bimax vs bsso

[lsubuilder]

Need some advise. Had braces as a kid. My bite was fixed (and im told my upper teeth tilted in to compensate) but it left me looking like this. also have been developing sleep apnea. Ive been talking to a new orthodontist who referred me to a local surgeon for bimax. Well the surgeon disagrees and thinks I only a bsso. His plan is to pull lower teeth and create an overjet to bring my jaw forward. Im not sure this is going to improve my profile much. Recently found out he only like to preform surgery on one jaw. Does this guy sound like he knows what hes talking about?

So looks like I will have to travel out of state for this. Im in Louisiana and was looking in either Houston or Dallas. I know Gunson is great in California. Im confused how that would work for follow up appointments as air travel would add up.

[lsubuilder]

ceph

[Post bimax]

Looks like your occlusal plane is pretty steep.  I think you need a bimax with counter clockwise rotation. Gunson would be good for getting comprehensive analysis, and a good surgeon if you can afford him.  Some big names that do what I think you need.

Wolford (kinda old though)
Movahed
Relle
Alfaro (Spain)
Gunson

[GJ]

You need a pretty drastic rotation, so I agree with PB's list. Though, there are a lot of no-name surgeons that do good work, too, so maybe you can find one in your area. If you get local leads try to also talk to their patients. Richard Joseph in Flordia has nice results, but last I heard he was only taking FL residents. You might be close enough he'd work on you. There was a guy in the Northeast (Henry? I think that was the last name) who I heard did good work, too.

Any extractions as a kid? Some people do get recommended lower extraction only so they can move the jaw linearly. Not sure that would do enough for you. It's generally better for flat occlusions and where not a lot of advancement is needed. You have a steep occlusion and need quite a bit of advancement. Hence a big CCW movement might be best, though it can be unstable.

[kavan]

Well, your upperjaw would best NOT be brought forward. Lower only (if that can be done) would bring some improvement. But tradeoff is lower jaw tooth extractions to do it. However, the upper jaw could be cut, tilted down in the back and posterior part of it filled with a big downgraft. That would allow minimum upper jaw forward displacement and tend to maximize the advancement to the lower jaw and more so than the single BSSO offered to you.

[lsubuilder]

No never had any extractions. I had a feeling the guy i went to didnt know what he was talking about. I he acted like i was crazy asking about rotation. Ill have to look into those doctors thanks. Ive looked into Alfaro but im not sure how this all works when traveling overseas. My orthodontist already seemed shocked when i said i was looking in other states

[PloskoPlus]

Of those mentioned, Relle is the most conservative, but few complain about him. Alfaro and Gunson are known to have left so many bad bites, that I wouldn’t trust either. Wolford invented CCW. Movahed is supposedly his best student. Taylor in Houston is also supposed to be very good and affordable. Realistically you only have one shot at this, so make it count. You need significant CCW rotation.

[Post bimax]

No never had any extractions. I had a feeling the guy i went to didnt know what he was talking about. I he acted like i was crazy asking about rotation. Ill have to look into those doctors thanks. Ive looked into Alfaro but im not sure how this all works when traveling overseas. My orthodontist already seemed shocked when i said i was looking in other states

The cost of going to a different state or even international is nothing compared to a lifetime of unhappiness due to A poor functional and/or aesthetic outcome. This is a complex and risky procedure. Not the time for deal-hunting

[Post bimax]

Of those mentioned, Relle is the most conservative, but few complain about him. Alfaro and Gunson are known to have left so many bad bites, that I wouldn’t trust either. Wolford invented CCW. Movahed is supposedly his best student. Taylor in Houston is also supposed to be very good and affordable. Realistically you only have one shot at this, so make it count. You need significant CCW rotation.

Movahed does seem to get almost universally positive reviews. I’m not sure if this is a function of the type of cases he takes on, the fact that his operation volume is still relatively low since he’s young, or if he’s actually just that good.

[PloskoPlus]

Movahed does seem to get almost universally positive reviews. I’m not sure if this is a function of the type of cases he takes on, the fact that his operation volume is still relatively low since he’s young, or if he’s actually just that good.

I distinctly remember mentioning here that some of his patients have posterior open bites in the photos on his site. Those photos are no longer there.

[Post bimax]

I distinctly remember mentioning here that some of his patients have posterior open bites in the photos on his site. Those photos are no longer there.

The one negative review I found complained of posterior open bite. Not sure if it’s the same case.

[ArtVandelay]

Go on a consultation spree, a lot of the high volume top guys will give you a full surgical plan in your very first appointment.

Since you have an old school ceph, it looks like your surgeon didn't take a CBCT scan aka 3D xray. I'd avoid surgeons who don't do 3D planning.

[Post bimax]

Go on a consultation spree, a lot of the high volume top guys will give you a full surgical plan in your very first appointment.

Since you have an old school ceph, it looks like your surgeon didn't take a CBCT scan aka 3D xray. I'd avoid surgeons who don't do 3D planning.

Most won’t do the CBCT until the planning appointment immediately prior to surgery. This is Gunson’s method too.

[ArtVandelay]

Most won’t do the CBCT until the planning appointment immediately prior to surgery. This is Gunson’s method too.

Ohh Gunson wanted a CBCT's for me but maybe it's because I was a revision case.

[Post bimax]

Ohh Gunson wanted a CBCT's for me but maybe it's because I was a revision case.

I'm also a revision case but he didn't take a CBCT during the consult.  Maybe it's case-by-case. Should definitely go with a surgeon that uses one for the week-of-surgery planning.