A reason why many bimaxes go wrong

hansmoleman

hansmoleman

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Bimax is a complex procedure and many factors will affect its success. But here's one often overlooked on .org: orthodontics.

Have you ever wondered why in medical environments bimax is typically associated with orthodontics, while in .org most people get the surgery right away? Sure, surgery-first is a legit approach SOMETIMES, but why is it that almost every single user on .org follows the surgery-first protocol? What a coincidence!

In this recent study (by Alfaro's team), less than 10% of the patients are assigned to the surgery-first protocol: https://pubmed.ncbi.nlm.nih.gov/35643566/

My interpretation: surgery-first is a legit protocol if the patient adheres to the objective inclusion and exclusion criteria*. Essentially, you should go for surgery-first if both your jaws are equally recessed.

Otherwise, it will lead to sub-optimal results. Typically, in class 2 patients following surgery-first, the surgeon will overdo the maxilla advancement and CCW rotation to compensate for the poor orthodontics on the lower jaw. But the average .org user will have an urge to get the surgery, and no patience at all. The greedy surgeon will notice this urge and take advantage of the patient.

*Here's Alfaro's inclusion criteria and exclusion criteria:

1697551767260


Notice how Alfaro admits that the main reason for sugery-first are having an impatient incel as a patient.

This is the curve of Spee by the way:

1697551879576


Do you have a deep curve of Spee and the surgeons you consulted who were pushing you for surgery-first didn't even mention it? Guess why they didn't.

Imagine visiting a cheap Turkish surgeon asking for bimax, and the surgeon, instead of taking your money straightaway, saying: "You have a steep curve of Spee, do orthodontics for one year and come me see later"? The patient who goes to Turkey to get a cheap bimax won't accept that, he'll go to the first surgeon who does the surgery right away, and the surgeon won't be stupid to let the money escape. I'm not saying that Alfaro won't do the same by the way (he literally admits it in his inclusion criteria).
 
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high iq , how do you know if you have this curve and whats the solution then ?
 
Greycel supremacy 😢
 
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high iq , how do you know if you have this curve and whats the solution then ?

I mean, I attached a diagram. It's easy to see in the mirror/taking a selfie. It's not a problem on its own, it just means that it's likely that surgery-first will be sub-optimal for you. You'll get better results with orthodontics.
 
Can I dm you my pics and scans so you can evaluate if surgery first approach I am planning atm wont fuck me over?
 
Legit. I had my first consultation for a bimax some weeks ago bc of sleep apnea and the surgeon said my bite is 100% correct but I still have to get braces for 6 months in order to fix both jaws after the surgery.
 
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Can I dm you my pics and scans so you can evaluate if surgery first approach I am planning atm wont fuck me over?
Just tell your surgeon that you don’t have a problem with getting braces if needed
 
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Just tell your surgeon that you don’t have a problem with getting braces if needed
Charite in Berlin, Dr. Pagnoni and Dr. Safi all said I am very suitable for surgery first yet I dont fully trust them..
 
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Charite in Berlin, Dr. Pagnoni and Dr. Safi all said I am very suitable for surgery first yet I dont fully trust them..
And What was the opinion from the Charite?
 
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Okay, so by exluding Class II patients does he mean they need pre surgery orthodontics to be a good candidate or he will never operate on them? Because the latter is retarded coming from a maxofacial surgeon jfl
 
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Okay, so by exluding Class II patients does he mean they need pre surgery orthodontics to be a good candidate or he will never operate on them? Because the latter is retarded coming from a maxofacial surgeon jfl
He means they need orthodontics.
 
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Can I dm you my pics and scans so you can evaluate if surgery first approach I am planning atm wont fuck me over?
Feel free to if I can help, but best thing to do is to ask a legit surgeon and make them clear that you are not in a rush.
 
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Charite in Berlin, Dr. Pagnoni and Dr. Safi all said I am very suitable for surgery first yet I dont fully trust them..
consult RAMIERI too, if he says you dont then you can be 100% sure that you dont need them.
 
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High iq thread my fellow greycel
 
Bimax is an easy surgery and the design is everything but most surgeons know nothing of asthetics. I could fix like all of you if I wanted.
 
consult RAMIERI too, if he says you dont then you can be 100% sure that you dont need them.
he said I'd need it but the consultation with him was shit and I dont like him as a surgeon
 
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he said I'd need it but the consultation with him was shit and I dont like him as a surgeon
Why was it shit? And if he says u need to then u should def contemplate it, he doesn't just say it for no reason.
 
