jawsurgeryforums.com
Before/After Photos => Overbites => Topic started by: hara.v on June 21, 2012, 12:12:38 PM
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Hello guys!
Has any of you come across Lower Jaw Distraction Surgery before? it sounds like an amazing option for people who only need lower jaw surgery...
http://www.youtube.com/watch?v=chU4ImyeZl8
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that is a VERY good point :(
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It's used to correct bite deformities in adults as well, particularly in the case of large mandibular deficiencies (>20mm). However skilled surgeons can achieve these advancements in a single surgery anyway.
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It's a much better procedure than standard jaw surgery for a huge number of reasons. I suspect it will become standard in the future.
Arnett/Gunson don't agree. From the article "Drs. G. William Arnett and Michael J. Gunson on Esthetic Treatment Planning for Orthognathic Surgery"
"Distraction osteogenesis, in our opinion, will not substitute for conventional ortho-gnathic surgery. Well-done orthognathic surgery with rigid fixation produces occlusal, facial, and airway results that are the gold standard. Distraction osteogenesis does not, and will not, treat the bite in three planes of space with the same quality and precision as conventional, well-done orthognathic surgery. When thinking of distraction, we must realize its limitations. Establishment of precise vectors for distraction is exceedingly difficult. Moving a complex object such as the mandible to within 1mm of accuracy is a veritable impossibility with distraction. There are also severe limits on achieving final occlusion compared with traditional orthognathic surgery. What are the valid clinical reasons to avoid the Le Fort I and sagittal osteotomies in favor of distraction? Previously held beliefs that distraction was kinder to nerve and joint tissues have been proved false. We must be careful not to lower our standards for the sake of using new technology"
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Well there you go!
I now cannot think of a single advantage to traditional orthognathic surgery over distraction osteogenesis.
On second thought, I don't see how you could perform impaction or setback with distraction, but for other movements, I think distraction is far superior.
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Maurice Mommaerts in Belgium performs distraction osteogenesis, I believe. But I don't think most surgeons will just fit a distractor for cosmetic reasons. DO is usually used to correct severe deficiencies as in the case of conditions like treacher collins or crouzon syndrome.
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http://www.northsideoralsurgery.net/
Another surgeon who works with DO.
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http://www.academicjournals.org/jphe/PDF/pdf2011/April/Dheeraj%20et%20al.pdf (http://www.academicjournals.org/jphe/PDF/pdf2011/April/Dheeraj%20et%20al.pdf)
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http://www.academicjournals.org/jphe/PDF/pdf2011/April/Dheeraj%20et%20al.pdf (http://www.academicjournals.org/jphe/PDF/pdf2011/April/Dheeraj%20et%20al.pdf)
Thanks for posting link.
I find this topic interesting. I've heard of this option before, but it seems fairly new. It would be interesting to learn more from actual post distraction patients.
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Dude, I understand you're upset but your language is out of control and kinda childish in this and other posts on here. We're all adults on here, let's act like it, yeah?
no problem. if you're disturbed/offended by my language, i apologize and i'm more than happy to censor myself in the future. but please do not tell me what an "adult" is supposed to act like. such pronouncements are essentializing, judgmental and worst, narrow minded.
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Distraction osteogenesis can be used to widen the mandible. This seems to be the ideal solution for crowding in Class 2 patients because most of them have narrow mandibles to begin with. Extractions worsen the problem while widening corrects it. I'm going to ask Dr. Arnett about widening my lower jaw (and possibly my upper jaw) during the orthodontics phase.
http://www.accutechortho.com/products/distrax (http://www.accutechortho.com/products/distrax)
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Distraction osteogenesis can be used to widen the mandible. This seems to be the ideal solution for crowding in Class 2 patients because most of them have narrow mandibles to begin with. Extractions worsen the problem while widening corrects it. I'm going to ask Dr. Arnett about widening my lower jaw (and possibly my upper jaw) during the orthodontics phase.
http://www.accutechortho.com/products/distrax (http://www.accutechortho.com/products/distrax)
Hey man, that would be FASCINATING to hear his answer to to whether that's possible. Alas, I already had extractions and deeply regret it. My ortho as I said did not know about any of this. I suspect though, it may all be slightly more complicated than we think --but I look forward to hearing his response! Thanks!
