Before & after IMDO jaw and facial distraction surgery explained 

I can't believe this video is 9 years old! I'm also surprised this procedure hasn't become more mainstream yet. I believe it is a potential game changer for treatment of small lower jaws in adolescents. I love Dr. Coceancig's book. I have given away 10 copies of it already.

This is how orthodontics should be. Identifying the underlying cause and treating it, by taking a holiestic approach and seeing how everything effects each other, by expanding the arch and allowing more breathing in the airway.

Would be priceless to see an update on this case, 10 years later, and see how this developed

Paul, I can't thank you enough for your efforts at illustrating both the problem and the treatment. Conceptually, the relevance of the airway to orthodontics is largely missed but I believe this video will go a long way to changing that. I have some comments/questions: 1) The boy, as illustrated, still has an open mouth posture and forward head position post-treatment. Unless the functional aspects of his behavior - the postures that led to this morphology - are corrected, his growth will not proceed in the desired direction but may lead to the same type of relapse seen in conventional orthodontics. Proper teaching of oral posture, body posture and breathing dynamics is an essential followup to this amazing treatment just as surely as physical therapy is applied to any skeletal surgery. This aspect must also be part of modern airway-oriented orthodontics. 2) In my view, are larger percentage of patients with this morphology also have a VERTICAL overgrowth of the maxilla resulting in not only it's narrowness, but also it's vertical excess and horizontal retrusion. Very few in orthodontics recognize that with excess overjet there is also a RETRUSION and FALLING of the maxilla. It is the result of the breathing difficulties which kept the mouth open, the head forward and the mandible pulled back by neck and sublingual muscles (and perhaps trauma). As a result, the maxilla needs not just expansion, but lifting and advancement as well. There happens to be one growth-oriented technique that can accomplish this but it can only be done BEFORE the shedding of the primary teeth. How do you accomplish this shape change? 3) I am also concerned with the PRIOR damage that inevitably occurs - whether clinically evident or not - to the TM joints from the strain of poor posture, restricted breathing, aberrant swallowing and jaw mechanics of this particular morphology. How are you accommodating these treatment needs in your procedures? 4) While your revolutionary treatment will become standard of care for those who have slipped through the cracks, it is important to know that correcting the offending habits when they begin can prevent this type of facial growth pattern and avoid this situation to begin with. 5) From whom do we learn more about this application? Again, your work will move orthodontics forward (pun intended) in the 21st century. Thank you SO much, Barry Raphael Raphael Center for Integrative Orthodontics and Mt. Sinai School of Medicine

What an amazing accomplishment!!. Thanks for sharing. I'm curious to find out why there are 9 jerks that disliked this incredible benign transformation. I suppose its the semi-rationality of human nature!!

Paul. Impressive presentation of an equally impressive game-changing technique. A new treatment option for small lower jaws where a better alternative is greatly needed. Well done!

A fantastic presentation that well illustrates the problem and the impact of treatment beyond the teeth through excellent visuals and commentary.

Profound video highlighting the advances in surgical/orthodontic correction of dentofacial deformities. I found this video very informative and exciting. Utilizing modern technology to correct facial deformities in a less invasive manner is the future of Orthognathic Surgical correction. Excellent video. I'm motivated to learn more about this technique. C. Ken Templeton

I need this. But I also need money

i had this surgery and am loving the results :)

I’m victim of malpractice by Federico Hernández Alfaro (maxillo Monkey-facial Institute in Barcelona). Looking for an experienced professional for the revision this time.

Thanks Ken... to find out more, come to Barcelona in October 2013 for ICOMS

Very nice presentation Paul.

Simply Amazing! The changes are astounding given the time period. Will this procedure work on an Adult (age 25) or is their any other procedure similar that is recommended and/or better suited for an adult of that age?

Fabulous work - bravo

awesome work. I'll be bringing my child in for a consultation. He's got a case which is very similar to Patrick's.

can IMDO be conducted on a middle aged adult, say 35?

fascinating video! I wonder what you can do for adults with this class II malocclusion

What about mandibular transverse expansion in addition to this entire treatment?

hello dr paul, I have had 4 teeth extracted, thus my chin, upper and lower jaw has receded, I believe. I am aware that orthognatic surgery is available to bring it forward, which opens up the airway but is it not possible to do distraction osteogenesis of both mandible and maxilla for my case ?,

Doctor, the results are amazing. How can I get this done in the USA?

