Thinking of going for DJS

[trandom]

Had another consultation with the more experienced maxfac and he suggested we move both the mandible and the maxilla in a way that would not alter the bite, which basically means there's no need for ortho treatment afterwards.

Since I am seeking good amount of forward movement I am not sure why not move the mandible forward to correct my overbite & get an extra 2-4mm projection @ POG.

I'm attaching the photos again through imgur, together with the first plan (where the bite is altered).

I've also edited the simulation to showcase how I'm going to look if the plan is the same expect that the bite also stays the same.

I think the issue with this simulation is that it does not account for soft tissue "bounce back" as the thickness of the soft tissue stays the same (length between POG - skin stays the same)

https://imgur.com/a/2lnbao7

[lookism]

Had another consultation with the more experienced maxfac and he suggested we move both the mandible and the maxilla in a way that would not alter the bite, which basically means there's no need for ortho treatment afterwards.

Since I am seeking good amount of forward movement I am not sure why not move the mandible forward to correct my overbite & get an extra 2-4mm projection @ POG.

I'm attaching the photos again through imgur, together with the first plan (where the bite is altered).

I've also edited the simulation to showcase how I'm going to look if the plan is the same expect that the bite also stays the same.

I think the issue with this simulation is that it does not account for soft tissue "bounce back" as the thickness of the soft tissue stays the same (length between POG - skin stays the same)

https://imgur.com/a/2lnbao7

you wouldnt need any braces? does the movement include any rotation?

[trandom]

you wouldnt need any braces? does the movement include any rotation?

Yes, I won't been any braces.

The plan is to displace both the maxilla and the mandible in a way that keeps the bite as it is right now.

He's also planning to rotate the maxilla with posterior downgraft (which is a bit odd to me since I have a little too much gum show) and move both the maxilla and the mandible forward a lot, with POG movement of around 20mm.

[lookism]

so you can rotate a jaw without changing the bite?

[trandom]

so you can rotate a jaw without changing the bite?

If you rotate both the maxilla and mandible the same amount, why not?

[LeFort 3000]

Who did the 2nd plan? you can pm me if you may if you dont want to publice the name. just for interest, it looks ofc like a photoshop version of a surgery and will not be like that in real life, but it shows the doctor has a great understanding of how a jaw area should look like to be aesthetically pleasing.

[trandom]

There's 1 thing I don't really understand, surgeon #2 says that he's going to keep the bite the same, yet in the simulation, the relationship between my lips changes a lot, and in the simulation, they actually meet perfectly (instead of my upper lip being forward).

I understand that the CCW might have an effect on this one, but is it enough to fix it?

[lookism]

If you rotate both the maxilla and mandible the same amount, why not?

i dont know i just read here a lot that surgery without braces is so uncommon and rare. maybe its a european thing to do it without braces

[trandom]

If your bite is good you don’t need braces, you basically don’t need any pre or post op treatment, some call it “surgery last”

[GJ]

If your bite is good you don’t need braces, you basically don’t need any pre or post op treatment, some call it “surgery last”

And some call it "asking for errors"...

[trandom]

And some call it "asking for errors"...

And why is that?

[GJ]

And why is that?

Obviously if you can only move the jaws and not the teeth, the margin for error becomes extremely slim. Most good, successful jaw surgery is within 1mm of accuracy. So being 1mm off is a success with the bony movement. If you have no braces to refine the teeth that extra 1mm you are screwed, unless the surgeon somehow nails the surgery to .01mm of accuracy, which is possible, but not probable.

[trandom]

This is doable only in case that this margin of error can be corrected with Invisalign, like in my case, I'm meeting with Prof. A next week, will update on my proposed plan.

[GJ]

This is doable only in case that this margin of error can be corrected with Invisalign, like in my case

The margin of error for any surgery is 1mm, and if your bite is off 1mm, it won't be able to be corrected with Invisalign.

If you get a sub 1mm outcome, which is possible but not probable, then yeah, it's possible to avoid braces. I'd put the odds of success with that around 5-10%.

[lookism]

The margin of error for any surgery is 1mm, and if your bite is off 1mm, it won't be able to be corrected with Invisalign.

If you get a sub 1mm outcome, which is possible but not probable, then yeah, it's possible to avoid braces. I'd put the odds of success with that around 5-10%.

so basically all surgeries that are done for the purpose of sleep apnea (most people have an ok bite) will destroy the bite. because braces are not common in that regard?

and any idea why the "surgery first approach" is so much more common in europe in comparison to the usa?