PLS HELP me choose pre-surgical orthodontic path! SFOT, extractions…

[runnergirl36]

I”m considering jaw surgery to correct my skeletal class 2 overbite which was corrected by severely slanting my lower teeth outwards during childhood braces. Surgeon isn’t sure if she’ll do a BSSO or DJS yet, though I’d prefer bsso. Now to decompensate the teeth enough, I have a few options:

1. Extract two bottom premolars (all my wisdom teeth already gone so seems like I wouldn't have a lot of teeth??), then TADs + braces or invisalign (would this allow for more decompensation?)
   A. Only con I could think of is that this can decrease tongue space if only a BSSO is done--I have no idea if this is true??

2. Extract just one bottom incisor (yes, I know this would mess up my midline but I'm not really concerned with the aesthetics of my smile as much as I am my actual face)--this would allow for more decomp and less total treatment time

3. Intraproximal stripping + TADs and plates (ortho didn’t say what kind) + braces/invisalign
A. apparently this wouldn’t allow for as much decompensation? Is this true?
B. Do I have the option of extracting more teeth later if this is absolutely needed?

One ortho said I could try SFOT but it might not do much and can be very painful, so I’m on the fence on this.

Surgeon is okay with bringing my bite to an edge-to-edge bite and then completing further decompensation after surgery if needed. Due to reasons I really can’t get into but hope you will respect, I need to get to surgery / complete the pre-surgical ortho phase as FAST as possible. Which will allow me to do so and is safest?

[bigopenbite]

Hi, I did not have the same issue as you, but I did have a textbook surgery Case, considered TADs and ended up with headgear Which is working. I would be really cautious with a tight timeline as it's hard to predict how teeth move, TADs might fall out, one surgeon I consulted with told me 5% of surgery patients may need a second surgery etc. I do recall reading though that despite significant presurgical ortho almost always being done sometimes it is possible to do the surgery at the beginning of treatment, though it may not be optimal.