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Ok, just found out that Dr David Hirsch at NYU does jaw distraction as well
http://www.manhattanmaxillofacial.com/oral-surgery-manhattan/distraction-osteogenesis.html (http://www.manhattanmaxillofacial.com/oral-surgery-manhattan/distraction-osteogenesis.html)
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Ok, just found out that Dr David Hirsch at NYU does jaw distraction as well
http://www.manhattanmaxillofacial.com/oral-surgery-manhattan/distraction-osteogenesis.html (http://www.manhattanmaxillofacial.com/oral-surgery-manhattan/distraction-osteogenesis.html)
pekay, thanks a lot for that info as it's something I am interested in. Unfortunately i already had extractions of my four bicuspids -had i not done that i would have had distraction to actually grow my jaw to accomodate my teeth --in the description on Hirch's site it indicates he uses it to build space for "dental implants" --I wonder, however, if he actually does it as a replacement for jaw surgery though --that is, if like Dr. Coceancig he would do only distraction instead of a bsso or lefort. I believe this is certainly the future, but I wonder why right now it's not the clear alternative. Let's continue to investigate this, if you contact Hirsch, do let us know, and I will do the same.
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Department of Oral and Maxillofacial Surgery in Boston, MA also does distraction osteogenesis
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Department of Oral and Maxillofacial Surgery in Boston, MA also does distraction osteogenesis
do you know which hospital pekay (by the way thanks again for this) I'm actually a grad student in boston(but live in Canada right now) so it might be worthwhile to check out when I move back...thanks....
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do you know which hospital pekay (by the way thanks again for this) I'm actually a grad student in boston(but live in Canada right now) so it might be worthwhile to check out when I move back...thanks....
http://www.massgeneral.org/omfs/services/treatmentprograms.aspx?id=1216 (http://www.massgeneral.org/omfs/services/treatmentprograms.aspx?id=1216)
if you're still in Boston, you should definitely schedule a consult with Dr. Leonard Kaban
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http://www.massgeneral.org/omfs/services/treatmentprograms.aspx?id=1216 (http://www.massgeneral.org/omfs/services/treatmentprograms.aspx?id=1216)
if you're still in Boston, you should definitely schedule a consult with Dr. Leonard Kaban
thanks man, I'll hopefully be back in Boston sometime late spring summer to defend my thesis finally, so thanks for the suggestion! I also wanted to post this --he's one of the pioneers regarding distraction and WOW he can do a lot of amazing stuff. By the way, if you or anyone else has not yet had extractions of bicuspids(look it up if you don't know what I'm talking about) DON'T HAVE IT DONE(or at least get like 5 other opinions from surgeons and orthos).
Regardless, this quite clearly shows the lower jaw can be distracted width wise, lengthwise, as well as upper and all sorts of stuff. I'd browse the site a bit --and also this place looks like a real centre for this tye of thing which is really imp. because it would have designed protocols and a lot of experience instead of a doc who is just doing distraction on his own somewhere.
Also, I wonder since it's in Venezuela if the prices are better than North America.
It would be GREAT to talk to some patients who have visited this place/doctor and more examples.
http://www.distractionosteogenesis.com/ (http://www.distractionosteogenesis.com/)
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No extractions!!!!!! Run !! Get other opinions.
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s**t. My dentist told me I would need extractions, now I'm not sure if I should get them or look into this first.
DO NOT GET EXTRACTIONS. THEY WILL TELL YOU ALL SORTS OF THINGS TO JUSTIFY THEM. THERE ARE MANY ALTERNATIVE.
