing the results. That's just my analysis though. Regardless, I assume this positioning signals that there is something not exactly correct about my skeletal development.

[kavan]

Yes. There would be gaps if you did not know:

a: The A point is about 4 degees ahead of where you put it. So, SNA approx 72
b: Where the B point would be. SNA= SNB=72 (approx), therefore ANB=0
c: That when ANB=0, the 'Wits analysis' number would also be 0
d: That a Wits number of 0 is class 1 class= balance between both jaws
e: That your SN line being 20 degrees away from a horizont is in EXCESS of the norm.

Although I don't know exactly what the norm for SN line relative to horizont is, it could be around 10 degrees. So, an approx 10 degree deviation of the SN norm would account for SNA being 72 when the SNA norm is about 82.

In essence the deviation from the norm inclination of the SN line relative to a horizont would account for the deviation your SNA has from the norm.

Factoring the deviation and the Wit's # in, this would be considered class 1 skeletal BALANCE and NOT an indication to advance either the maxilla or mandible or both.

Outside of that the salient observation to make which is 'intuitively obvious' to a lot of people and in the absence of knowing anything about these points IS there is GOOD BALANCE to the jaws and harmony to the profile.

That is a sufficient # of gaps for me to fill in.