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Plastic Surgery( Grabb)Ali jasim > Facial Skeletal Augmentation With Implants and Osseous Genioplasty > Flashcards

Facial Skeletal Augmentation With Implants and Osseous Genioplasty Flashcards

1
Q

The subcutanouse plane is typically preferred for implant
placement.

A

F The subperiosteal plane is typically preferred for implant
placement.

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2
Q

Incisions should be planned away from the implant pocket

A

T

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3
Q

Rigid fixation minimizes the risk ofinfection

A

Rigid fixation minimizes implant malposition and reduces
risk ofinfection.

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4
Q

Horizontal osteotomies should be placed at least 5 mm
caudal to the canines to avoid tooth root injury as well as to
reduce risk of mental nerve injury

A

T

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5
Q

Placement of intraoral incision should be I cm anterior
to the gingivolabial sulcus, allowing for proper wound
closure

A

T

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6
Q

preoperative evaluation

A

3D CT scanning, stereolithographic modeling, 3D printing posteroanterior and lateral cephalometric radiographs and panoramic x-rays

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7
Q

skeletal augmentation with autogenous bone can remodel, in time
affecting its size and shape.

A

T

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8
Q

Implant migration and adjacent bone erosion also tend to be lower in porous implants

A

T

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9
Q

Solid silicone implants offer several advantages

A

can be effortlessly carved to achieve a desired shape and size,
as well as be easily fixated with screws or sutures.
infection, although low regardless of the implant type, has been reported to be lower when silicone implants are used.

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10
Q

Implant placement is described in both supraperiosteal and subperiosteal planes

A

T

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11
Q

The subperiosteal pocket dissection is
preferred why?

A

The subperiosteal pocket dissection is
preferred as it involves a plane of dissection that is bloodless and safe
relative to surrounding neurovascular structures

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12
Q

A major advantage of screw fixation over the other methods
(e.g., sutures) relates to more accurate final contour because gaps
between host bone and the implant are eliminated

A

T

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13
Q

Most aesthetic facial augmentation occurs in the middle and lower
thirds ofthe face

A

T

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14
Q

Augmentation ofthe midface can be divided in four
major areas&raquo_space;»

A

malar, submalar, paranasal, and infraorbital rim.

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15
Q

skeletal augmentation are equivalent to
soft-tissue augmentation and resuspension;

A

F skeletal augmentation should not be seen as equivalent to
soft-tissue augmentation and resuspension; these are two separate entities that when used appropriately can have a synergistic effect

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16
Q

Incision placement for insertion of malar implants can vary and
include the intraoral, coronal, or eyelid routes

A

T

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17
Q

Careful carving ofthe implant on its posterior surface and
rigid fixation minimize visibility and malposition

A

T

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18
Q

In patients with
a relatively normal occlusion, deficient midface projection can be corrected with facial implants

A

T

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19
Q

When properly placed, paranasal implants
can simulate the visual effect ofLeFort II advancement

A

F of LeFort I advancement

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20
Q

the upper gingivalbuccal sulcusincision
is made just lateral to the piriform aperture

A

T

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21
Q

When screw fixation is employed, care
should be taken to avoid the root ofthe canine

A

T

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22
Q

Compromise ofthe nasal
airway can occur ifimplants are positionedover the piriform aperture.

A

T

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23
Q

Augmentation of the infraorbital rim can decrease
the incidence of lower lid malposition by reversing the “negative”
vector

A

T

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24
Q

Better exposure ofthe midface skeleton can be obtained by incorporating an intraoral sulcus incision

A

T

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25
Q

Prior to closure, malar soft tissue should be resuspended over the secure
implant

A

T

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26
Q

The deepest portion of the temporal fossa is the anterior inferior
fossa, which is the sphenoid bone contribution

A

T

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27
Q

If a previous reconstructive surgery was performed in the temporal area, access is gained
through the old scar and the PMMA is placed over the deficient
muscle.

A

T

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28
Q

Ifpatients have not had surgery or have
had the temple used as a remote access to other regions of the face
(i.e., subperiosteal facelift), then the implant is placed beneath the
temporalis muscle though an incision in the temporal hair-bearing
scalp

A

T

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29
Q

In an ideal face, the upper lip should be projecting
2 mm beyond the lower lip,

A

T

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30
Q

the lower lip should be projecting the same distance beyond the chin

A

T

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31
Q

Riedel’s line is a rapid
means of assessing the adequacy of chin projection.

