Recent Posts

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Aesthetics / Re: Why such little extra tooth show? Anterior downgrafting
« Last post by kavan on May 29, 2024, 08:30:53 PM »
Hi Kavan,

thanks for the response. Here is a picture of my simulation which shows the two downgrafts

Then it would have to do with combined or competing rotations.
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Aesthetics / Re: Why such little extra tooth show? Anterior downgrafting
« Last post by SV123 on May 29, 2024, 08:06:52 PM »
My guess would be you have a long lip/a lot of soft tissue. Also, 2.5mm is a lot...

Ah ok. I just want to make sure I am getting the right amount of anterior downgraft for my SFS case.
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Aesthetics / Re: Why such little extra tooth show? Anterior downgrafting
« Last post by SV123 on May 29, 2024, 08:05:00 PM »
Hi Kavan,

thanks for the response. Here is a picture of my simulation which shows the two downgrafts
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Functional Surgery Questions / Re: SARPE while MMA for better breathing
« Last post by kavan on May 29, 2024, 06:21:22 PM »
I made the text that extensive because I tried to convey my thought process in as much detail as possible.

To put it more simple: What are the odds that palate expansion (via a expander device) will impact the nasal cavity if expansion is performed shortly after DJS with CCW and posterior downgraft. Regarding the stability of the area, where the LF1 took place and the skull and the maxilla are now connected to the additional bone of the downgrafting.

Try thinking in terms of getting the palate expander IF you need a wider palate for say a better smile like if you have buccal corridors hiding the back of your smile. If in addition to  it widening the palate it also helps nasal breathing than great.
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Aesthetics / Re: Why such little extra tooth show? Anterior downgrafting
« Last post by kavan on May 29, 2024, 10:58:46 AM »
I REMOVED my prior entry which was my GUESS of as to why 'only getting 2.5mm upper tooth show'. I removed it because in hind site I was THROWN FOR A LOOP when the OP 'clarified' the downgraft measures to the posterior and anterior maxilla as being 10.5mm posterior downgrafting and 6.8 anterior downgrafting. Yet NO SUCH measures were listed on the displacement proposal.

So as to the question of :'... why am I only getting an extra 2.5mm of tooth show from the 6.8mm anterior downgrafting? Does the 10.5mm posterior downgrafting counter act the tooth show to some degree?', in retrospect was an invalid one to ask given the displacement proposal  NEITHER lists a 10.5mm posterior downgraft NOR a 6.8 anterior downgraft. So, I removed my response to the OP's question.

The actual displacement proposal cites 3.23 for ANS and 8.77 for PNS. Nothing in it about any 6.8 and 10.5.  Only the advancement at the pogonian cites a 10.5 measure.
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Functional Surgery Questions / Re: Improved nasal breathing through downgraft
« Last post by GJ on May 29, 2024, 09:55:50 AM »
If you get CCW then the volume increase is going to be in the lower airway, which is what you want for apnea. To get more volume in the upper airway you'd have to move it linearly, though, maybe moving it down would do that, too. I'm not sure on that but it does make sense.
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Functional Surgery Questions / Re: SARPE while MMA for better breathing
« Last post by GJ on May 29, 2024, 09:53:45 AM »
I made the text that extensive because I tried to convey my thought process in as much detail as possible.

To put it more simple: What are the odds that palate expansion (via a expander device) will impact the nasal cavity if expansion is performed shortly after DJS with CCW and posterior downgraft. Regarding the stability of the area, where the LF1 took place and the skull and the maxilla are now connected to the additional bone of the downgrafting.

I'm not convinced palate expansion is possible with stable results in adults, and might even cause complications to the tissue, etc. How old are you?
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Aesthetics / Re: Opinions on my plan
« Last post by GJ on May 29, 2024, 09:50:38 AM »
That's a huge movement and probably not justified bases on the scan you posted. The ANS can be trimmed to help with protrusion, to some extent.
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Aesthetics / Re: Why such little extra tooth show? Anterior downgrafting
« Last post by GJ on May 29, 2024, 09:47:23 AM »
My guess would be you have a long lip/a lot of soft tissue. Also, 2.5mm is a lot...
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Surgeon Reviews and Leads / Rhino Doctors
« Last post by GJ on May 29, 2024, 09:46:06 AM »
Some positive names I have heard recently: Katrib, Hyman and Balikci.

I can't vouch for any of them as it's second hand information. But, maybe this helps someone looking for leads.
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