Minimally Invasive Aesthetic and Functional Jaw Surgery - State of the Art

Traditionally patients with an imbalanced facial appearance, dental and orthodontic problems, and sleep and breathing disturbances, need to undergo orthognathic “jaw” surgery. It has recently been shown that facial growth can be stimulated and orthodontic treatment be accelerated by minimally invasive procedures possibly avoiding the need for jaw surgery. In this talk Dr. Girod reviews the current state of the art of jaw surgery and minimally invasive procedures.
Speaker: Sabine Girod, MD, DDS, PhD

[@perseuscameron]

Fantastic. Thank you.

[@krachenford9594]

Good doctor!

[@gaylecheung3087]

Fascinating

[@leisamaribekkers312]

Could you use distraction osteogenesis to broaden the maxilla in an adult? I am in Australia and am waiting for orthodontists here to be trained in inserting a MISME due to the loss of upper jaw anchorage teeth - traditional orthodontics can't be used. I broke my jaw when i was eleven when i was kicked by a horse and they wired my teeth together edge to edge. But i do feel that i would have had an underbite as my daughter who is now four knocked her two front teeth in half and then shortly afterwards started developing and underbite.? Look forward to some feedback. Warmest Regards Leisa Mari Bekkers

[@saintetienne755]

Did you get a reply?

[@othsasaa5386]

Its technically possible since when they do the SARPE for adults and they also get a hyrax expander appliance which they use to turn a key and slowly expand the maxilla. I think that defines what you asked (distraction osteogenesis).

[@nsxproperties560]

The second patient looked worse, why did you shorten his face? That was a mistake.

[@shuikai272]

Stanford loves to impact, they think bringing the mandible up improves the airway (when it reality you're shrinking the face and compromising the nasal airway).

[@greerohlsson2463]

The face was down and it needed to be forward. It strains the eyes, crushes the sinuses, and causes the nose to deviate over time if your face is too downward.

[@blockbuster1979]

I agree. He looks worse. You're not supposed to shorten the face, at least that's what Dr. Alfaro says. It produces an uneasthetic result.

[@h.debeau7995]

If bone can grow, then I don't see why adults can't try the minimal invasive method for children.

[@Whaheyyy]

It does work on adults too however there are issues relating to the rate of growth, precision (especially for the dental kind, note that traditional orthognathic surgery is accurate to 1-2mm, it is hard to get this accuracy with the bone growing process) and strength of the new bone that grows. I have seen academic articles about people getting distraction osteogenesis of the mandible as old as 45 successfully however at this age it is only reserved generally for severe and unique medical conditions/deformities. In saying this results are best in children and young adults however success is fairly consistent for most people up to the age of 30-35 depending on the type of distraction. It is not uncommon for distraction to be done beyond completion of the growth stage (over 18). Actually quite famously in the early 2000s there was a wave of 'cosmetic' surgery in the form of distraction done to make people taller in China following economic growth as China opened it's doors more and more to the West. There were a number of stories talking about those who had done this and the severely weakened bones that they had following the surgery...

[@AceofDlamonds]

@@Whaheyyy I think I would have been a good candidate for distraction in my childhood or teen years if it weren't for my dental issues (chicken or the egg in that situation?). Another question: does this work on the more sensitive upper maxillary region? the lower orbital or malar region which is super important for appearance and perception.

[@downo]

Anyone who was told to get this surgery. Check out Orthotropics, that's the least invasive approach.

[@be246]

not when you are over 25. im looking forward to my double jaw surgery after mewing till my 25.

[@downo]

@@be246, as someone who's gotten that surgery. It will never fix your face entirely, is totally dependent on what the specific surgery entails and should you have any minor asymmetries, they will be amplified. Also, as far as I know, you are required to wear braces, which will further retain your teeth at their underdeveloped position. It is helpful if your bite is incorrect, but for looking better it is restricted in various ways. "Mewing" just means correct oral posture which can and should be corrected at any age. Teeth move all the time. Whilst the development of your bones perhaps slow down around that age, it does not inhibit changes in your bite, which is the number one focus and priority of a "functional jaw surgery".

[@be246]

@@downo in my case, they did retract my maxila. thats why i wanted to do double jaw surgery, dont u think would be helpful? my mandible is naturally recessed, she didnt grow properly becuase of my bad oral posture

[@downo]

@@be246, it's really difficult to tell just from this and there are always multiple treatment options. How did they retract you maxilla? Do you mean braces? I cannot stress enough that braces have a significant risk factor for facial coherence. A double jaw surgery might correct your jaw position and bite, but will not broaden your smile or expand your pallete. If you do it, make sure you get the best treatment ever. Ensure that your surgeon is cosmetically aware and informs you about the risks and potential of the surgery. Also, require 3D skeletal pictures and not just X-ray scans with additional pre and post surgery results that can be achieved.

[@downo]

@@be246 I've found this cosmetic surgeon's highly insightful video about correcting the common asymmetry resulting from jaw surgery, it doesn't have that many views but is extremely resourceful in terms of reliability. It shows how complex the jaw are. Shifting it into a new unnaturally attained position will result in a new problem to be fixed by additional treatment: kzbin.info/www/bejne/f3jQl4aHhJeHapI