A

T

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32
Q

Men tend to have larger, more projected
chins compared to women

A

T

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33
Q

An ideal chin implant is one that augments the mentum while
merging laterally with the anterior aspect of the mandibular body

A

T

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34
Q

Extended porous implants have limited flexibility and are typically designed in two pieces to allow placement through a reduced
incision

A

T

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35
Q

the submental incision for Chin implant is more commenly used

A

T

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36
Q

intraoral incision draw backs?

A

limited exposure of the anterior mandible.
associated with superior malposition of the implant
soft-tissue ptosis

37
Q

This is usually secondary to improper mentalis muscle repair at the time of wound closure and results in a witch’s chin
deformity.

A

T

38
Q

chin augmentation remains the most popular type of mandibular augmentation

A

T

39
Q

A suction drain is usually placed in the operative site
which exits through the postauricular area in mandibular augmentation

A

T

40
Q

Serious complications after alloplastic augmentation of the facial skeleton are rare

A

T

41
Q

Alloplastic implant complicationsinclude infection, migration, malposition, and asymmetry Bone resorption

A

T

42
Q

. Bone resorption of adjacent areas
has been reported and is associated with solid implants. Bone resorption is significantly less likely with porous implants

A

T

43
Q

The total reoperation rate was 10% and mostly due to implant
malposition, asymmetry, or displeasing contours

A

T

44
Q

If implant infection
does occur, antibiotic treatment alone is usually sufficient.

A

F If implant infection
does occur, antibiotic treatment alone is usually not sufficient. In such
cases, implant removal is recommended along with an antibiotic regimen. Implants can be replaced at 12 months after infection cessation

45
Q

The horizontal genioplasty remains as the second most commonly
performed osteotomy of the facial skeleton, next to rhinoplasty

A

T

46
Q

Compared to prosthetic chin implants, osseous genioplasty allows for a
more powerful and versatile alteration of chin morphology and shape.

A

T

47
Q

This includes not only correction of sagittal deficiency, but also can
includevertical lengthening, reduction, and correction of asymmetries.

A

T

48
Q

muscles that attach to the anterior plane
of the chin

A

mentalis, depressor angularis, and depressor
labii inferioris

49
Q

muscle attachments on the
lingual aspect of the chin

A

include mylohyoid, geniohyoid, and genioglossus.

50
Q

It is the latter group that contains the perforating
branches responsible for maintaining blood supply of the caudal
chin segment following elevation of the anterior periosteum and
horizontal osteotomy

A

T

51
Q

To avoid injury to the mental
nerve, the horizontal osteotomy should be planned at least 5 mm
caudal to the foramen in a caudal-oblique angle.

A

T

52
Q

Those favoring alloplastic augmentation over osseous genioplasty cite
several theoretical advantages including

A

technical ease, less pain, and a relatively low complication risk.

53
Q

Advatage of genolasty aver soft tissue implants

A

the horizontal genioplasty offers potential correction in multiple planes, anterior, posterior, and vertical
Alloplastic augmentation with chinimplants can be
effective in correcting mild to moderate volume deficiencies in the
sagittal plane

Major limitations of alloplastic methods occur when
trying to correct vertical excess or any asymmetries of the anterior
mandible
osseous genioplasty is more amenable to
surgical revision if such a condition is indicated

soft tissue of the chin has not been degloved and there is
no scar capsule formation to address

54
Q

genuiplasty should not be seen as a replacement to orthognathic surgery

A

T

55
Q

The distance from
the stomion to the menton should be twice the length of the distance
between the subnasale and the stomion.

A

T

56
Q

The lower lip, and not the other structures in the mid and upper face, determines the extent to which the
chin should be advanced

A

T

57
Q

When advancing the chin, the ratio of soft tissue to skeletal displacement is generally 3:2

A

T

58
Q

the response
ofsoft tissue to a posteriorly repositioned chin is less predictable and
typically O.5:l

A

T

59
Q

Labiomental groove depth should also be evaluated when determining if a patient is a good candidate for osseous genioplasty what the normal measurments

A

4 mm in women and 6 mm in men.

