Is distraction ostogenesis good for long face syndrome?

[screwsandplates]

I exhibit all the symptoms of long face syndrome (gummy smile, narrow face, high/narrow palate, small airway, flat cheeks, mouth breathing, forward head posture, and extractions as a kid). I'm looking around for jaw surgeons and I have my eye on Gunson (I feel pretty confident with him, but Ashley's case does worry me). So far, I'm imagining counterclockwise rotation and impaction, both jaws moved forward (called BSSO I believe. I left my surgical plan in another room), and HA grafts with cadaver bone.

Understandably, my mum has been doing a lot of research about this subject too. She thinks that distraction ostogenisis would be a good option.

Would double jaw surgery or distraction ostogenisis be better for long face syndrome? My bite is good and comfortable, but my airway is really small and my face is long, gummy, and lacking definition.

[CK]

I exhibit all the symptoms of long face syndrome (gummy smile, narrow face, high/narrow palate, small airway, flat cheeks, mouth breathing, forward head posture, and extractions as a kid). I'm looking around for jaw surgeons and I have my eye on Gunson (I feel pretty confident with him, but Ashley's case does worry me). So far, I'm imagining counterclockwise rotation and impaction, both jaws moved forward (called BSSO I believe. I left my surgical plan in another room), and HA grafts with cadaver bone.

Understandably, my mum has been doing a lot of research about this subject too. She thinks that distraction ostogenisis would be a good option.

Would double jaw surgery or distraction ostogenisis be better for long face syndrome? My bite is good and comfortable, but my airway is really small and my face is long, gummy, and lacking definition.

your situation sounds pretty comprehensive. with long face syndome the deformity is beyond the jaw so i dontknow how d.o would be superior to rotation in that regard

as far as i know rotation is ideal for long face syndrome and has a lot of cases to support. did gunson propose ha grafts with cadaver bone? that's new to me.

[Lazlo]

I exhibit all the symptoms of long face syndrome (gummy smile, narrow face, high/narrow palate, small airway, flat cheeks, mouth breathing, forward head posture, and extractions as a kid). I'm looking around for jaw surgeons and I have my eye on Gunson (I feel pretty confident with him, but Ashley's case does worry me). So far, I'm imagining counterclockwise rotation and impaction, both jaws moved forward (called BSSO I believe. I left my surgical plan in another room), and HA grafts with cadaver bone.

Understandably, my mum has been doing a lot of research about this subject too. She thinks that distraction ostogenisis would be a good option.

Would double jaw surgery or distraction ostogenisis be better for long face syndrome? My bite is good and comfortable, but my airway is really small and my face is long, gummy, and lacking definition.

If you guys find someone who is willing to do distraction osteogenesis LET ME KNOW!!!

[pekay]

If you guys find someone who is willing to do distraction osteogenesis LET ME KNOW!!!

* Dr Relle does distraction osteogenesis

http://www.la-coms.com/oral-surgery-procedures/distraction-osteogenesis.asp

* so does Dr Schendel http://www.facecenterla.com/about/about.html

(Leader in the field of distraction osteogenesis for the correction of facial deformities)

http://www.calsleep.com/md-schendel-california-sleep-surgeons-palo-alto.html

* Dr Leonard Bruce Kaban (Head of Maxillofacial Surgery at Harvard School of Dental Medicine)

(Clinical Interests: Distraction osteogenesis)

http://www.massgeneral.org/omfs/doctors/doctor.aspx?id=16475

* Dr David Hirsch

(Dr. Hirsch uses distraction osteogenesis to treat selected deformities and defects of the oral and facial skeleton)

http://www.manhattanmaxillofacial.com/oral-surgery-manhattan/distraction-osteogenesis.html

* Dr Eric J. Dierks

http://www.head-neck.com/meet-our-physicians-and-surgeons/

[Lazlo]

Thanks Pekay, but the problem is they list it but only do it in very special cases, or in cases where it's unclear to me why they do it. I asked Schendel point blank for DO and he was a bit evasive about it. Then basically just said we can get the results you want without it.

I asked a guy who wrote the textbook on Distration Osteogenesis Cesar Guerrero and he said, "your case is not extreme enough for DO".

I think there was a time, like 5-10 years back when they thought, and I have read, several max facs saying that DO was the future, major advantages over traditional surgery. But for some reason that doesn't seem to have panned out.

This is what I do think however. One of the major limitations with having an absolutely ideal result is lack of your own bone for the advancement. If you had DO first to grow your jaw out a bit, and then have jaw surgery I think people could get even better results. The problem is, and I wouldn't mind having two operations, but that the distractors need to be left in for 6 months to consolidate and only then could you have the next regular surgery. this is all speculation on my part though.

I'd really like to see cases where someone has gotten DO instead of regular surgery. Only that Paul Coceancig guy in Australia does DO this way, but his patients are all adolescents.....

[Lazlo]

i think they're using it for making room for implants. I don't think a single one of them are using it as a substitute for traditional surgery. If you look at those who have the question and answers form, they've all just cribbed from the same textbook!!! lolol

[pekay]

D.O on the upper jaw (13mm retrusion), BSSO on the lower

[Lazlo]

man, poor guy, glad to see he got some major relief. But that's exactly what I've been told, they do use DO when there isn't enough native bone --there's no way they could have aligned this guy's jaw without DO on the upper jaw.

[pekay]

The best result you will ever see from Prof Sailer (lol)

[Lazlo]

so they seem to only use it when there's clearly not enough bone to do a straight advancement. what i'm saying is that for some people if they grew more bone with DO they could potentially do even better advancements. i think....

i have to applaud plus 1 for being such a treasure trove of resources!

[Kristen]

The best result you will ever see from Prof Sailer (lol)

Wow !     That is truly incredible.    How life changing for her.

[fedfan]

I have a question that isn't related to the subject of this thread but I didn't want to create a new one for it.

Does anyone know if CCW rotation makes the face shorter, longer, or if it remains the same? What about CW rotation?

[Lazlo]

I have a question that isn't related to the subject of this thread but I didn't want to create a new one for it.

Does anyone know if CCW rotation makes the face shorter, longer, or if it remains the same? What about CW rotation?

shorter

[CK]

I have a question that isn't related to the subject of this thread but I didn't want to create a new one for it.

Does anyone know if CCW rotation makes the face shorter, longer, or if it remains the same? What about CW rotation?

rotation will shorten the lower face.

[fedfan]

Thanks for the quick answer guys. So I take it CW rotation makes the lowerface longer.