Why was it shit? And if he says u need to then u should def contemplate it, he doesn't just say it for no reason.
His surgery sim was shit and it felt rushed
 
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Would this bite need braces first?
IMG 20231018 010412
 
unnecessary slander of Turkish surgeons

those damn greedy Turks and their cheap surgeries, not like the noble Italians and their 24k euro 1mm bimaxes
 
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unnecessary slander of Turkish surgeons

those damn greedy Turks and their cheap surgeries, not like the noble Italians and their 24k euro 1mm bimaxes
It was an example. I also mentioned Alfaro literally admitting impatient incels are a use case for surgery-first. And I have no reason to believe Italian surgeons have difference incentives.
 
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i dont understand how it works

Say that your lower mandible is more recessed than your upper mandible. Say that your bite is fine because:
- your teeth naturally adapted to the skeletal situation (yes, this happens)
and/or
- you had orthodontic work done.

If the upper/lower jaw relation is bad but the bite is good, it means that teeth are in an unnatural position to compensate (upper teeth reclined, lower teeth proclined). Example, look at this lower teeth:

1697646948158


They are flaring out to compensate.

It's easier to see it with diagrams.

Compensation (cucking you):

1697647018178


Decompensation (further cucking you but pre-requisite for proper bimax):

1697647041346


For class 3, it's the same as class 2 but reversed.
 
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Say that your lower mandible is more recessed than your upper mandible. Say that your bite is fine because:
- your teeth naturally adapted to the skeletal situation (yes, this happens)
and/or
- you had orthodontic work done.

If the upper/lower jaw relation is bad but the bite is good, it means that teeth are in an unnatural position to compensate (upper teeth reclined, lower teeth proclined). Example, look at this lower teeth:

View attachment 2498269

They are flaring out to compensate.

It's easier to see it with diagrams.

Compensation (cucking you):

View attachment 2498273

Decompensation (further cucking you but pre-requisite for proper bimax):

View attachment 2498274

For class 3, it's the same as class 2 but reversed.
How tf is class 2 bad for surgery first if compensation worsens the overbite though?
 
How tf is class 2 bad for surgery first if compensation worsens the overbite though?

Because it’s unlikely that a class 2 case will be fully decompensated on their own. Even if they didn’t get any braces at all, teeth naturally try to adapt to the jaw.

There is a reason why with class 3 it’s not exactly the same, but I can’t remember.
 
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Because it’s unlikely that a class 2 case will be fully decompensated on their own. Even if they didn’t get any braces at all, teeth naturally try to adapt to the jaw.

There is a reason why with class 3 it’s not exactly the same, but I can’t remember.
Can u try to find why and then lmk when u do please?
 
Bimax is a complex procedure and many factors will affect its success. But here's one often overlooked on .org: orthodontics.

Have you ever wondered why in medical environments bimax is typically associated with orthodontics, while in .org most people get the surgery right away? Sure, surgery-first is a legit approach SOMETIMES, but why is it that almost every single user on .org follows the surgery-first protocol? What a coincidence!

In this recent study (by Alfaro's team), less than 10% of the patients are assigned to the surgery-first protocol: https://pubmed.ncbi.nlm.nih.gov/35643566/

My interpretation: surgery-first is a legit protocol if the patient adheres to the objective inclusion and exclusion criteria*. Essentially, you should go for surgery-first if both your jaws are equally recessed.

Otherwise, it will lead to sub-optimal results. Typically, in class 2 patients following surgery-first, the surgeon will overdo the maxilla advancement and CCW rotation to compensate for the poor orthodontics on the lower jaw. But the average .org user will have an urge to get the surgery, and no patience at all. The greedy surgeon will notice this urge and take advantage of the patient.

*Here's Alfaro's inclusion criteria and exclusion criteria:

View attachment 2496165

Notice how Alfaro admits that the main reason for sugery-first are having an impatient incel as a patient.

This is the curve of Spee by the way:

View attachment 2496171

Do you have a deep curve of Spee and the surgeons you consulted who were pushing you for surgery-first didn't even mention it? Guess why they didn't.

Imagine visiting a cheap Turkish surgeon asking for bimax, and the surgeon, instead of taking your money straightaway, saying: "You have a steep curve of Spee, do orthodontics for one year and come me see later"? The patient who goes to Turkey to get a cheap bimax won't accept that, he'll go to the first surgeon who does the surgery right away, and the surgeon won't be stupid to let the money escape. I'm not saying that Alfaro won't do the same by the way (he literally admits it in his inclusion criteria).
BOTB + bump
 

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