Extraction gaps not closed for surgery

[Dopesaint]

Background: I have a class 2 bite and currently going through braces and decompensation for maximum advancement.

My orthodontist told me today my premolar extraction gaps will not be fully closed in time for my surgery this December, however I can still have the surgery and have my gaps closed post op.

Has anyone else went through surgery with their gaps not fully closed? Would this effect maximum advancement? If so I think I will postpone, only reason I got decompensation is for aesthetic reasons.

Edit: My surgery procedures are Lefort 1, BSSO CCW and Genioplasty.

[GJ]

How big a gap is open?

[Dopesaint]

How big a gap is open?

The gap from my left extraction gap is 6mm, my right extraction gap is substantially bigger, probably 10mm or more. I can provide pictures if that is better.

[Dopesaint]

I’m assuming whatever mm of extraction gap I have during surgery would’ve been added to my advancement if the gaps were closed?

[InvisalignOnly]

I had class 2 and had the surgery about 7 weeks ago (exactly the same type you're going to have), and my extraction gaps were not fully closed, I had maybe 1-2mm left on one side and 2-3mm on the other. I have self ligating braces that continued working so on one side my gap is now fully closed and on the other side there is maybe 2mm left. I don't think this was a big issue in my case, probably would have been better if the gaps were already closed but they did not make a big difference. However, any bigger gaps than that would have been an issue.

How fast are your teeth moving, does your ortho use power chains and are they tightened regularly? I had mine tightened every 3 weeks. To be very honest, if you have a 10mm gap now, I do not see how that will be almost closed by December. I think you should talk to the surgeon about this and ask how it will affect the plan.

Gaps aren't only a problem because the advancement will be less - they are a problem because if you have big gaps before surgery, how can they get the bite right? If they close the gaps later, you'll end up in class 2 again.

[Dopesaint]

I had class 2 and had the surgery about 7 weeks ago (exactly the same type you're going to have), and my extraction gaps were not fully closed, I had maybe 1-2mm left on one side and 2-3mm on the other. I have self ligating braces that continued working so on one side my gap is now fully closed and on the other side there is maybe 2mm left. I don't think this was a big issue in my case, probably would have been better if the gaps were already closed but they did not make a big difference. However, any bigger gaps than that would have been an issue.

How fast are your teeth moving, does your ortho use power chains and are they tightened regularly? I had mine tightened every 3 weeks. To be very honest, if you have a 10mm gap now, I do not see how that will be almost closed by December. I think you should talk to the surgeon about this and ask how it will affect the plan.

Gaps aren't only a problem because the advancement will be less - they are a problem because if you have big gaps before surgery, how can they get the bite right? If they close the gaps later, you'll end up in class 2 again.

Yes I’m getting them tightened every 3 weeks and power chains where the gaps are. Thank you for your insight, I am going to see my surgeon in November, so depending on my gap size then, maybe I’ll have to postpone.

[InvisalignOnly]

What about elastics? I have just remembered that I had elastics too, that probably speeded up the process a lot. In any case, it is better to wait for the gaps to (almost) close, you don't want to risk a less than optimal result.

[GJ]

The gap from my left extraction gap is 6mm, my right extraction gap is substantially bigger, probably 10mm or more. I can provide pictures if that is better.

Those are both too large. 1mm or so would likely be fine.
Why are they rushing this? How does he explain how it's fine to do surgery with gaps that large? There is zero chance the bite fits, and it increases the odds of a strange surgical movement because the movement is determined by putting the final models on an articulator and that determines the movement.

[Dopesaint]

Those are both too large. 1mm or so would likely be fine.
Why are they rushing this? How does he explain how it's fine to do surgery with gaps that large? There is zero chance the bite fits, and it increases the odds of a strange surgical movement because the movement is determined by putting the final models on an articulator and that determines the movement.

I attached some photos, I don’t think I measured correctly. Smaller gap is my left extraction gap.

My orthodontist and surgeon are in a different state, I think it just hasn’t been discussed that I might not be ready.

https://ibb.co/vdRhV8S
https://ibb.co/KN3p4Vj

[InvisalignOnly]

These are smaller than what you said but one of them is still way too large. Ask the ortho if elastics are an option. It should definitely be discussed with the surgeon, I would personally mention it to him before November.

[Dopesaint]

These are smaller than what you said but one of them is still way too large. Ask the ortho if elastics are an option. It should definitely be discussed with the surgeon, I would personally mention it to him before November.

Thank you, I will do.