An interview with Simonas Grybauskas

[...]active mechanotherapy is indicated after condilectomy, which would be a little bit complicated if orthognathic surgery is simultaneous. [...]the most important indications for two stage surgery are: 1) When it is necessary to lengthen the short side (due to hypoplasia), then distraction osteogenesis is performed in the first stage and a retention period of nine months is allowed for the patient (Figs 2A to 2F). Restart of orthodontic treatment on both arches at once: after segmental bimaxillary osteotomies the upper jaw segments change vertical height and torque. [...]the front 6 or 8 or even 10 brackets need to be rebonded in a passive line or the archwire needs to be bent according to the new position and torque of front teeth. [...]this technique was associated with a significant amount of errors and inaccuracies related to mistakes that could be made in every step: face-bow positioning and recording, transfer of the upper dental arch position to the articulator, model-block surgery.9 In patients with craniofacial asymmetries, the entire cranial base may be rotated and may not match the clinical coordinate system in which we examine the patient empirically and plan surgical movements (Fig 5A). [...]when the face-bow transfers the models to the articulator, the coordinate system will be different: during the clinical examination, the glenoid fossas are not in the same frontal plane and axial plane, in craniofacial asymmetries (Fig 5B). If this is not done, the head will be randomly dropped in the coordinate system and the lower part of the face will be constructed around wrong planes. [...]even small rotational errors will result in visible asymmetry, occlusal cants or less than ideal facial outcome.