(BIMAX) Which surgeon will accurately tell me if I need decompensation?

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I kinda already made this thread but nobody really answered it properly so I decided to rephrase the title.

If I wanted to know if decompensation would help me, which surgeon would give a totally unbiased perspective?

Pagnoni/Safi tend to be surgery first always so I think they're not unbiased, same with Ramieri who is too traditional and almost always recommends premolar extractions + 6-18 months of braces to decompensate.

So then who should we speak to?
 
just try to figure out yourself. do your bottom teeth lean forward? if so, get decompensated. are they strait up and down, and you have steep occlusal plane, and you have recessed maxilla? then you can probably get away with surgery first.

when i went to an ortho and mentioned decompensation, he was like "lol. how are they going to decompensate your teeth? they're not compensated in the first place."

this is why Ramieri recommends extractions - in order to make room to push the lower teeth back. this is probably because he doesn't like to do large rotations or large maxillary advancements so he needs a large linear advancement of the mandible to make surgery "worth it" in his opinion. that's just me speculating.
 
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just try to figure out yourself. do your bottom teeth lean forward? if so, get decompensated. are they strait up and down, and you have steep occlusal plane, and you have recessed maxilla? then you can probably get away with surgery first.

when i went to an ortho and mentioned decompensation, he was like "lol. how are they going to decompensate your teeth? they're not compensated in the first place."

this is why Ramieri recommends extractions - in order to make room to push the lower teeth back. this is probably because he doesn't like to do large rotations or large maxillary advancements so he needs a large linear advancement of the mandible to make surgery "worth it" in his opinion. that's just me speculating.
This helped me understand compensation better and now I know that I'm probably a surgery-first candidate since my bite is perfect in spite of my supremely recessed maxilla. Thanks bud
 
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