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    Chad Carter (Course Director)

    Member
    February 12, 2023 at 1:15 am

    Joti, I think there are two parts here:

    1) Absolutely state the skeletal goals in the Trans/A-P/Vertical dimensions – if that is what the question asks.

    2) If the question asks about treatment then I can see situations where the Board would expect that we identify a 3 piece vs. 2 piece LeFort I.

    So general question for folks – What are the clues you look for in recommending a 2 or 3 piece segmental LeFort? And even more on that – what about a SARPE before a LeFort?

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    Anish Gala

    Member
    February 12, 2023 at 12:10 pm

    If It’s a Class 2 case, I’d probably be more inclined to do a SARPE 1st then the BSSO.

    If it was an Open Bite Surgical Case with 3 planes of occlusion I would consider treatment planning a 3 piece,

    As an aside, I know from my clinical experience, oral surgeons in my area do not like to do 3 piece or even 2 pieces surgery.

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      Chad Carter (Course Director)

      Member
      February 13, 2023 at 7:42 am

      Anish, those are great plans!

      SARPE definitely for a transverse only maxilla issue OR sometimes with severe transverse (>6mm) you need a SARPE first then a segmental LeFort after (LeFort multipiece cannot do >5-6mm)

      You hit the nail on the head with the Multi-Plane occlusion – that’s I think ABO test worthy! [I don’t think IVRO vs. L-cut BSSO, etc. is really where they intend our specialty to focus – let surgeons do surgery – we set goals]

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        Anish Gala

        Member
        February 18, 2023 at 12:41 pm

        The board Sample Case #7 asked about a camouflage class 3 tx plan.

        Now lets flip that what would a class 2 camouflage case, would you think U4s ? Should our first instinct be to go to be retraction of maxillary arch with TADs?

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          Chad Carter (Course Director)

          Member
          February 18, 2023 at 10:43 pm

          I do think of a classic Class II camouflage as extraction of U4s and L5s (if going for a Class I molar finish and the crowding works out etc). That is just “standard” though…. there are many options to consider. Sometimes it can be extraction U4s alone… many different ways to think about it. Retraction is very promising as well but I don’t do much whole arch distalization like some speakers show these days.

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