Should i get bsso

[wagbox]

Is my mandible short or just recessed (my front teeth bend backward and push it back slightly)

@nelson says I should not get BSSO but I have been mentalcelling over the past few days because I have to decide soon

First pic is me biting down

And here i am jutting as much as possible

 

[Gosick]

You need lf1+bsso and ccw rotation and a rhino afterwards

 

[Deleted member 1476]

 

[LordNorwood]

Definitely looks recessed to me
@Golden Glass

 

[wagbox]

Is my mandible short or just recessed (my front teeth bend backward and push it back slightly)

@nelson says I should not get BSSO but I have been mentalcelling over the past few days because I have to decide soon

First pic is me biting downView attachment 258041

And here i am jutting as much as possible
View attachment 258042

@Sergio-OMS Please help

You need lf1+bsso and ccw rotation and a rhino afterwards

My orthodontist agrees that need lf1, but my oral surgeon said it would give a chimpanzee look. Looking at these pics I am siding with my ortho. Also, is ccw rotation possible with just facepulling or is another procedure necessary?

 

[Golden Glass]

I think you would benefit from bimax. You just need to make sure the right movements are done.

 

[Deleted member 4790]

@Sergio-OMS Please help

My orthodontist agrees that need lf1, but my oral surgeon said it would give a chimpanzee look. Looking at these pics I am siding with my ortho. Also, is ccw rotation possible with just facepulling or is another procedure necessary?

I’d Le Fort + IMDO

 

[wagbox]

I’d Le Fort + IMDO

Why IMDO over BSSO?

 

[Deleted member 4790]

Safer for the inferior alveolar nerve + widens the mandible + better contour

 

[Golden Glass]

Safer for the inferior alveolar nerve + widens the mandible + better contour

So it definitely widens the mandible?
@GetThatBread look at that, no need to be depressed over MSDO not doing so, since you’re also getting IMDO.

 

[GetThatBread]

So it definitely widens the mandible?
@GetThatBread look at that, no need to be depressed over MSDO not doing so, since you’re also getting IMDO.

MSDO widens the mandible/anterior also but not the posterior significantly. IMDO is much more invasive and it’s only done if you have an extreme over bite. I have no class malocclusion so it wouldn’t suit me. I’m going to speak to a maxillofacial surgeon and see if it can widen the entire lower jaw. Ronald Eads MSE practitioner told ron that it is basically MSE for the lower jaw so in theory it should widen everything.

 

[wagbox]

Safer for the inferior alveolar nerve + widens the mandible + better contour

Would I have to get this before or after MSE?

 

[Deleted member 4790]

Would I have to get this before or after MSE?

After MSE, but MSE must be planned accordingly. They should not be independent treatments.

MSDO widens the mandible/anterior also but not the posterior significantly. IMDO is much more invasive and it’s only done if you have an extreme over bite. I have no class malocclusion so it wouldn’t suit me. I’m going to speak to a maxillofacial surgeon and see if it can widen the entire lower jaw. Ronald Eads MSE practitioner told ron that it is basically MSE for the lower jaw so in theory it should widen everything.

Well I wouldn't say 8-10 mm overjet is an extreme one. And it can be created with a simultaneous Le Fort

 

[Theonewhowillascend]

You should first fix your nose and then see if you need this

 

[Deleted member 4790]

So it definitely widens the mandible?
@GetThatBread look at that, no need to be depressed over MSDO not doing so, since you’re also getting IMDO.

It widens the mandibular body at the level of the molars.

You should first fix your nose and then see if you need this

No way. Nose is the last part to be addressed.

 

[wagbox]

You should first fix your nose and then see if you need this

No, I have a class 2 malocclusion.

 

[Theonewhowillascend]

No, I have a class 2 malocclusion.

Ok then
You still need a rhino though and i think it will increase your psl more than bsso but you never know

 

[wagbox]

Ok then
You still need a rhino though and i think it will increase your psl more than bsso but you never know

It's never recommended to get rhinoplasty before jaw surgery (especially lefort, which can drastically change the appearance of your nose).

 

[Theonewhowillascend]

It's never recommended to get rhinoplasty before jaw surgery (especially lefort, which can drastically change the appearance of your nose).

Yeah thats true i had forgotten about it

 

[forwardgrowth]

So it definitely widens the mandible?
@GetThatBread look at that, no need to be depressed over MSDO not doing so, since you’re also getting IMDO.

