Is 3mm LF1 good for my case? How severe is my recession?

[surgeryplanning]

Hello Guys,
I have class 3 underbite and downward growth. The surgeon I talked to suggested doing surgery first 3MM LF1 and doing 10mm genio as well as some cheek implants. I am wondering if the 3MM LF1 is enough or do I need a bigger movement? I have also talked to another surgeon who said he would do 4mm LF1 after decompensation which would require extraction of pre-molars so that was not an attractive option for me. Let me know what you think from this CEPH

 

[Donkeyballs]

try mewing and cold showers first and then talk to your surgeron. bump

 

[Donkeyballs]

did the second surgeon that will do 4mm also do genio?

 

[surgeryplanning]

did the second surgeon that will do 4mm also do genio?

yea he would do but his plan would require braces before hand and extractions ( I already had braces before but now Im kinda in camouflage ortho position) so I dont want to do braces before surgery. I would like surgery first if possible

 

[Donkeyballs]

yea he would do but his plan would require braces before hand and extractions ( I already had braces before but now Im kinda in camouflage ortho position) so I dont want to do braces before surgery. I would like surgery first if possible

yeah, almost always extractions arent necessary but it makes the surgery for the orthos easier (but almost always just for wisdom teeth), I had some reports and studies about this.
Also will both surgerons cut on the same point? Maybe one will perform a higher lf1
Also do you know why he will remove the premolars? Because if he does it may be to create more space in order to pull your teeth back which is why premolar extractions happen, whicl will also pull back the aleovar process of the maxilla, so that extra 1mm may be for nothing (at least talking about the alevoar process not the rest of the maxilla.
I honestly recommned talking to him about this or if you already know tell me, plus I guess this surgeon will also cost you more because of extractions and etc and quite longer

 

[surgeryplanning]

yeah, almost always extractions arent necessary but it makes the surgery for the orthos easier (but almost always just for wisdom teeth), I had some reports and studies about this.
Also will both surgerons cut on the same point? Maybe one will perform a higher lf1
Also do you know why he will remove the premolars? Because if he does it may be to create more space in order to pull your teeth back which is why premolar extractions happen, whicl will also pull back the aleovar process of the maxilla, so that extra 1mm may be for nothing (at least talking about the alevoar process not the rest of the maxilla.
I honestly recommned talking to him about this or if you already know tell me, plus I guess this surgeon will also cost you more because of extractions and etc and quite longer

The surgery first surgeon will do a High Cut Lefort 1. I am just not sure if it is worth while to do but he said he will also do 3mm BSSO which I found strange cause I have class 3 right - so why is LF1/BSSO movement the same. However, he also proposed to do jaw/ramus-widening.

 

[longjohnmong]

Do you even know what 3mm Lefort means?

 

[surgeryplanning]

Do you even know what 3mm Lefort means?

Yea my upper jaw would be brought forward 3mm

 

[longjohnmong]

Yea my upper jaw would be brought forward 3mm

The whole thing? So if you got only CCW rotation and no other movement of the maxilla, that would be 0mm Lefort?

 

[SubhumanForever]

@BlackpillRemedy

 

[BlackpillRemedy]

@BlackpillRemedy

Thank you for tagging me

Hello Guys,
I have class 3 underbite and downward growth. The surgeon I talked to suggested doing surgery first 3MM LF1 and doing 10mm genio as well as some cheek implants. I am wondering if the 3MM LF1 is enough or do I need a bigger movement? I have also talked to another surgeon who said he would do 4mm LF1 after decompensation which would require extraction of pre-molars so that was not an attractive option for me. Let me know what you think from this CEPH

Obviously if they perform a decompensation prior to surgery the results will be far better. You’ll always have a somewhat class 3-ish look to you unless you do it, bc the teeth will be at a very awkward angle, and the advancement will be less than ideal. Basically you’ll still be class 3, just less class 3 than now

I also don’t know about the genio, it sounds criminal to reduce an entire 10 mm. Also taking a quick glance at you it seems awkward to reduce the chin on someone who already has a crap chin projection due to dentoalveolar protrusion, but it might be a good idea if you’re actually getting bimax rather than just le fort 1 and the chin sticks out a lot after changing the occlusal plane (still idk, could be a good plan but in this case you should ask to see the planning to be sure, since it’s a bit sus)

The cheek implants sound like a very good suggestion, many class 3 malocclusioncels have recessed malar bones so getting that addressed is very important if that’s your case.

If you wanna get the procedure without decompensation you can ask for a compensatory camouflage intervention to be added to your le fort 1. I would specifically ask for this procedure:

U-shaped osteotomy in management of paranasal deficiency - PubMed

When paranasal deficiencies are not accompanied by occlusal alterations, mobilization of the maxilla via Le Fort I osteotomy may not be justified. In this preliminary, report for the first time is presented a U-shaped osteotomy (USO) that mobilizes anteriorly and/or superiorly the maxillary bone...

pubmed.ncbi.nlm.nih.gov

Read about it on pubmed

 

[SubhumanForever]

Thank you for tagging me


Obviously if they perform a decompensation prior to surgery the results will be far better. You’ll always have a somewhat class 3-ish look to you unless you do it, bc the teeth will be at a very awkward angle, and the advancement will be less than ideal. Basically you’ll still be class 3, just less class 3 than now

I also don’t know about the genio, it sounds criminal to reduce an entire 10 mm. Also taking a quick glance at you it seems awkward to reduce the chin on someone who already has a crap chin projection due to dentoalveolar protrusion, but it might be a good idea if you’re actually getting bimax rather than just le fort 1 and the chin sticks out a lot after changing the occlusal plane (still idk, could be a good plan but in this case you should ask to see the planning to be sure, since it’s a bit sus)

The cheek implants sound like a very good suggestion, many class 3 malocclusioncels have recessed malar bones so getting that addressed is very important if that’s your case.

If you wanna get the procedure without decompensation you can ask for a compensatory camouflage intervention to be added to your le fort 1. I would specifically ask for this procedure:

U-shaped osteotomy in management of paranasal deficiency - PubMed

When paranasal deficiencies are not accompanied by occlusal alterations, mobilization of the maxilla via Le Fort I osteotomy may not be justified. In this preliminary, report for the first time is presented a U-shaped osteotomy (USO) that mobilizes anteriorly and/or superiorly the maxillary bone...

pubmed.ncbi.nlm.nih.gov

Read about it on pubmed

What do you think about this guy's fear about extraction of pre-molars? It's a common idea that losing pre-molars is bad and you shouldn't do it. Is it justified or a myth?

 

[BlackpillRemedy]

What do you think about this guy's fear about extraction of pre-molars? It's a common idea that losing pre-molars is bad and you shouldn't do it. Is it justified or a myth?

Losing premolars = less mouth space which in people with narrow airways could increase the risk of sleep apnea, but this risk is so minimal and if you have muh correct tongue posture (nobody does, but anyway) the dentoalveolar space lost should make absolutely no difference.

In short, no, in 99% of cases this fear isn’t justified.

In terms of aesthetics, if you have dentoalveolar protrusion you should absolutely do it, it’ll get rid of protrusion and that way you’ll stop looking like u have a monkey mouth.

If you don’t have dentoalveolar protrusion it makes sense to not want this done, though, but the dude in the x ray has a massive dentoalveolar protrusion so…