Anyone in Brisbane Australia had IMDO with Dr. Paul Coceancig

[Zad]

Hi there
I've pretty much just comes across IMDO and am pretty blown away by what I have seen so far given what can be accomplished in such a short time-frame.
I have a son with fairly significant chin recession (only 9 years old at present) and has considerable crowding in the bottom teeth and about a 10mm over jet and large overbite. It seems pretty obvious he will need intervention and I am trying to limit the emotional trauma as much as possible.
I would love to meet with anyone in Brisbane who has had the treatment, mainly to discuss pros and cons.
Regards
Zad

[Optimistic]

Hi there
I've pretty much just comes across IMDO and am pretty blown away by what I have seen so far given what can be accomplished in such a short time-frame.
I have a son with fairly significant chin recession (only 9 years old at present) and has considerable crowding in the bottom teeth and about a 10mm over jet and large overbite. It seems pretty obvious he will need intervention and I am trying to limit the emotional trauma as much as possible.
I would love to meet with anyone in Brisbane who has had the treatment, mainly to discuss pros and cons.
Regards
Zad

Isn't he in Sydney?

In any case at nine years old perhaps it is worth discussing your son's situation with an orthotropic specialist (google Dr Mike Mew). Perhaps his facial issues are the result of things such as poor oral posture and mouth breathing?

[Zad]

Yeah he is in Sydney tho apparently they get a lot of people from interstate. As far as i'm aware Dr Paul C is the only one doing IMDO in Australia (is that correct?)

[PloskoPlus]

Unless the required advancement is huge, distraction osteogenesis is pointless.  You still have to cut bone, and double the operations - put distractors in, take them out vs one-time jaw surgery.  I would simply wait till your son stops growing (18, 19). 12 months in braces, surgery, 6 more moths in braces, done.

[Optimistic]

Unless the required advancement is huge, distraction osteogenesis is pointless.  You still have to cut bone, and double the operations - put distractors in, take them out vs one-time jaw surgery.  I would simply wait till your son stops growing (18, 19). 12 months in braces, surgery, 6 more moths in braces, done.

I don't agree with this entirely.

The first part yes. IMDO looks all well and good but the simple fact is you're replacing a one-off operation with two, plus the pain of making the advancements between those operations.

As for the second one about waiting until he stops growing I do disagree. OP appears to be focused purely on operations, but what about asking why all this has happened? It seems to me that it's most logical to at least ensure there are breathing techniques, good oral posture and all that in place prior to any operation. Things we know for a fact cause facial deformities. If Dr Mew's results are anything to go by then this alone could make a significant difference for the child. What good would an operation be at his age if his face continues to grow without the tongue in the right place to prevent vertical growth? Or why advance a mandible if he will continue to breath through his mouth only to have it recess once more as he gets older?

I would at the very least take this preventative approach first to see how much it could benefit him. There's a very good chance - especially at his age - that he could avoid surgery entirely. It could dramatically alter his facial development going forward to the point where the results are better than surgery - particularly when combined with chewing harder gums to encourage bone growth. This isn't hyperbole either. The simplest example of this would be the infraorbital rims. Jaw surgery will advance the jaws and fix the bite, but the aftermath of the poor habits which led to the need for surgery often leave people with a flat or recessed midface (week cheekbones and under eye support). If he could develop as nature intended he'd have a much more balanced appearance.

Finally, if after pursuing this route you find surgery is still a necessity then by all means consult with Dr Coceanig. His results seem decent enough. That said, the best maxillofacial surgeons in Australia appear to be working in Melbourne out of MOFS (Andrew Heggie, for example).

----

Probably not the kind of response you were looking for but I hope you find it helpful nonetheless.

[Jol]

Perhaps his facial issues are the result of things such as poor oral posture and mouth breathing?

I think it's nonsense to suggest a 10mm overbite can be the result of poor oral posture or mouth breathing, seriously.....

[Jol]

Unless the required advancement is huge, distraction osteogenesis is pointless.  You still have to cut bone, and double the operations - put distractors in, take them out vs one-time jaw surgery.  I would simply wait till your son stops growing (18, 19). 12 months in braces, surgery, 6 more moths in braces, done.

