jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: novakmali on September 22, 2015, 12:03:33 PM
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What does mean bimaxilliary protrusion?
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I show no upper teeth, short face syndrome, you saw my pictures on topic vertical max def, don I have bimax RETRUSION
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File too large, what should I do
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File too large, what should I do
Resize it.
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Comments, maxfac previously stated I am symetric, wtfff???
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Today, he stated he is "not willing to perform the surgery".. Previously, he said that I am symetric and sent me to ortho, which obvioisly cant help me..in my conclusion, croatian medicine is bulls**t. and doc signed wrong paper??? He thinks he is somekind of maxillofacial god and that he is the best..as I said he is not able to downgraft maxilla
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Please, comments on my ceph
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Please, comments on my ceph
Where is it?
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Picture is several posts above, i am posting it again
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I think people are interested in seeing an X-ray ceph.
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Is is ok?
[attachment deleted by admin]
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Is is ok?
How is it that the soft tissue projects THAT MUCH from where the bone of your chin is???
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How is it that the soft tissue projects THAT MUCH from where the bone of your chin is???
Lol are you joking? You've never seen the super atypical soft tissue abnormalities from misdeveloped jaws?
OP your right, you have retrusion not bixmaxillary protrusion. It is a rather a severe class II. The vertical deficiency is causing the "squishing" appearance of the lower 1/3rd which is partly why their chin soft tissue is so prominent.
If the jaws are normalized, that'll be reduced but usually in these cases, the chin button is still prominent yet aesthetically pleasing afterwards. Sometimes reduction genioplasty is done.
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I cant show my upper teeth, have vertical maxilliary deficiency, MAin problem...maxfac in croatia said i am symetric???
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So what should prof.Pelo do?
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better??
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please, slowly understand me what is my problem...our best maxfac said i am symetric and he signed paper??? ortho in croatia said i have bimax protrusion?? i think they are all wrong..HELP
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why you think I should pull wisdom teeth in upper jaw since I have no 5tooth in upper jaw?
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does correcting overbite with my braces differ from pre-surgery orth if I decided to go with prof pelo? i mean is difference huge, or it is similliar path?
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Yes, but i have room in upper jaw since my 5tooth is extracted..surgeon was wrong, in croatia orthognatic surgery is not developed and no one would downgraft maxilla..i am seing two more, but plan to go with prof pelo..i will do what ever he says
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Lol are you joking? You've never seen the super atypical soft tissue abnormalities from misdeveloped jaws?
OP your right, you have retrusion not bixmaxillary protrusion. It is a rather a severe class II. The vertical deficiency is causing the "squishing" appearance of the lower 1/3rd which is partly why their chin soft tissue is so prominent.
If the jaws are normalized, that'll be reduced but usually in these cases, the chin button is still prominent yet aesthetically pleasing afterwards. Sometimes reduction genioplasty is done.
So, downgrafting maxilla, pre-post orth, what about mandible, i think advancement?
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does correcting overbite with my braces differ from pre-surgery orth if I decided to go with prof pelo? i mean is difference huge, or it is similliar path?
I had to have de compensation orthodontics for two years prior to surgery. When younger I had premolars extracted for camouflage treatment of my class 2 bite which only made things worse. Although I don't think that we should expect perfection from surgery I really think that prior ortho work helps for a better result.
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In first column is standard value, then is my value, third column is difference, and finally graph
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I think he is referring to dental protrusion. When there is crowding, the front teeth move forward in the arch pushing the lips forward which can mask jaw position.
OP you are going to need braces to correct your bite issues, upright and align your teeth. This should change your face quite a lot. It is difficult to see on the picture of the x-ray you posted. Can you upload an actual image of the x-ray? It looks like your wisdom tooth is pushing the teeth forward. I would like to see an upclose picture of your bite from both the front and profile view.
I was reffering to maxilliary retrusion
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I know that need braces before op to correct my overbite, but cant find surgeon in croatia who will solve my skelet issues..braces alone wont fix my face??
