We agree with one possible exception.. You wrote

10 different doctors can give you 10 different descriptions of
the exact same procedure.  Also, 10 different doctors can give you 10
(or even more) different treatment options.

TRY

10 different doctors can give you fifty different descriptions of
the exact same procedure.  Also, 10 different doctors can give you
fifty one (or even more) different treatment options.

Depending on whether you have g-o-o-o-ooo-o-oooo-od insurance.

Joking about the last line, of course. All you need is _ _ insurance!

JOEL

1.  The cause of *my* bilateral degenerative joint disease of the TMJs
is the direct result of a *bothched* orthognathic surgery of the
mandible performed twenty-one (21) years ago in 1983.

2.  The first TMJ surgery I had was in 1984 and it was the second
surgical attempt to correct some of the conditions I was left to suffer
as a result of the other surgeon's failure and dishonesty.  The first
reconstructive effort involved cutting out bone fragments that had fused
my mandible to my cheekbone (zygomatic arch) and left me with a
significant loss of muscle integrity after 14 months of disuse and
surgical scaring.  Anyway, ....

3.  During that first bilateral TMJ surgery, a material known as
Silastic was placed into the joints after the degenerative tissues of
the ankylosed joints was excised away from the cranium where the
condylar heads were fused.

4.  The material that was to be used was to be chosen in the operating
room according to the surgeon's opinion as to the better fit.  The
alternative material (second choice) was that of "Proplast" which at the
time was the new kid on the street.

A few years later after more ankylosis of the joints, a decision was
made to use a partial joint replacement for both joints that would "line
the glenoid fossoe" with metal in hopes that the bone would not grow and
fuse to the skull again.  At that point in time, I was aware that the
material Proplast was a source of trouble and I did NOT want to be part
of that population.  My surgeon (someone closer to my home) took over my
case and he knew that I didn't want any Proplast implanted ... so he
told me what he apparently wanted me to know:  He said that even though
Vitek made the glenoid fossa, it was actually lined with Silastic on the
portion that would rest against the skull, and the metal was on the side
that was inside the joint where the condyle (what was left of them)
articulated (not that mine ever really articulated either).

Well ... I asked.  I was told.  I heard.  The glenoid fossae failed
miserably ... leaving me again in horribly unbearable pain.  They were
removed at a later point and the surgeon described them as having been
shredded apart by the bone in the joints.  The only reason the bone was
moving was because of the use of continuous passive motion exercise and
other very, very physically aggresive stretching techniques that never
worked but only aggravated the heterotopic bone formation.

Looking again to the future, the skull was eroded with at least one hole
in it from the Proplast that pressed against it for however long it had
been... so "hole in my head" ... and no mandibular function ...

You know what ... this story is so long and so horrible that I really
can't do it justice.  I went about it as I have only to point out that
if you (or anyone else) has an idea that I didn't ask enough questions
about materials and methods of surgery ... you simply have absolutely no
idea about anything that went on in my life.  

Ask anyone who has read "The TMJ Iatroepidemic" if I asked enough
questions ... believe me, I learned how to ask more questions than
anyone wants to be asked.  Until you know enough to ask high quality
questions, you will not receive high quality answers.  

As for my current joint materials, they had not received FDA approval at
the time of implantation.  My insurance company covered the surgery (at
whatever rate they covered it at and we picked up what they didn't) as a
"humanitarian procedure" because without it, I had a very high risk of
death.  There are people out there who would do anything to see that
total joint replacements for the TMJ are not available (on the market).  
The same company that made mine is now called TMJ Concepts and their
joints are FDA approved.  www.tmjconcepts.com

Webby

No Toni, you mis-understood.  My point was that the OP had pretty much
decided that her Orthodontist's recommendations were not appropriate and
wanted us to support her idea of not following through with the suggested
treatment plan.  It is entirely her right to compromise the treatment plan
and do less than ideal.  However, her tone of speech suggested that she
could make the decision based on finances and convince rather than on
desired final outcome.  If you were having heart surgery, you would discuss
all the possibilities, but you would decide on the final result and take
whatever path you needed to get there.  My comparison was simply to give the
practitioner the freedom to choose a path to get to the final result.  If
you cannot afford it, or do not desire it, then you compromise.

Frankly, I was hoping for a direct response from the OP so as to get more
information from Her/him.  I may have misunderstood the OP.