Venting Orthodontist wants to pull out four premolars for jaw surgery

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TcEfforts

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I‘m not sure if he has much experience preparing patients for jaw surgery but where I live I don’t have many choices neither and he looked like the best I could find here.

He said at least two premolars must be pull out from my lower jaw so that the surgeon can move forward more mm during BSSO. In my upper jaw he is going to study my case wether it’s possible not to extract the other two premolars but he thinks he needs because of inclination or angulation of my arch superior/upper jaw or something like that(at this point I was already freaking out).

He didn’t rush the meeting, spent more than one hour discussing and explaining my case, maybe he is trying to do his best but I don’t know. No time for a second opinion from another orthodontist, he kept my exams and x-ray and next week I have already another meeting with him, that’s when I’m going to decide if either I accept the treatment he is offering or I turn him down and take a chance with other orthodontists.
 
Lorsss

Lorsss

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I would trust the doctor
 
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TcEfforts

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Lorsss said:
I would trust the doctor
Seriously, I don’t know what to do.
+12mm of BSSO isn’t too risky? That’s what is gonna happen if he pulls out my two premolars from lower jaw.
 
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ibuprofen87

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My surgeon said he didn't think any teeth would need to be pulled, and then the ortho I consulted with locally said they'd need to pull 4. And then another ortho noped out in the first 10 minutes of speaking with me, so I'm still looking, hopefully the first two were incompetent rather than the surgeon

In the consult the surgeon said he thought he could achieve 9mm maxilla/15mm mandibular advancement using LF1+BSSO w/CCW. But my occlusion is already good (only ~2mm under bite) so I'm not sure where the space comes from, but he is a well regarded surgeon as far as I can tell
 
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TcEfforts

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ibuprofen87 said:
My surgeon said he didn't think any teeth would need to be pulled, and then the ortho I consulted with locally said they'd need to pull 4. And then another ortho noped out in the first 10 minutes of speaking with me, so I'm still looking, hopefully the first two were incompetent rather than the surgeon

In the consult the surgeon said he thought he could achieve 9mm maxilla/15mm mandibular advancement using LF1+BSSO w/CCW. But my occlusion is already good (only ~2mm under bite) so I'm not sure where the space comes from, but he is a well regarded surgeon as far as I can tell
I found this article that made me think twice about tooth extraction.

Although it’s not related to orthodontic treatment with jaw surgery in mind it’s very scary anyway.

Tomorrow I’m going to meet this orthodontist again, if he insists about premolars extraction I‘ll have to find a competent doctor for me to get a second and better opinion.
 

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