60
Q

Sagittal
advancement or vertical shortening of the symphyseal segment
would result in softting of the labiomental groove

A

f Sagittal
advancement or vertical shortening of the symphyseal segment
would result in deepening of the labiomental groove

61
Q

In the setting of a long lower face and a deep labiomental fold, correction should include orthognathic surgery rather than osseous
genioplasty alone

A

T

62
Q

The majority
ofindividuals requesting aesthetic enlargement ofthe chin have class
II malocclusion secondary to mandibular retrognathia

A

T

63
Q

Although
prior orthodontic treatment can convert class II malocclusion into
type I, it corrects the underlying skeletal problems

A

T

64
Q

Routine workup
includes a lateral cephalometric and panoramic x-ray and frontal,
profile, and oblique photographs at a minimum.

A

T

65
Q

Maintaining a 1 cm cuff of mucosa and mentalis in the gingival
side of incision will facilitate later muscle repair and incision closure

A

T

66
Q

Complete degloving of the
symphysis is not preferred as reattachment of soft tissues can be
unpredictable, increasing the risk for a witch’s chin deformity.

A

T

67
Q

The limit of dusection

A

Exposure is carried laterally until both mental nerves are visualized and posteriorly to the inferior border of the mandible, but
not further

68
Q

if vertical elongation is needed, interposing
blocks of bone substitute can be inserted into the osteotomy gap previously created.22·23 A gap of less than 5 mm needs no interposition
implant

A

T

69
Q

Mentalis muscle is then reattached using interrupted sutures, a crucial step in preventingsoft-tissue ptosis and a witch’s chin deformity.

A

T

70
Q

Wound dehiscence and infection are rare after osseous genioplasty

A

T

71
Q

In the setting of a dehiscence without infection and with no loose or
exposed hardware, most resolve without intervention

A

T

72
Q

If infection is
suspected and bone fixation is not loose, localized debridement and
irrigation followed by antibiotics serve to avoid unnecessary removal
of hardware

A

T

73
Q

More than half of all patients undergoing osseous genioplasty will
have some degree of temporary neurosensory loss

A

T

74
Q

Dental complications can also occur

A

T

75
Q

Tooth devitalization is probably one of the most serious complications after osseous genioplasty and can be avoided by placing
the osteotomy at least 30 mm caudal to the occlusal edge of the
mandibular canines

A

T

76
Q

Tooth devitalization is probably one of the most serious complications after osseous genioplasty and can be avoided ,how you can aviod it ?

A

can be avoided by placing
the osteotomy at least 30 mm caudal to the occlusal edge of the
mandibular canines

77
Q

Soft-tissue ptosis is usually secondary to improper mentalis
muscle repair at the time of wound closure and results in a witch chin’s deformity

A

T

78
Q

It can be corrected by excising soft tissue through
an elliptical incision in the submental area

A

T

79
Q

Lower lip retraction
resulting in increased lower incisor show can also occur secondary to improper mentalis muscle repair

A

T

80
Q

Lower lip retraction correction

A

Correction can be achieved
through an intraoral incision and cephalically suspending anterior
periosteum

81
Q

Using a submental incision for alloplastic augmentation
genioplasty may reduce risk of infection, wound dehiscence, and implant migration.

A

T

82
Q

An ideal implant material is one that is biocompatible and has minimal interaction with the surrounding tissues,
such that its morphology is maintained after placement

A

T

83
Q

Screw fixation in paranasal implant minimizes
asymmetries and malposition

A

T

84
Q

Riedel’s line is a rapid
means of assessing the adequacy of chin projection. A line is drawn
tangential to the upper lip and lower lip and the chin should fall
on this line

A

T

85
Q

An intraoral mucosa! incision provides adequate exposure of
the mandibular ramus and body in the subperiosteal plane

A

T

86
Q

If extensive anterior movement of the chin segment is anticipated, it
might be necessary to detach the anterior belly of the digastric muscles from the lingual surface

A

T

87
Q

For vertical shortening of the chin,
two parallel horizontal osteotomies with removal of the intervening
bone segment are used. The inferior cut is always made first for ease
of handling.

A

T

88
Q

Root exposure can occur
if incision is placed too close to the gingiva and is most likely in
patients with gingival resorption

A

T

89
Q

Horizontal osteotomy should
be performed using a reciprocating saw at least 4 mm below the
mental foramina in order to avoid nerve injury.

A

T

Plastic Surgery( Grabb)Ali jasim (92 decks)

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