Author Topic: Posterior Downgraft - What exactly is it?  (Read 3580 times)

trandom

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Posterior Downgraft - What exactly is it?
« on: February 17, 2021, 02:20:19 AM »
I keep seeing this term and from my basic understanding of it, what it does is lower the posterior part of the maxilla which creates CCW rotation of it and might be a good choice for someone who would want to do CCW but does not expose excessive gum, hence anterior impaction will cause his gums to disappear when smilling.

I have researched online and I can't find a sufficient explanation as for what it is exactly, not even a diagram.

I would appreciate it if someone could explain it to me.

kavan

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Re: Posterior Downgraft - What exactly is it?
« Reply #1 on: February 17, 2021, 10:02:34 AM »
If you keep seeing this term on this board then try using the search function of this board by plugging in; posterior downgraft.
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trandom

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Re: Posterior Downgraft - What exactly is it?
« Reply #2 on: February 27, 2021, 04:47:29 AM »
 Hi Kavan,

I searched and haven't found any explanation for it, it's a term that's being used here a lot but I still don't have an understanding of how it works exactly.

Alfaro told me he will do Posterior downgraft on me instead of interior impaction since he does not want to cover up my gums more, but I don't really understand the mechanics behind it.

kavan

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Re: Posterior Downgraft - What exactly is it?
« Reply #3 on: February 27, 2021, 03:23:40 PM »
Hi Kavan,

I searched and haven't found any explanation for it, it's a term that's being used here a lot but I still don't have an understanding of how it works exactly.

Alfaro told me he will do Posterior downgraft on me instead of interior impaction since he does not want to cover up my gums more, but I don't really understand the mechanics behind it.

Well, I don't have an 'exact' definition for it to provide. I've never needed an 'exact' definition for it because CONCEPTUALLY, it relates to a very elementary geometric principle, in particular the CCW ROTATION of a TRIANGLE around around a fixed pivot point.

Such a triangle can be constructed from points; ANS, PNS (on the maxilla) and point Pog on the chin. When fixed point is ANS and rotation is CCW, PNS moves DOWN and Pog moves OUTWARD.

The posterior downgraft is something needed to 'WEDGE' PNS downwards and keep ANS fixed.
It can be conceptualized as a wedge shape addition (graft) used to CCW rotate a triangle of points; ANS, PNS and Pog.

Included is a link showing the rotation of a basic triangle and how it can be related to the triangle constructed from points; ANS, PNS and Pog.

http://jawsurgeryforums.com/index.php/topic,7883.0.html
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SmallJaw12

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Re: Posterior Downgraft - What exactly is it?
« Reply #4 on: February 27, 2021, 09:16:01 PM »
I also found this image of how the maxilla actually looks after downgrafting(warning: NSFW)- https://www.instagram.com/p/CDz77PLFlbl/?hl=en
Though here it's an overall downgraft and not just a posterior one, you can probably understand it better from this. So there's a gap created which is then filled with the graft.

kavan

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Re: Posterior Downgraft - What exactly is it?
« Reply #5 on: February 27, 2021, 09:53:44 PM »
I also found this image of how the maxilla actually looks after downgrafting(warning: NSFW)- https://www.instagram.com/p/CDz77PLFlbl/?hl=en
Though here it's an overall downgraft and not just a posterior one, you can probably understand it better from this. So there's a gap created which is then filled with the graft.

There is no better way to understand the principles in maxfax displacements than having some grounding in basic geometrical relationships.
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SmallJaw12

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Re: Posterior Downgraft - What exactly is it?
« Reply #6 on: February 27, 2021, 11:34:24 PM »
Hi Kavan, yeah I agree :). Having knowledge about the displacements and movements is absolutely necessary to understand what's going on.
This is just to help him visualise the wedge shaped addition(grafting) which you wrote about in your previous post.

kavan

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Re: Posterior Downgraft - What exactly is it?
« Reply #7 on: February 28, 2021, 02:57:36 PM »
Hi Kavan, yeah I agree :). Having knowledge about the displacements and movements is absolutely necessary to understand what's going on.
This is just to help him visualise the wedge shaped addition(grafting) which you wrote about in your previous post.

Although you are correct to show the illustration where the SPACE left behind from the displacement is that which is filled in via the downgraft, the space left behind  isn't a wedge. It's quadrilateral; a four sided figure. A wedge section is a 3 sided figure. For example, if I cut of the VERTEX from a wedge of cheese, it's no longer a triangle shape. It's a 4 sided figure.

So, the illustration is that of a downgraft that has anterior + posterior downgrafting. Hence CW + CCW where CCW is more than CW for a NET CCW rotation.

It's not a wedge shape because the wedge shape (left behind to be filled via a downgraft) relates to the rotation of a triangle around a FIXED point (the vertex corresponding to the ANS point). See illustration I linked to. The GREEN triangle; A, B', C' is actually the DISPLACEMENT of the BLUE triangle; A,B,C when rotated X degrees CCW. The A point is FIXED (not displaced with the CCW rotation). The space left behind is A,B, B' which is a wedge.

The illustration you showed is not a wedge because the ANS point (corresponding to the A point in the triangle illustration) is not FIXED. It's displaced downward which RELATES to anterior downgraft which is Clockwise.

So, for the concept of CCW when the 'A' point of a triangle= the 'ANS' point of a triangle constructed on the face; ANS, PNS, Pog and where that A point is FIXED is a 'pure' CCW rotation. The rotation is effected by 'prying' the B point down to B' which, in turn, displaces C to C'. B to B' is the downward distance of the posterior downgraft which arises by rotating X degrees around the fixed A point. C to C' is the advancement of the chin point that is effected from the rotation.

A point= ANS point on the facial triangle. B point= PNS on the facial triangle. C point= Pog point on the facial triangle.
A  prime sign '   after the point means the point has been displaced to a different location.

The best way to conceptualize the geometrical displacements in action is to cut out a shape of a triangle (use cardboard). Fix point A (pin it down). Trace it. Rotate it (CCW). Trace it after you rotate it. You will see how the C point moves forward when you move the B point down and the A point is fixed. Cut out a variety of triangle shapes. (Each person has a different triangle construct from ANS, PNS, Pog points.)

The rotation of a triangle is a very fundamental concept to maxfax rotations. People who are DISCONNECTED to the CONCEPTUAL geometry of that will have a very difficult time understanding maxfax displacements. Because maxfax displacements deal with points, lines, angles planes and rotations which relates to geometric principles.


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Luis_McLovin

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Re: Posterior Downgraft - What exactly is it?
« Reply #8 on: July 09, 2021, 02:57:43 AM »
I also found this image of how the maxilla actually looks after downgrafting(warning: NSFW)- https://www.instagram.com/p/CDz77PLFlbl/?hl=en
Though here it's an overall downgraft and not just a posterior one, you can probably understand it better from this. So there's a gap created which is then filled with the graft.

Hello SmallJaw, I’m purposefully replying here (aware its been inactive for at least 120 days) because you specifically referenced Otavio Cintra, a Brazilian Maxillo who conferences with Arnett Gunson. Do you have more information about Otavio Cintra? His cases show remarkable work with asymmetrical patients, and his techniques include CCW work.

I ask on the grounds that I am interested in being a candidate who too has similar asymmetry and CCW deficiency.