General Category > Aesthetics
Thoughts on this BiMax?
IconVillage:
--- Quote from: valhalar on May 20, 2019, 09:34:58 PM ---Some people on here have argued that if you only need a lower jaw surgery, then BSSO is better because you do the surgery once. IMDO requires a surgery, then turning the intermandibular distraction each day, and then another surgery to take the appliances out. However many adults with small lower jaws will require a jaw extension coupled with a genioplasty. IMDO is suitable because you could potentially do the genioplasty upon removal of the distraction device... I am not quite sure if there is another wait period however.
An example is shown here: https://www.instagram.com/p/66MRpXnEtw/
12mm of advancement with IMDO, followed by 10mm of advancement with a geniopaully (It's a genioplasty - this doctors version of it).
--- End quote ---
I assume the guy in the picture also had bite issues? I don't think this can work for a class 1 bite but mandibular recession right?
valhalar:
--- Quote from: IconVillage on May 20, 2019, 09:54:53 PM ---I assume the guy in the picture also had bite issues? I don't think this can work for a class 1 bite but mandibular recession right?
--- End quote ---
I have a Class I bite and mandibular recession. Dr Coceancig recommended I lengthen my lower mandible but did not say what he would do to achieve it. I am assuming it would be braces, followed by IMDO or BSSO. I only went for a single meeting and he seemed busy, I also had zero understanding of jaw surgery at the time so didn't ask what procedure it would entail. I haven't gone back yet and will seek the opinions of other macfacs to get a proper assessment before I make up my mind because he is apparently rather expensive. One member said their estimated cost was about $30k AUD after medicare. If I find other surgeons are not careful in their aesthetic concerns then I will considering returning to him.
There's no reason to say a Class I bite and a small mandible is not a candidate however. They can move the lower teeth backward with braces to create a large Class II overbite. They'll then perform surgery to extend the lower mandible so that the teeth meet. Other times you might need double jaw surgery to lengthen the maxilla forward so the longer mandible will meet it correctly.
The patient in this photo https://www.instagram.com/p/66MRpXnEtw/ started with a significant Class II bite so the process was likely faster.
valhalar:
I should also add that often times a Class I bite combined with a small mandible actually means that you have both a small upper and lower jaw. A small mandible but large maxilla often has a much greater overbite and is more often referred immediately to maxfac surgeons. Class I bites with small mandibles are just camouflaged by orthodontists, and they often have larger noses and seek rhinoplasty.
You need a full face analysis to determine if this is the case. If it the case you will probably need a double jaw surgery which will provide you a better result but can have it's downsides too.
PloskoPlus:
12 mm is well within the realm of bsso.
Abdulrahman:
--- Quote from: valhalar on May 20, 2019, 10:39:14 PM ---
They can move the lower teeth backward with braces to create a large Class II overbite. They'll then perform surgery to extend the lower mandible so that the teeth meet.
--- End quote ---
Are you sure about this part? Moving the lower teeth back, particularly the molars, is next to impossible. The alveolar bone in the lower jaw is less malleable and the lower teeth are constantly pushed forward by the upper teeth through mesial drift.
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