If I get my braces now, and go in spring to prof.Pelo for opinion, can I do some damage? I mean isnt overbite huge?
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OK, but in one of your earlier posts, you said the ortho said you have bimax protrusion, right?
Am I clear in understanding:
1) The surgeon said you don't need he is not willing to perform surgery, and
2) the surgeon referred you to an orthodontist, and
3) the orthodontist said you have bimax protrusion
See, I think you are so focused on the skeletal maxilla that you can't hear them telling you that you have to get the dental maxilla/dental mandible in the correct position. Did the ortho say you had skeletal bimax protrusion or dental bimax protrusion? I think they are trying to help you, but are you trying to skip the process of putting your teeth into the correct position first? The two are so related, you cannot skip the dental part and go straight to the skeletal surgery.
Yes, you understood..but i need clockwise rotation to elongate my face, dont i? No one in cro can help me, so I contacted prof Pelo and plan to see him
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Novakmali, I understand your frustration. Many of us fight the same battle because we cannot seem to get a clear answer to our problems. It seems jaw surgery is an area in which many people get ripped off and disappointed because instead of getting the proper and correct treatment, they end up getting half-ass treatment by a surgeon or dentist or ortho who really does not have the skill set to solve their problems. Or who "kind of" fixes it, says "good enough," takes their $$ cut and moves the patient along.
In your case you have many dental issues and what I think needs to be clarified is:
1) Was the surgeon who referred you to an ortho telling you your issues could be solved by braces alone?, and
2) Can the ortho give you a prediction of where you will be after orthodontic treatment?
3) Does Pelo think you will need surgery?
4) If you choose Pelo as your surgeon will he work with the ortho you were referred to or does he have his own ortho?
The reason you need this clarified is if you need both, the ortho and surgeon must work together as a team with the surgeon calling the shots. Do you need both? I simply cannot tell where you will be after your dental issues are corrected. I wish some of the other forum members would give their opinion. My concern for you is that you may attempt to get a surgery-first solution and if you do you may not end up with the best results.
See, when your teeth are uprighted, it is going to make a big difference. Look at the two lines I drew on your ceph. They are the pretty close to the same length (I free handed so might not be exactly the same length, but close). Pretend the red line is your original tooth position. Now, when we shift it back (blue line) look how much height you gain. This is exaggerated, but illustrates the point.
Now, after understanding just how much difference uprighting your teeth will make, try to grasp where your teeth/bite/jaws will be after all the dental treatment you need is finished.
You need so much ortho work, I cannot tell if you will need rotation/advancement or not when it is finished.
Ask both the orthodontist you were referred to and ask Pelo when you see him.
This is going to take some time. Try not to get frustrated.
1.yes, he said, but that is not true, because three ortho told me they cant make my teeth visible since upper jaw did not grew vertically
2.hard
3.pelo said 100% and only surgery will solve my skeletal issues
4.generally, via mail, he said he could work with croat ortho, since i cant go every month to rome
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I dont have 5tooth in my upper jaw, is it necessary to extract my wisdom tooth?
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What does it mean I need to correct "the plane"?
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One big question.. Is it better to straighten the teeth since I have no both 6tooth in my lower jaw, or to make room and put implants? If I plan to do the surgery in 5years, isnt better to straighten the teeth..
I am in doubt:1. To wear braces and correct overbite and to go to Pelo in 2 years
2.to go to pelo first and seek for opinion
Will my face tighten after gwtting braces, i mean will i look so saggy as i look now..i dont have money for op now, so i would rather wear braces and fix my bite..
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One big question.. Is it better to straighten the teeth since I have no both 6tooth in my lower jaw, or to make room and put implants? If I plan to do the surgery in 5years, isnt better to straighten the teeth..