Is this done in the USA, list of providers?

Hi Paul, is this effective in Adults as well?

I’m currently in recovery for this surgery but for an underbite opposed to an overbite. I’m one week past my surgery and if anyone has questions about it ask and I’ll be sure to inform you about my experience so far

nosal air volume increase by 6% i can assume that using all that devices we are achieving that. but does any volume because mathematics would not work. and what is about chin do we get forward growth ?

That first boy looked like Franklin the 🐢

it is nice vedio but more vedios should be available in future on patient basis and rewiew

Hey Paul, if someone has one tmj that is shorter than the other, can these procedures still be carried out or do you beleive it would cause TMJ issues?

I have been offered this procedure today on my very severe overbite. Can anyone explain how long I need to be off ?? The pain level ?? I’m 38 and I worry about the jaw relapsing.

Tha's great. removed the source that was blocking lower arc and vertical grow's face. Quicly, at this age, kids refuse to use like should, the orthopedics appliances. Is a problem for them, for us and for parents. Social view, is very important to plain an orthodontic treatment. They, don't wear at school...party...and et cetera, so, our work is hard. I recommended this procedure.

Just amazing work. How in the world did you arrange the skeleton angle???

I've seen this video many times before and I am still amazed by the result. One question: when is mandibular expansion required? Is it just functional or also for the aesthetic aspect of it? Say for instance that you would like to have the jawline of Brad Pitt. Is mandibular expansion a means of that pursuit?

Is this available in canada?

yes

Had I lived in Australia you had been the obvious choice. However, Sweden is quite far from you :( I've asked my doctor here to expand the mandibular to give the jaws a wider appearance but that was out of the question..

I'm not sure what you mean

I'm not sure what you are asking

also can this treatment be done in the Uk

Brutal.

Hi Paul, I am looking at IMDO as a treatment option and will be scheduling a consultation next week. I do have an overbite that was "corrected" by braces, although this never fixed the root of the problem: short lower jaw. However, given what I am looking for, if I bring the lower jaw forward, that would cause an underbite. Is there an orthodontic treatment to move the upper jaw forward a few mm? Or perhaps move it forward and downward? I do not want a LeFort 1 by any means, but I am nervous that this may be a necessity if I move the mandible forward. Does the Hirax just expand the upper jaw horizontally, or can it move it forward as well. Perhaps a solution would be to receive new braces to move my upper teeth more outward and my lower teeth more inward to fix the resulting malocclusion.

Hello Mr paul, I have a prognathe, my lower jaw goes left, what makes my face not symetrical at all, I am 36 by th way, can I get results without going through surgery? thanks for answering.

Would this procedure be covered by insurance we we have it?

Do you offer courses?

Treatment using surgery right?

Hello sir is this procedure available in india

Hey Dr. I am 17 years old and I already have braces, I needed jaw surgery (well I still do) but I decided not to go that rout because of the pain, now I'm regretting it but I get my braces off in a month my jaw isn't perfectly align but I was wondering if I could still get this procedure even if my bite was almost corrected with elastics?

I got braces and had them for 2 years and they misaligned my jaws, my teeth are offcentre, would this fix them?

I wish to knew those.. Before i excract teeth i am so sad 😥😥.

How can a overbite cause daytime sleepiness?

Do you know some Orthondists in Germany especially in Bremen that know you and the imdo procedure?

Is this an alternative to a BSSO?

Hey can vertical lengthening of3 cm is possible

Is this surgery possible only in Australia? I'm from europe

Is this possible on a 20 year old?

Sir is ur clinic avilabale in india

This treatment is not truly understanding the cause and cure of maloclusion. If you want to prevent maloclusion it is much simpler than this. Please look into orthotropics and the tropic premise. Changing oral posture in children will be far more effective than this invasive treatment

Heeeeelp

lucky white boy with great health care in america anyways