Should I get MSDO?

[monecel]

My palate and mandible are both narrow which is bad for aesthetics and also has caused crowding at the bottom row of my teeth. In addition to this I have a deep bite meaning my mandible should ideally be more projected to line up with my upper teeth.

To fix this I want to get a bimax with a 3-piece lefort & ccw. The 3-piece lefort expands the palate which should help with airway and should improve teeth show, however because I have a significantly narrow teeth row on my mandible as well then I also want to expand it. I found some appliances that could potentially help but I'm still interested if MSDO could be the right option.

MSDO is where they create a midline osteotomy on your chin and basically split your jaw in two and they can torque the TMJs slightly, expanding your mandible width and improving the jaw angle at the same time. This seems like it would be the ultimate fix and would work perfectly with the 3-piece lefort so teeth line up however I'm not sure if it's worth the extra cost/specialty. Not many surgeons do it and it may have to be done with a less reputable surgeon.

Also technically it would be a 6-piece mandible because it would include the BSSO, MSDO and sliding split genioplasty.

So I'm not sure if the additional complexity/risk would be worth it rather than just going for a lower dental expansion appliance. It wouldn't change the mandible width but it would help my teeth fit better.

Any thoughts?

a good video on it:

 

[Whirr22222]

My palate and mandible are both narrow which is bad for aesthetics and also has caused crowding at the bottom row of my teeth. In addition to this I have a deep bite meaning my mandible should ideally be more projected to line up with my upper teeth.

To fix this I want to get a bimax with a 3-piece lefort & ccw. The 3-piece lefort expands the palate which should help with airway and should improve teeth show, however because I have a significantly narrow teeth row on my mandible as well then I also want to expand it. I found some appliances that could potentially help but I'm still interested if MSDO could be the right option.

MSDO is where they create a midline osteotomy on your chin and basically split your jaw in two and they can torque the TMJs slightly, expanding your mandible width and improving the jaw angle at the same time. This seems like it would be the ultimate fix and would work perfectly with the 3-piece lefort so teeth line up however I'm not sure if it's worth the extra cost/specialty. Not many surgeons do it and it may have to be done with a less reputable surgeon.

Also technically it would be a 6-piece mandible because it would include the BSSO, MSDO and sliding split genioplasty.

So I'm not sure if the additional complexity/risk would be worth it rather than just going for a lower dental expansion appliance. It wouldn't change the mandible width but it would help my teeth fit better.

Any thoughts?

a good video on it:

The only guy who did it got his license taken from him. Seemed too good to be true anyway.

 

[lurking truecel]

The only guy who did it got his license taken from him. Seemed too good to be true anyway.

No pag, bell, and some other does it

 

[monecel]

No pag, bell, and some other does it

I didn't know pag does it nice

 

[monecel]

The only guy who did it got his license taken from him. Seemed too good to be true anyway.

I think his issues were with other procedures other than the MSDO and also his personality negatively affecting patient experiences. MSDO seems pretty intuitive you just need to avoid nerve issues etc. 6 piece mandible seems pretty wild though