I am in doubt:1. To wear braces and correct overbite and to go to Pelo in 2 years
2.to go to pelo first and seek for opinion
Will my face tighten after gwtting braces, i mean will i look so saggy as i look now..i dont have money for op now, so i would rather wear braces and fix my bite..
Surgical orthodontics are completely different from normal orthodontics.
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Give me details, please
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i dont have both 6tooth in lower and 5tooth in upper jaw...do i have to have all the teeth to go for jaw surgery
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i know guys, i apologise..you have been helpfull, tnx
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The very first thing you have to do is select a surgeon. You have to have a consult to determine if this is the surgeon that you would like to work with. You will find that different surgeons will have different plans to correct your issues. You go with the one that you trust and believe in and feel you can have a good relationship with. After you select your surgeon, the surgeon will direct the orthodontist on what position he wants the teeth put into to make them ready for surgery. So the answer is go to the surgeon first and seek his opinion. Just be honest if you cannot afford the surgery now. Ask for the surgeons opinion on how you should proceed and if you need your wisdom teeth removed and/or need an implant. A good surgeon should be able to loosely predict the soft tissue changes you might expect.
Keep in mind when you consult with a surgeon, it's not just you deciding if you want this surgeon. The surgeon can decide he does not want you as a patient. You need to be respectful and listen to them. If you come into a consult telling them you MUST HAVE YOUR MAXILLA DOWNGRAFTED that can be interpreted as a difficult patient who is not willing to listen or follow instructions so they can reject you as a patient. This stuff in complex. It's basic supply and demand. There are more people who want the surgery than there are skilled surgeons so they can be picky and charge a lot of $$.
This is a long process that requires a lot of patience. You will need to do some research, reading papers like that link I gave you earlier in the thread.
FYI, the people on this forum are not doctors. We are regular people just like you who are sharing our knowledge on our own time. A surgeons opinion trumps our opinion most times. When people attempt to help you, you need to say "thank you" and be polite to them. Then when you gain knowledge, you will need to answer any questions for newbies you know the answer to.
FaciNgIt - - That is some of very best and concise advice posted on the forum. Well said.
Would add: Do not know where the OP is located, but keep in mind that the few really good surgeons who do this work - - and who are statistically likely not in your home town - - will normally work with your local orthodontists (if your local orthos are willing) to get your teeth set up properly for surgery. So do not be afraid to travel to find the right surgeon to do your work.
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I tried to contact prof clauser, but no one responded on my two mails
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Prof. pelo is my first option, but padova is much closer to zagreb, so i would also set cons with prof clauser, has anyone contacted him via mail
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So, what sholud i ask at cons..i would like longer, defined, narrow face
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So, no need for some cheek impl, just jaw correction, or better downgrafting...is it easier for surgeon to do cw or ccw?
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Let the surgeon do the driving. Surgery is very complicated and the surgeon must make his/her own treatment plan. If you do not like his plan, you get a different surgeon. Don't blow your chance to get this fixed by trying to tell the surgeon how to do his/her job.
What you say is fundamental - - and often overlooked.
That most difficult of human characteristics to evaluate:
Does the person I need to rely upon exercise "consistent good judgment" ?
The "good judgment" is not even exactly like the pornography thing - - very hard to define but you normally know it when you see it.
Except with good judgment, it may take some effort before it becomes apparent . In that case, you really have to rely on extrinsic information, including documented training and experience of the surgeon, and then a face to face with the surgeon.
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Does the person I need to rely upon exercise "consistent good judgment" ?
Except with good judgment, it may take some effort before it becomes apparent . In that case, you really have to rely on extrinsic information, including documented training and experience of the surgeon, and then a face to face with the surgeon.
Bobbit is spot on here. I made this mistake, not with my surgeon but with my orthodontist and I'm back to square one now, only a few thousand dollars poorer and carrying some red flags for new providers. I mean I should have known, he was bulls**tting and didn't really seem to care.
