Author Topic: Class II patients and functional apliances  (Read 14935 times)

pekay

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Re: Class II patients and functional apliances
« Reply #15 on: July 25, 2013, 06:04:36 PM »
i have seen some great transformations (kids -> teenager) with braces only







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Kristen

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Re: Class II patients and functional apliances
« Reply #16 on: July 26, 2013, 12:20:31 PM »
 :-\Lucky kids     ....   They got a good ortho

Alue

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Re: Class II patients and functional apliances
« Reply #17 on: July 26, 2013, 04:32:23 PM »
:-\Lucky kids     ....   They got a good ortho

Or they were cherry picked good results, poor results get swept under the rug. 

pekay

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Re: Class II patients and functional apliances
« Reply #18 on: July 26, 2013, 04:36:07 PM »
Or they were cherry picked good results, poor results get swept under the rug.

for sure

however that guy doesn't to seem to hesitate when it comes to surgery

http://bowbeerortho.com/before__after/surgical_cases
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x

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Re: Class II patients and functional apliances
« Reply #19 on: July 26, 2013, 04:36:42 PM »
the problem with looking at kids is we assume there's an alternative universe where they end up looking deformed because they didn't get the right ortho, didn't get extractions, didn't get surgery at a young age when we have no idea how they would've turned out otherwise. that's where all this early surgical intervention nonsense started up

and to me all those kids look like there problem was mostly with the dentition and not the skeleton

x

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Re: Class II patients and functional apliances
« Reply #20 on: July 26, 2013, 04:38:03 PM »
for sure

however that guy doesn't to seem to hesitate when it comes to surgery

http://bowbeerortho.com/before__after/surgical_cases
again, not seeing before/afters that blow away adults. I've seen plenty of adults with just as nice of results

pekay

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Re: Class II patients and functional apliances
« Reply #21 on: July 26, 2013, 04:45:33 PM »
that's where all this early surgical intervention nonsense started up


not non-sense

ask sharptoys to send you the paper that he sent me

the problem is early surgical intervention comes in making the right diagnosis = is my son/daughter going to end up with a cute/endearing overbite or underbite that is easily fixable or is it going to be one of those cases where the entire face becomes distorted? <- I would imagine that only a few select surgeons can safely make that decision
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CK

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Re: Class II patients and functional apliances
« Reply #22 on: July 26, 2013, 04:46:08 PM »
i have yet to see one case where a truly deformed adult becomes highly attractive, but i have seen plenty of truly night and day cases with young people. the ortho examples above seem dental exclusive as you suggested.

then again we have seen some kids who get surgery and end up meh later or require more surgeries. really depends on the individual.

Quote
the problem is early surgical intervention comes in making the right diagnosis = is my son/daughter going to end up with a cute/endearing overbite or underbite that is easily fixable or is it going to be one of those cases where the entire face becomes distorted? <- I would imagine that only a few select surgeons can safely make decision

orthos seem more comfortable in employing unsophisticated and proven to be harmful appliances in their treatment plan. i bet if more resources were poured into diagnosing growth disorders early in life rather than slapping on braces at the first sign of bite problems we would all be better off....except for orthos who would be making far less $$$$. 

x

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Re: Class II patients and functional apliances
« Reply #23 on: July 26, 2013, 04:54:42 PM »
yea i agree but i have yet to see one case where a truly deformed adult becomes highly attractive, but i have seen plenty of truly night and day cases with young people. the ortho examples above seem dental exclusive as you suggested.

then again we have seen some kids who get surgery and end up meh later or require more surgeries. really depends on the individual.
that's what I'm saying. those people who become highly attractive, I bet if they had waited to get surgery, they would've been one of those adults who we'd classify as having "a great starting point, but just the jaws are throwing everything off" much like this girl pekay once posted:



In my opinion it comes down to the uncontrollable features, not at what point in your life you get surgery

not non-sense

ask sharptoys to send you the paper that he sent me

the problem is early surgical intervention comes in making the right diagnosis = is my son/daughter going to end up with a cute/endearing overbite or underbite that is easily fixable or is it going to be one of those cases where the entire face becomes distorted? <- I would imagine that only a few select surgeons can safely make that decision
I sourced the article from Wolford that describes how downwards & backwards growth continues in spite of surgical intervention, feel free to post your source because I have yet to see one that backs the growth can be redirected theory you keep proposing

x

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Re: Class II patients and functional apliances
« Reply #24 on: July 26, 2013, 05:00:43 PM »
here's the abstract and article again 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


pekay

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Re: Class II patients and functional apliances
« Reply #25 on: July 26, 2013, 05:02:44 PM »
Euphoria: I actually have the link myself, check PM

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x

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Re: Class II patients and functional apliances
« Reply #26 on: July 26, 2013, 05:12:07 PM »
I'll go ahead and post the abstract, but first, let us be clear. I'm in no way suggesting surgery during growth isn't effective, won't work. What Ive seen time and again on here is the notion that, specifically in long face syndrome cases it seems, bones of the upper face that were grown downward and backward will suddenly stop and start growing forward like they're ideally supposed to. This is the supposed advantage, of early intervention correct?

Management of the growing patient with mandibular dentofacial deformities presents a unique and challengingproblem for orthodontists and surgeons.The surgical procedures required for correction of the deformity mayaffect postsurgical growth and dentofacial development.Further, facial growth may continue postoperativelyand negate the benefits of surgery performed, resulting in treatment outcomes that are less than ideal.Fromindividual patient characteristics, the type of deformity, and the indications for early surgical intervention, it ispossible to effectively treat many cases during growth.A thorough understanding of facial growth patterns isessential, and each case needs to be evaluated individually.Surgery is often undertaken with the expectationthat additional treatment, including more surgery, may be required after the completion of growth.The materialpresented here is based on the available research and the senior author?s clinical experience of more than 25years in the correction of mandibular deformities in the growing patient.Advantages and disadvantages ofspecific surgical techniques for correction of common mandibular deformities and pertinent age and surgicalconsiderations are discussed.The material should be viewed as a general outline that provides broadguidelines for management of these patients.The management of maxillary deformities will be discussed inPart 2 of this article.(Am J Orthod Dentofacial Orthop 2001;119:95-101)

Tiny

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Re: Class II patients and functional apliances
« Reply #27 on: July 26, 2013, 05:17:17 PM »
There is one before/after, can't find it now but I think it's Arnett/Gunson - the girl with the red hair, about 18, overbite/underdeveloped mandible  She looked amazing post-surgery, huge improvement

pekay

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Re: Class II patients and functional apliances
« Reply #28 on: July 26, 2013, 05:23:24 PM »
There is one before/after, can't find it now but I think it's Arnett/Gunson - the girl with the red hair, about 18, overbite/underdeveloped mandible  She looked amazing post-surgery, huge improvement

her?

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pekay

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Re: Class II patients and functional apliances
« Reply #29 on: July 26, 2013, 05:38:47 PM »

sorry, what do you want me to say? i don't have much stake in that early intervention theory as I was told that my upper face developed properly, I would be extremely happy if I could have surgery now with a "top guy" but unfortunately due to logistics related problems I'm forced to either settle with a guy that is doing mandibular set-backs in 30mins (wtf?) or walking away completely

witnessed two cases myself 1) mom's best friend her 17 year old daughter (class 2, gummy smile) had surgery at that elite craniofacial surgery center in Campinas and has now relapsed (she is 22-23? and her gummy smile sorta came back) 2) Class III girl over at the .br forum had surgery for her underbite when she was 19 and has relapsed completely (under-bite came back)
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