CBCT 4 months after DJS - questions

[InvisalignOnly]

Still I think there should be some stichtes from the outside or at least a band aid after the surgery, which couldn't be unnoticed. Stichtes should be there at least for 2 weeks.

Yes there were! I never really noticed them though because I had some sort of a bandage on that area plus lots of swelling and bruising in general so never paid attention to the tiny holes. By the time everything else was over, the holes disappeared.

[InvisalignOnly]

I will have to respectfully disagree that "Arnett Plates" are the standard.  He just likes them promotes and the has a cult like following who for no scientific reason think they are better.  I would be willing to bet that more BSSO's are done using position screws than plates and using a 3-4 mm poke in the cheek you cannot see in 10 days.  Look at the literature and stability and outcome are indiscernible. 

Arnett, and he is a friend, promotes that "if you do not use plates you get condylar resorption and relapse".  This is total BS.  I presented our research at the Arnett Forum in 2019 using 3D mapping of the condyles after a statistically significant number of Class II and Class III DJS done with position screws and guess what.....resorprtion was insignificant and less than 0.5mm which is considered adaptive.  Furthermore there was apposition in other ares, again adaptive.  No change in the occlusion as expected.  Arnett/Gunson claim that anything other than manual positioning of the proximal segment and then using two plates causes the medial pole of the condyle to resorb and cause relapse.

Again total BS.  In our study I used a specially designed BBSO segment holding clamp, which is heresy in the Arnett/Gunson camp, and guess what....not a single patient had any resorption on the medial pole.  When I presented our data and answered questions directly from Arnett the audience was stunned. 

Be very careful in what is considered "gospel" and standard of care.

You made my day with this comment, thank you!!! I don't care about what hardware they used or how they got it in, as long as I will not have a relapse.

[InvisalignOnly]

Small puncture pokes that close up quick and you don't see due to the swelling. Also with fat grafting, they make the small puncture poke to introduce the cannula and they close up quickly.

That's exactly what happened, I didn't really notice them as the whole area was swollen and bruised, and by the time bruising disappeared, they closed up. I cannot see or feel them at all now. Anyway, interesting to know that someone pushed a bunch of metal screws through my skin from the outside