What alternatives are there to extractions?

[BlueShark7]

Skeletal overjet about  8mm
Dental  overjet 1 mm
Am interested in BSSO to correct skeletal  discrepancy but am wondering if there are any alternatives to extracting teeth in order to dentally decompensate prior to surgery?
TIA.

[notrain]

Skeletal overjet about  8mm
Dental  overjet 1 mm
Am interested in BSSO to correct skeletal  discrepancy but am wondering if there are any alternatives to extracting teeth in order to dentally decompensate prior to surgery?
TIA.

You can advance the mandible via Counterclockwise rotation of the entire maxillo mandibular complex (MMC) without any dental overjet. However, to get any meaningful advancement mm wise, this changes your appearance drastically and requires a good surgeon (stability).

I remember your picture from another posting, and I don't think you are a candidate for aggressive roation. If you post a lateral x-ray, I can be more specific, but if memory serves me right you are a low angle patient (brachycephalic growth pattern with increased pogonion projection, forward and upward rotation of the mandible on a class 2 skeleton).

This would only leave clockwise rotation, as your MMC is already counterclockwise rotated by nature (brachycephalic pattern). CW rotation lengthens the face. AFAIR you have a short midface, CW rotation would give you a longer lower third. Also, CW rotation rotates the mandible downwards which negates part of the advancement you are getting from the surgery, so it is doubtful that the surgeon would be able to produce a good result.

I think the choice in your case is to either go with the conventional surgical plan (extractions to decompensate the lower jaw) or forego surgery altogether.

[BlueShark7]

You can advance the mandible via Counterclockwise rotation of the entire maxillo mandibular complex (MMC) without any dental overjet. However, to get any meaningful advancement mm wise, this changes your appearance drastically and requires a good surgeon (stability).

I remember your picture from another posting, and I don't think you are a candidate for aggressive roation. If you post a lateral x-ray, I can be more specific, but if memory serves me right you are a low angle patient (brachycephalic growth pattern with increased pogonion projection, forward and upward rotation of the mandible on a class 2 skeleton).

This would only leave clockwise rotation, as your MMC is already counterclockwise rotated by nature (brachycephalic pattern). CW rotation lengthens the face. AFAIR you have a short midface, CW rotation would give you a longer lower third. Also, CW rotation rotates the mandible downwards which negates part of the advancement you are getting from the surgery, so it is doubtful that the surgeon would be able to produce a good result.

I think the choice in your case is to either go with the conventional surgical plan (extractions to decompensate the lower jaw) or forego surgery altogether.

Thanks notrain, I would probably opt not to have bimax as the change to my mid face would be too great. Cw rotation would be pointless also as my lower jaw is already set back in relation to the rest of my face. I was more wondering if there was an orthodontic alternative for creating that over jet, like could they move the molars back and everything back from there? Or even some kind of DO? I'm just not quite sold on extractions for the sake of a bsso yet a bsso is really the only thing that would correct my class 2 base

[notrain]

I was more wondering if there was an orthodontic alternative for creating that over jet, like could they move the molars back and everything back from there? Or even some kind of DO?

No, because:

a) Molars are double rooted and are very hard to move. Even with TADs you cannot move an entire dental arch backwards.

b) Even if a) wasn't true, by moving the entire arch backwards you would move the molars right where the surgeon has to cut the mandible, making surgery impossible.

DO is pointless as well, as you can't just make the lower jaw wider and leave the upper jaw as is. Your dental arches wouldn't fit anymore.

[dantheman]

extractions for the purpose of a BSSO is not a big deal. I'm thinking about going this route too following my next consultation if the surgeon agrees this is the best course of action.

[BlueShark7]

extractions for the purpose of a BSSO is not a big deal. I'm thinking about going this route too following my next consultation if the surgeon agrees this is the best course of action.

I'm starting to come around to the idea, I know extractions aren't necessarily the devils workshop but the idea of irreversibly losing healthy teeth is hard to swallow

[sean89]

EvK, I remember your picture, and there's no way you need jaw surgery.

It will make absolutely no difference to your appearance and I'd be surprised that any surgeon would operate on you to be honest.