IMDO sadly doesn't widen intergonial distance, only at point at level of incision

However I think that BSSO technique posted recently does widen intergonial distance

 

[.👽.]

You need lf1+bsso and ccw rotation and a rhino afterwards

Isnt lf1 and bsso = bimax?

 

[Golden Glass]

Isnt lf1 and bsso = bimax?

Bimax is any kind of Lefort + BSSO. But since Lefort I is the most common, it’s almost always referring to Lefort I + BSSO.

 

[Deleted member 4790]

IMDO sadly doesn't widen intergonial distance, only at point at level of incision

However I think that BSSO technique posted recently does widen intergonial distance

not very predictable unless custom titanium guides and plates are used for the BSSO

 

[Deleted member 4887]

same situation as you buddy. Class 2 malocclusion is fucking brutal

 

[wagbox]

same situation as you buddy. Class 2 malocclusion is fucking brutal

It could be a lot worse man, it is not uncommon. And we live in an era where there is surgery to correct it which is a pretty wonderful thing imo

 

[Deleted member 4887]

It could be a lot worse man, it is not uncommon. And we live in an era where there is surgery to correct it which is a pretty wonderful thing imo

Yeah XXXtentacions nasal base was **** practically right below his eye and he was*** * widely regarded as very GL
But I don’t see how we have surgery to correct it we have mod lefort 3 and lefort 1 but even then...

 

[underdog]

not very predictable unless custom titanium guides and plates are used for the BSSO

In your experience does IMDO widen the intergonial width?
Or does it only widen the chin (incision point)?

 

[Deleted member 4790]

The osteotomy is between first and second molars

this is what IMDO does:
You might be confusing IMDO with MSDO, @underdog

 

[eyearea]

bump

 

[Deleted member 4790]

bump

?

what do you want to know?

 

[everythingmatters]

not very predictable unless custom titanium guides and plates are used for the BSSO

So you want to say that if I want to expand the intergonia distance, custom titanium guides and plates MUST BE USED for the BSSO?

Although I suppose the price of the surgery would rise, right?

 

[Deleted member 4790]

So you want to say that if I want to expand the intergonia distance, custom titanium guides and plates MUST BE USED for the BSSO?

Although I suppose the price of the surgery would rise, right?

Well, in medicine and surgery we can never speak in absolutes.

 

[everythingmatters]

Well, in medicine and surgery we can never speak in absolutes.

Well then it would be recommended, right?

 

[Deleted member 4790]

Well then it would be recommended, right?

Very much.

 

[everythingmatters]

Very much.

If custom titanium guides and plates are used, can more stable advance be achieved in BSSO? So in theory it would allow you to be less conservative in the movement, right? Which could translate to more forward growth . Is this correct, Dr Sergio?

 

[Deleted member 4790]

If custom titanium guides and plates are used, can more stable advance be achieved in BSSO? So in theory it would allow you to be less conservative in the movement, right? Which could translate to more forward growth . Is this correct, Dr Sergio?

Indeed, but only if bigger plates are designed.

 

[everythingmatters]

Indeed, but only if bigger plates are designed.

What would be the minimum lower jaw advance to achieve noticeable aesthetic changes? 6 mm (which is supposed to be the maximum recommended) would not be very noticeable aesthetically speaking, right?

In other words, would it be worth having the BSSO surgery for cosmetic reasons for a 6mm advancement?

 

[Deleted member 4790]

What would be the minimum lower jaw advance to achieve noticeable aesthetic changes? 6 mm (which is supposed to be the maximum recommended) would not be very noticeable aesthetically speaking, right?

In other words, would it be worth having the BSSO surgery for cosmetic reasons for a 6mm advancement?

there are more factors than that, but yes, 6 mm is noticeable

 

[spark]

not very predictable unless custom titanium guides and plates are used for the BSSO

As far as I understand it there are no plates required at the end of the IMDO treatment right? So when the thing is done after the second procedure only the bone remains and no artificial metal in the mandible right?

 

[Deleted member 4790]

As far as I understand it there are no plates required at the end of the IMDO treatment right? So when the thing is done after the second procedure only the bone remains and no artificial metal in the mandible right?

I older patients sometimes bone hasn’t hardened enough at the time of distractor removal. If this happens I place new plates for several months to prevent relapse.