Dr. Jacobson at FCLA told me he could turn the molars out, do surgically assisted palatal expansion or even suggested DISTRACTION OSTEOGENESIS.
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just learned that Dr. Fued Samir Salmen brazilian maxillofacial surgeon does jaw distraction
^ for all the future JSF brazilian members
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meh not really that impressed
lower jaw distraction + Le Fort + sliding genioplasty
(http://i.imgur.com/4Bg8m5v.jpg)
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meh not really that impressed
lower jaw distraction + Le Fort + sliding genioplasty
(http://i.imgur.com/4Bg8m5v.jpg)
I think she needed more counterclockwise rotation.
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I think she needed more counterclockwise rotation.
Yeah that seems to be case, we're probably a few years behind when it comes to jaw distraction
This woman had a far superior result with traditional surgery
(http://i.imgur.com/fe2YFnV.jpg)
is it even possible for a female to have a bad result?
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Yeah that seems to be case, we're probably a few years behind when it comes to jaw distraction
This woman had a far superior result with traditional surgery
is it even possible for a female to have a bad result?
This girl had a much bigger gummy smile than the first girl. That allowed her surgeon to rotate her jaws much more.
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I think my current look is relatively similar to this woman's afters:
(http://www.arnettcourses.com/sites/default/files/uploads/face-fig8.jpg)
both the woman and I have a short ramus of the mandible and then the jaw kind of slopes downward and away, rather than the ideal of a 'square jaw' which seems to make a face much more attractive
what I'm wondering is, does distraction osteogenesis have the potential to lengthen the vertical length of the ramus and create that angle rather than a rounded jaw?
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I think my current look is relatively similar to this woman's afters:
(http://www.arnettcourses.com/sites/default/files/uploads/face-fig8.jpg)
both the woman and I have a short ramus of the mandible and then the jaw kind of slopes downward and away, rather than the ideal of a 'square jaw' which seems to make a face much more attractive
what I'm wondering is, does distraction osteogenesis have the potential to lengthen the vertical length of the ramus and create that angle rather than a rounded jaw?
no
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no
do you have a problem with me or something?
That post is months old AND you already gave me a respectful answer to it the first time. Try reading next time.
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do you have a problem with me or something?
That post is months old AND you already gave me a respectful answer to it the first time. Try reading next time.
i don't have a problem with you, i was just updating my response --it's not possible through DO. take a chill pill.
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i don't have a problem with you, i was just updating my response --it's not possible through DO. take a chill pill.
from my end it seemed curt and dismissive, sorry if i misunderstood
it's technically possible, although not realistic for any of us. what you said about the 'true' gonial angle coming out with advancement is definitely true
also I just got rejected so I feel like s**t.
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from my end it seemed curt and dismissive, sorry if i misunderstood
it's technically possible, although not realistic for any of us. what you said about the 'true' gonial angle coming out with advancement is definitely true
also I just got rejected so I feel like s**t.
By a girl?
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By a girl?
yep.
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lol. cold approaches aren't really my forte
oh well there you go, cold approaches are NO ONE'S forte. they rarely if EVER work. don't take it personally at all. I've seen incredibly hot guys get rejected with cold approaches and while I'm not hot at all, and I've picked up a few chicks with cold approaches (on drugs, both me and the girl(s) so that doesn't count I suppose? I dunno) . It says nothing about you being rejected though.
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oh well there you go, cold approaches are NO ONE'S forte. they rarely if EVER work. don't take it personally at all. I've seen incredibly hot guys get rejected with cold approaches and while I'm not hot at all, and I've picked up a few chicks with cold approaches (on drugs, both me and the girl(s) so that doesn't count I suppose? I dunno) . It says nothing about you being rejected though.
Legit. That was the liquid courage in full effect, you need to be drop dead handsome to be cold approaching
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very interesting indeed.
Only available in Australia at the moment?
Another vid:
http://vimeo.com/30843938 (http://vimeo.com/30843938)