What's the shortest time for decompensation before surgery?

[Mark32]

This is something that I've really been scratching my head about. You often read about people wearing braces for 18 months before surgery but can this period be reduced considerably?

In my case, I've wondered would less time be required as some of my class III tendency came about through late growth. At this stage - around 17/18 - my jaw bones must have reached a point of being less maleable as my teeth didn't tip in the slightest to compensate and I ended up with an edge to edge bite. For that matter my lower incisors almost seem proclined - tipped forwards of my two lower canines. Whereas people with a class IIIish profile often seem to have their lower incisors tipped more posteriorly - sort of leaning back with their cusps posterior to those of the canines.

For me the seemingly proclined inclination of my lower incisors is I think false as retroclined compensation had already occurred with my lower canines and first premolars.

But could someone who has less compensation among their anterior teeth to begin with (due to a class III tendency that arrises partly from late growth) require less time in braces before before they're ready for surgery?

[notrain]

decomp takes 12-18 months. it's not simply about over / underjet but also to match both dental arches transversally for their postop occlusion. excessive curve of spee in one or both jaws has to be levelled as well if present. you also have to derotate teeth and alleviate crowding - basically all the heavy lifting is done preop and fine tuning is done postop (~ 6months)

it's not just about creating large over / underjets.

[healer]

maybe with wilckodontics (AOO) with corticotomy

http://en.wikipedia.org/wiki/Accelerated_orthodontic_treatment

[nrelax11]

Mine was 8 months before surgery

[Langpam]

It is possible to have Surgery First, though it's not offered by everyone. I had braces  ( Invisalign) fitted six days before my surgery. They were re inserted six days later.

[PloskoPlus]

13 months here.  Lower only for the first 7 months due to deep bite.

[PloskoPlus]

Saw Paul Johnson at the Nuffield yesterday and he said I'd probably be looking at 2 years all in all (braces, surgery & recovery).
Seemed crazy to me considering my current occlusion but he said the angle of my front teeth is the reason or something along those lines.

Does this really look like a bite that should be in braces for a YEAR before surgery??



He said he does more orthognathic proceedures than any other surgeon in the country so I believe him, just seems silly really.

Supposedly orthos using SureSmile can move teeth faster, but perhaps it's just hype.  You probably feel like that compensation orthodontics in your teens was a massive waste. Maybe they should just outlaw it.

[sean89]

Depends. Surgery first is being practiced (when suitable) in a lot of countries but not in the UK it seems.

[nrelax11]

What happens if you have surgery without decomp? And never have it

[buzzhead]

I had ortho when I was younger where they flared out my top molars to compensate for my maxilla being narrower than my jaw.  I have been in braces now again for eighteen months decompensating for bimax surgery.  Now that my molars are vertical one can easily see that the top is narrower. Why hasn't my ortho done a sarpe or even mentioned one as of yet?  Is something being considered by the surgeon that doesn't need to be done prior?  Any insight would be greatly appreciated.  And by the way I was told that I should expect 12 to 18 months prep for surgery.  Thanks.

[Mark32]

thanks for the interesting replies... I've been snowed under with work so only getting back to the forum now.

So the prep for surgery is much more complicated than I'd thought (it's not just tipping incisors forwards or backwards ).

Depends. Surgery first is being practiced (when suitable) in a lot of countries but not in the UK it seems.

I'm in the UK so I guess I'll have to go the long route of 12 to 18 months in braces first. If you get the surgery done first do you still have as lengthy a period of orthodontic work carried out?

Saw Paul Johnson at the Nuffield yesterday and he said I'd probably be looking at 2 years all in all (braces, surgery & recovery).
Seemed crazy to me considering my current occlusion but he said the angle of my front teeth is the reason or something along those lines.

Does this really look like a bite that should be in braces for a YEAR before surgery??

Hi, Tumerican. I don't know how to get a quote of the whole of your post with pics - for some reason it won't insert. But can I ask what type of jaw discrepancy you're having corrected. Is it a class III? It's just that your upper anterior teeth look as if they're proclined to fit over your lower teeth.

The other thing I was going to ask is are you in your twenties. I hope you don't mind but it's just that your teeth are in superb condition. I'm 32 and one of the things that puts me off posting pics of my bite here is that my teeth are in an awful state compared to yours. I have fillings in almost every back tooth.

Also, is Paul Johnson the surgeon based in Guildford in the UK?