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Did you know that bimaxillary treatment is more limited than you thought
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Understanding the limits of orthognathic surgery (i.e bimax)
Bimax = repositioning of the mandible and maxilla
in surgery these planes can be
1. Rotated clockwise (CW)
2. Rotated counter-clockwise (CCW)
3. Impacted
4. Downgrafted
Changing this plane affects various cranio-facial aesthetics
after understanding this brief explanation we can get into the various structural limits
Structural limits:
———————————————
A) Condylar seating
some preface; I saw some people saying in a PS forum that the condylar seating doesnt affect the treatment at all
so heres a brief study
condylar seating
Now that we got that out of the way, lets discuss how the condylar seating can possibly limit the treatment of bimax
If you reposition the occlusal plane incorrectly/overdone
The condyles may not naturally be positioned in a positive way this is due to structural limits (preoperative)
You can create risk of relapse
joint strain or instability
B) The Soft tissue in the surrounding areas
The face has soft tissue obviously if you overadvance/overrotate etc you can get negative sides
increased relapse
lip incompetence
C) Occlusal Contact
Your bite must be correct post surgery, over extreme movement can negatively impact orthodontics and relapse risk increases
D) Nerve Damage/Injury
Large advancements affect soft tissue, beyond certain distances it can cause nerve injury and affect postoperative anatomy,
E) Safe Ranges of movement
Some people have unrealistic expectations of movements
————————————
Understanding the limits of orthognathic surgery (i.e bimax)
Bimax = repositioning of the mandible and maxilla
in surgery these planes can be
1. Rotated clockwise (CW)
2. Rotated counter-clockwise (CCW)
3. Impacted
4. Downgrafted
Changing this plane affects various cranio-facial aesthetics
after understanding this brief explanation we can get into the various structural limits
Structural limits:
———————————————
A) Condylar seating
some preface; I saw some people saying in a PS forum that the condylar seating doesnt affect the treatment at all
so heres a brief study condylar seating
Now that we got that out of the way, lets discuss how the condylar seating can possibly limit the treatment of bimax
If you reposition the occlusal plane incorrectly/overdone
The condyles may not naturally be positioned in a positive way this is due to structural limits (preoperative)
You can create risk of relapse
joint strain or instability
B) The Soft tissue in the surrounding areas
The face has soft tissue obviously if you overadvance/overrotate etc you can get negative sides
increased relapse
lip incompetence
C) Occlusal Contact
Your bite must be correct post surgery, over extreme movement can negatively impact orthodontics and relapse risk increases
D) Nerve Damage/Injury
Large advancements affect soft tissue, beyond certain distances it can cause nerve injury and affect postoperative anatomy,
E) Safe Ranges of movement
Some people have unrealistic expectations of movements
https://pmc.ncbi.nlm.nih.gov/articles/PMC3681098/
TLDR: Advancements tend to be safe at moderate amounts, maxillary downgrafting has a significantly higher relapse risk than advancement or impaction
https://www.sciencedirect.com/science/article/abs/pii/S0278239105018525
TLDR: CCW rotation safe range is in between 4-8 degrees assuming healthy condyles
https://pubmed.ncbi.nlm.nih.gov/17470277/
TLDR: mandibular advancements tend to be very safe and stable
TLDR: Advancements tend to be safe at moderate amounts, maxillary downgrafting has a significantly higher relapse risk than advancement or impaction
https://www.sciencedirect.com/science/article/abs/pii/S0278239105018525
TLDR: CCW rotation safe range is in between 4-8 degrees assuming healthy condyles
https://pubmed.ncbi.nlm.nih.gov/17470277/
TLDR: mandibular advancements tend to be very safe and stable
———————————————
NOTE: All of these are limits but some blackpilled turkish muddafucka is still going to do whatever you wish lol, most of these mentioned are anatomical as theyre more important because most people will get treatment by a blackpilled aesthetic doctor so i thought there wasnt a need to mention it (only important if youre larping sleep apnea kekw or getting surgery in the west which is retarded imo (i.e american aesthetic doctors are butchers)
——————————————
———————————————
TLDR; Most limitations are anatomical and due to with people having too big of an expectation of movement with orthognathics. Please note you need a scan before determining. Please note this risks arent only threatening to airways, bite etc, (They can affect aesthetics!!)
Tags : @Idontknow- @yussimania @rraymond @Whiteboard7 @tomahawk @MouthBreathingElite (HOLY MASS TAGGING SORRY
)
NOTE: All of these are limits but some blackpilled turkish muddafucka is still going to do whatever you wish lol, most of these mentioned are anatomical as theyre more important because most people will get treatment by a blackpilled aesthetic doctor so i thought there wasnt a need to mention it (only important if youre larping sleep apnea kekw or getting surgery in the west which is retarded imo (i.e american aesthetic doctors are butchers)
——————————————
———————————————
TLDR; Most limitations are anatomical and due to with people having too big of an expectation of movement with orthognathics. Please note you need a scan before determining. Please note this risks arent only threatening to airways, bite etc, (They can affect aesthetics!!)
Tags : @Idontknow- @yussimania @rraymond @Whiteboard7 @tomahawk @MouthBreathingElite (HOLY MASS TAGGING SORRY
)