I would add, it's not just surgeon competence that you need to judge. You're also shopping for surgical philosophy, as you can't backseat drive every decision so find someone who shares your values. I don't believe in extra surgery for perfection and so I look for surgeons who share that philosophy for example. Like many here, I also don't believe in useless teeth. And I need someone who is patient and sensitive. When it comes to expertise, I need someone who understands sleep apnea and with orthopaedic expertise. Figure out what traits you are looking for in a surgeon and state them up front in your consults so you and your providers can decide if you are a good match. Some providers can go either way and you make their jobs easier if you tell them which way you want them to go. If not, then don't be afraid to ask for recommendations about who would be a good match. Though by my experience and for reasons I don't understand, I've never been able to get a surgeon to recommend another one even when they aren't competing for business. Last, I would say that this advice is hard to follow when you're starting the research process because we learn along the way. I suggest practicing on local surgeons first, whose relationships aren't likely to be of much value to you anyway. You want to make most use of your time with big name surgeons and don't want to burn bridges.
It sounds simple but this kind of process takes a long time to execute, a few months of time at least and up to a year. You'll live with risks and benefits for a lifetime, 50+ years, so it's worth the effort IMO. Once you pick up these skills, it's good for future surgeries and for your family too so I think it's worth the investment. Each surgery is different but for many procedures I wouldn't consider going to the guy down the street anymore.
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Tnx, now I have huge problem..professor Pelo first replied on my mail and said he thinks my case isnt so difficult, but when i asked for cons two weeks ago, didnt get any response..i found his one patient and she gave me number so i can book a cons without approval of professor pelo..do you think i need professors approval?
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Tnx, now I have huge problem..professor Pelo first replied on my mail and said he thinks my case isnt so difficult, but when i asked for cons two weeks ago, didnt get any response..i found his one patient and she gave me number so i can book a cons without approval of professor pelo..do you think i need professors approval?
Yes, that's why they have secretaries. You're taking this all too personally. They are too busy to remember everything about everyone. Again, that's why they have case files and secretaries.
BTW, I can feel your anxiety through my screen. Don't be like that at the consultation. Don't ask the same question over and over. Doctors don't want "difficult" patients and by difficult, I mean mental, not physical.
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It's true that surgeons don't want difficult patients but I don't know about hiding the anxiety. That's only likely to blow up in your face in the end, trust me. Better to be honest and find someone who knows how to handle anxious customers. Honesty is a sign of trust and many, not all, surgeons seem to sympathize. It's when you start hogging their time that you become a problem for them so spread your questions around in multiple consults. Just remember to bring copies of your imaging so that you don't get too much radiation in the process.
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What should I bring at cons? Wont professor do all the diagnosis? I mean ceph, panorex, etc.
So you think I cam arrange a meeting with secretary? Rico told me professor replied him about date of cons
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I can do ceph, craniogram and panorex in zagreb, since i am 24, will this data change with time?
I am afraid because didnt get professor's approval, i mean travelling from zagreb and if he doesnt show up or doesnt want to make a study?
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Yes, i am too emotional, sorry guys.. Two more questions:
1.100% sure that she doesnt speak english, so i should prepare text in italian?
2. Do you think I can get an appointment one month in advance, so I could plan my travel from zagreb.
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Before planning trip to italy, i visited another maxfac in croatia..she said i am surgical case, but wanted to talk with my ortho first..then i will go for another visit..you saw my pictures, i need CW rotation, bimaxilliary and mandibular advancement...i would appreciate if you could post question i should ask surgeon regarding nose, lips, upper teeth show, anything you have in mind
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After consultation with another maxfac, she suggested bsso and changing the angle of the mandible (clockwise rotation), but unsure about maxilla..guys what has to be done with my upper jaw, is downgrafting neccessary, or maxilliary rotation and mandibular advancement/rotation makes my face long enough..she is afraid, because i have small nose, that maxilliary downgrafting will make my face too long..pls comments, she will talk to my ortho, and then with me again