Has anyone heard of IMDO as a way to fix a big dental overbite and weak chin?

[OrthodontistExpert]

I see a sectional view of your airway... Not a volumetric one... And that's the point isn't it? Small data. Small come beam. Limited mind set. Extrapolation of a small number of facts into a world of myth and prejudice.

If you are on a jaw surgery blog, is it to denounce it and convert others to your cause, or is it to seek truth and ways of improving the status quo.

What I am saying is logical and based on scientific reason. But you seem to be coming at it with contempt, and a premise that is anti surgical from the start.

Your first statement was "I know a little... But I don't understand" it continues with a few statements that define your overall anti-surgical premise, and it ends with your vilifying surgery based upon imagined risks that are never expressed if youre informed.

When I go flying, I don't choose 23 year old F-111 pilots to fly my 747. The adverse risks of flying are controlled and non-expressed. There are different people for different tasks, and if you think about it... There are far more success stories with corrective jaw surgery than there are failures.

The challenge is to figure it out, and fly Qantas... Not stay in bed moaning about how scary the world could potentially be if you walked into the sunshine.

[LoveofScotch]

It's too bad this can't yet be used on the upper jaw.

[notrain]

@OrthodontistExpert

I have a question. I am scheduled to have bimax + genio jaw surgery next year. I have a class 2 jaw relationship on a horizontal growth pattern (slight short face, angle II/1 bite anomaly).

My surgical plan is to advance both jaws and to rotate the entire complex slightly clockwise. The lower jaw will obviously be advanced further than the upper jaw.

Because of the lower jaw advancement, my upper arch needs to be expanded orthodontically.

Now, would I get IMDO instead of BSSO, wouldn't I need an additional surgery (SARPE) to fit my upper arch over the distracted lower jaw since BSSO doesn't make the mandible wider and IMDO does?

Is getting IMDO still worthwhile in such cases (when surgical assisted upper jaw expansion is needed)? I should mention that my palate is neither narrow nor high, I have decent upper jaw development and slight maxillary prognatism and - besides wisdom teeth - no extractions in the upper jaw.

Do you generally think that IMDO is always better than BSSO or is it just used on kids ?

[OrthodontistExpert]

It appears IMDO is the ONLY way to get a wider lower jaw.
In kids, to advance the mandible by IMDO you ALWAYS have to widen the upper jaw.
Widening upper jaws in kids is easy and is done without surgery
In adults, you have to surgically widen the upper jaw with SARME or SARPE.

It seems logical, that with big moves... You do an IMDO + SARME at stage 1... Then a further BiMax advancement at stage 2.... This appears stable and can achieve big moves. The bigger the move the better the facial aesthetic results

[Gregor Samsa]

Can IMDO and SARPE be used to create a dental underbite if the patient already has a class I bite? I have a class I relationship between my teeth but I still have a skeletal underbite of around 1 cm.

[OrthodontistExpert]

Of course you can use SARME and IMDO to create a deliberate underbite. Then you would need a LeFort 1 advancement when they take out the appliances... But you would need a very good surgeon who is intimately familiar with all those operations.

There are many who will claim experience. Few who have experience... And success

[Modigliani]

^ Who would you recommend?

[Gregor Samsa]

Of course you can use SARME and IMDO to create a deliberate underbite. Then you would need a LeFort 1 advancement when they take out the appliances...

That would indeed be the goal of doing all of this (the bolded part). Assuming that the dental occlusion is perfect right now, would it be possible to recreate a bite as good as that after SARPE/SARME + IMDO + Le Fort I advancement? What would the timeframe for such a treatment be? None of the surgeons I have been in contact with have been willing to risk ruining a bite that good just for the aesthetical benefit of balancing the jaws.

[OrthodontistExpert]

I agree! Finding a surgeon to create a balanced aesthetic facial balance seems to be extremely rare.
They seem as a group to be focused on just mastering an operation let alone getting an orthodontically demanded bite... Fewer still look at airway widening or even long term TMJ health. Almost none have any digital expertise either, in order to use some of the sophisticated planning and diagnostic software coming into the market.
There are some emerging pioneers in Europe and even also (surprisingly) in Sydney, Australia.
Probably the way to look is to see how they present their real life cases online.
Surgery is far more than showing some before and after photos.
It's about changing volumes... Not planes or lines.
There are pioneers. But it's up to you to find them.

[Gregor Samsa]

Consultations cost money and take up a lot of time (especially when you need to fly to another country for the consultation) so it sure would help if surgeons were better at communicating with prospective patients.

[OrthodontistExpert]

Oh my god! Don't blame the surgeon for insisting that you visit them or charging for their time.
And haven't you heard of Skype?

[falcao]

I agree! Finding a surgeon to create a balanced aesthetic facial balance seems to be extremely rare.
They seem as a group to be focused on just mastering an operation let alone getting an orthodontically demanded bite... Fewer still look at airway widening or even long term TMJ health. Almost none have any digital expertise either, in order to use some of the sophisticated planning and diagnostic software coming into the market.
There are some emerging pioneers in Europe and even also (surprisingly) in Sydney, Australia.
Probably the way to look is to see how they present their real life cases online.
Surgery is far more than showing some before and after photos.
It's about changing volumes... Not planes or lines.
There are pioneers. But it's up to you to find them.

I refute almost everything said here. I consulted with four surgeons in Australia, and 3D planning software is a commonplace. All surgeons I saw (even the most local one 10-minute drive from my house) masterfully handled the software. They all do Cone Beam studies and have state-of-the-art software that tries to predict not only bone movement, but also soft tissue movement, airway analysis, nerve analysis etc. At the end of the consult I was given a 20-page study in PDF outlining the options or a CD to take home.

The statement that "almost no one at all has digital expertise" is preposterous. Unless the poster lives in a cave in some obscure place in the world.

Also, how a surgeon presents his cases online is definitely not the way to pick up your surgeon. Most of them, certainly the good ones, are pre-booked months in advance and certainly don't have the time for intensive online marketing. Another ridiculous piece of advice. 

[Balanced]

Is IMDO not possible for adults? Why not if all other forms of DO are possible in adults?