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Before/After Photos => Overbites => Topic started by: meo66 on January 15, 2021, 04:41:41 AM

Title: Jaw surgery for osa?
Post by: meo66 on January 15, 2021, 04:41:41 AM
Hi im considering jaw surgery for my osa. I have had uppp tongue base reduction  and rhinoplasty with fixed deviated septum and chin implant.cpap intolerant. im new on here and any advice on type of  jaw surgery etc. Attached ceph pan-thank you https://imgur.com/osKsxUH https://imgur.com/bFecpsq
Title: Re: Jaw surgery for osa?
Post by: GJ on January 15, 2021, 08:26:14 AM
Is it accurate that you're missing some teeth and that your wisdom teeth were never pulled? You'd likely want to have them pulled before surgery.

I see a small airway (hard to say, but it looks it on the scan) and a steep mandibular angle, which both would be corrected by doing a counter-clockwise rotation. From what you provided, it looks like you're a good candidate for the surgery.
Title: Re: Jaw surgery for osa?
Post by: meo66 on January 15, 2021, 06:25:55 PM
thank you for your help.next week iwill have 3d ct scan in bangkok .i will let you know how i get on.
Title: Re: Jaw surgery for osa?
Post by: meo66 on January 18, 2021, 07:48:26 AM
I had a 3d ct scan today and consultation with max surgeon in bangkok- he mentioned narrowing of the airway at the base of the soft palate-he recommended bi max but never mentioned removing the chin implant and doing a genioplasty? The cost was to expensive for me{about the same price of spain- he also said he could take the wisdom teeth out on day of surgery. Is it better to get wisdoms out months before surgery.? so i am looking at india at dr sunil or dr vikram shetty or korea.
Title: Re: Jaw surgery for osa?
Post by: meo66 on January 18, 2021, 08:29:14 AM
https://imgur.com/6OdRj7k
Title: Re: Jaw surgery for osa?
Post by: GJ on January 18, 2021, 08:34:49 AM
he also said he could take the wisdom teeth out on day of surgery. Is it better to get wisdoms out months before surgery.?

That's just another surgery on top of an already major surgery, so I wouldn't do them together. You could, like he said, but it's more trauma all at once...
Wisdom tooth removal isn't a walk in the park.
Title: Re: Jaw surgery for osa?
Post by: Rodin on January 18, 2021, 11:58:39 AM
https://pubmed.ncbi.nlm.nih.gov/29055570/

Study on implications of wisdom tooth removal before or at same time as bsso
Title: Re: Jaw surgery for osa?
Post by: kavan on January 18, 2021, 02:45:27 PM
https://pubmed.ncbi.nlm.nih.gov/29055570/

Study on implications of wisdom tooth removal before or at same time as bsso

It just gives an ABSTRACT of the study. If you read the entire study what does it say about the increase of risk of BAD BREAK when the wisdom tooth needed to be removed is also an impacted/ misoriented one or one not coming through the gum straight up?
Title: Re: Jaw surgery for osa?
Post by: Rodin on January 18, 2021, 06:53:36 PM
My apologies. This study should be accessible in its entirety.

https://www.researchgate.net/publication/263746252_Impacted_third_molars_in_sagittal_split_osteotomies_in_mandibular_prognathism_and_micrognathia

Combining M3 removal and BSSO minimizes all other costs and morbidity (as the first study states in it's abstract) but the incidence of an improper split is likely dependent on specific orientation, positioning, and root morphology. The above study would support that a mesioangulated molar relatively close to the surface, such as in the OP's scans, would not negatively impact the split as much as say one more vertically oriented and positioned lower in the mandibular body. The danger of a bad split is still there of course. Have to weigh whether the morbidity and cost of two separate procedures outweigh the increased risk of a bad split for the specific case.
Title: Re: Jaw surgery for osa?
Post by: kavan on January 18, 2021, 08:37:20 PM
thanz
Title: Re: Jaw surgery for osa?
Post by: meo66 on January 18, 2021, 10:14:51 PM
so is there a chance that moving the jaws forward alone would improve my osa? i have got used to having my chin implant.i  i really need a maxo that understands osa i
Title: Re: Jaw surgery for osa?
Post by: kavan on January 19, 2021, 03:35:50 PM
so is there a chance that moving the jaws forward alone would improve my osa? i have got used to having my chin implant.i  i really need a maxo that understands osa i

Yes. There is a chance. Because  bimax advancement is the surgery done to improve osa.
Title: Re: Jaw surgery for osa?
Post by: Sergio-OMS on January 20, 2021, 11:28:22 AM
Hi im considering jaw surgery for my osa. I have had uppp tongue base reduction  and rhinoplasty with fixed deviated septum and chin implant.cpap intolerant. im new on here and any advice on type of  jaw surgery etc. Attached ceph pan-thank you https://imgur.com/osKsxUH https://imgur.com/bFecpsq

UPPP and tongue base reduction is butchery in patients with structural problems. Enlarge the box, don’t cut its content away.

I know this doesn’t help you, I’m only replying so other people can prevent damage.
Title: Re: Jaw surgery for osa?
Post by: meo66 on March 18, 2021, 08:53:06 PM
Hi i just thought i would post my photos to maybe get some opinions? Thank you
Title: Re: Jaw surgery for osa?
Post by: meo66 on March 18, 2021, 08:55:48 PM
Photo 2 with chin implant.
Title: Re: Jaw surgery for osa?
Post by: kavan on March 19, 2021, 12:40:09 PM
The opinion is rather clear cut. If you have obstructive sleep apnea due to small airway/s and are CPAP intolerant, you would need bimax advancement to open up the airway/s.

The surgeon would decide whether or not the chin implant needs to be removed in order to also perform a sliding genioplasty along with the bimax advancement. That is because some of the muscles of the tongue attach to the chin bone. The sliding genioplasty allows the tongue to be advanced forward a bit, subsequently creating additional space needed to breathe more comfortably throughout the night.

The surgeon will decide whether to remove the wisdom teeth during the surgery or for you to have them removed before the surgery.

Title: Re: Jaw surgery for osa?
Post by: meo66 on March 19, 2021, 06:50:58 PM
thank you kavan
Title: Re: Jaw surgery for osa?
Post by: meo66 on August 20, 2021, 02:53:45 AM
Some info needed on high tensile tetanium v normal titanium for my double jaw genioplasty.which is best?thank you