kjohnt,
I think you're probably right that it's not worth all the expense and risk. I agree about widening the mandible too... I can't see how it wouldn't impact your joints in some way. Also, some sort of lengthening distraction that replicates BSSO doesn't really seem worthwhile if I need rotation anyhow and would therefore need jaw surgery.
I will probably get second opinion before pulling teeth, maybe send files to A&G perhaps. Still, the surgeon and ortho I spoke to did give me all the options. My own opinion is to agree, honestly. Even with wisdom teeth removed, there is no space. The wisdom teeth and highly impact and at an angle because there is no room after my last molars. The jaw bone goes vertical at that point. They mentioned shaving enamel off each tooth but that wouldn't give me enough movement, so my teeth would still be angled and my final result far less dramatic. I could accept the angle of my teeth, but that isn't really ideal either since I'd probably get some sort of bimax protrusion if jaws were properly aligned.
It isn't ideal. I'd love if I have a bit more space... but it seems the only reasonable solution.
I just really wanted to confirm that with some of you guys here to see. I will likely look to confirm that with A&G as well.
My upper jaw won't need braces at least. Well, not until right before surgery... at least that's a plus. I could even get braces behind my lower teeth too. Ultimately, it makes the time in braces better if it's not upper. The upper will be expanded though once the lower is brought forward since you are, in effect, widening the front of your mandible. Once decompensated, the front portion of the arch is wider. When moved forward in surgery it then is wider then the front of the maxilla, which is widened slightly to fit.
It all makes me a bit nervous, but I really do see it fixing my issues (hopefully!).