I'd suggest the initial IMDO operation is significantly less than doing it all in one go, you don't need to cut along the bone and then slide everything, there is less chance of nerve damage, the second operation is just day surgery, and distraction itself doesn't hurt at all - what does hurt is the irritation where the distractors come out of the gums.

[Jol]

I would love to meet with anyone in Brisbane who has had the treatment, mainly to discuss pros and cons.

Zad I'm in Sydney but if you want to discuss just PM me (my daughters had the operation)

[Optimistic]

I think it's nonsense to suggest a 10mm overbite can be the result of poor oral posture or mouth breathing, seriously.....

If you actually bother to look this up you'll see you're completely wrong. The effects such things have on facial develop cannot be overstated.

To willingly turn a blind eye to the potential causes of a medical condition, and forego remedying said causes is the height of foolishness. Furthermore, I already listed the numerous benefits of taking this approach regardless of whether or not it's playing a major role in this instance.

[Zad]

Thanks guys

Optimistic - Have been looking into Mike Mew though this would seem to take a lot of compliance from both my son and his mother.

Jol - have sent you an IM.

Regards

Zad

[Optimistic]

Thanks guys

Optimistic - Have been looking into Mike Mew though this would seem to take a lot of compliance from both my son and his mother.

Jol - have sent you an IM.

Regards

Zad

What do you think your son would want? And if you don't know the answer to that go ahead and ask any member of this board. If we could go back in time and be given the tools to avoid the predicament we're in every single one of us would take it.

Please be smart. Surgery in this case is concealment. It won't address the cause and it won't address other issues beyond his chin projection and bite - there's so much more to it than that.

[Zad]

Guys. Not sure if you are still around but wanted to give an update.

Firstly thanks for your help Jol - it's much appreciated and I hope the surgery had had the long term benefits as well as the initial. You really were helpful and open with info.

I saw 3 people re orthodontics.  Two gave an estimate of a couple of rounds of braces plus herbst or something similar.  The third was myobrace for 2 years (via Dr Flutter who I believe learnt from Mike Mew). 

Before going on a big thanks also to Optomistic for being honest.  In hindsight I see how correct your points are.  The tone can come across a little obnoxious at the time (yes I would say the same thing in person:) though your words kept playing in the back of my mind and made more sense as I became educated. Reading back on it now I see exactly where you were coming from the reason for the passionate views.

So...my son who had a 10-11mm over jet and apparently needed 4 extractions (via conventional - though prob not via Imdo) after 16 months has enough room for all teeth and has a 3-4mm ovejet.  The improvements to his face are very recognisable. He's just turned 11 so will be done by 11.5 with no further treatment I believe.

To be honest the treatment has been very hard in terms of compliance.  The hour a day wear of the myobrace isn't too bad but it kept on falling out at night which required tape on the mouth and gloves as he was pulling tape off in his sleep.  Might sound ott though I know I would have preferred this as a child.  Now just the tape seems to be enough.

The other was the wire which he wore for 4 months behind the top teeth to give more room.  It really was the ugly duckling stage though 2 weeks after removal the gaps had closed up and he had much more room which allowed the lower jaw to come forward.

I also had a significant other who wanted the conventional treatment though wasn't willing to look into what that actually meant.

At the end of 16 months I'm pretty worn out and my son's over it though he doesn't have a point of reference having not had braces before.  I'm extremely glad I made the decision I did and just maybe I'll get a thanks one day (probably when my son is my age:)

If anyone has any q's send me a msg and we can chat or I can send some pics etc.

Once again thanks for all your help as it's a big decision and everyone's perspective is different on what's best for their kids.

Love your work

Zad

[Jol]

Thank-you for the update Zad, I'm glad it's all working out.

And thanks for asking, almost 4 years later the IMDO results are still just as amazing really. One funny thing is that her wisdom teeth came through and the orthodontist being the perfectionist he is put her braces on them as well (no he didn't charge any extra).

[Zad]

Great to hear Jol.  I remember your daughter's case well and the change as very noticeable.