Orthodontic and Orthognathic Surgery

Question 1

What typically happens to the Class III appearance before surgery and why?

Answer 1

The Class III is made to appear worse by the orthodontist in order to get the most out of the surgery

Question 2

What are the 3 different types of surgical procedures relating to the maxilla?

What is the aim of these surgeries?

Answer 2

Le fort 1, 2 and 3

Aims to correct deficiency of the naso-maxillary complex and zygomatic arch

Question 3

What are the 3 types of surgical procedures carried out on the mandible?

Answer 3

1. Bilateral Surgical Split Osteotomy (BSSO) - most common
   Anterior-posterior and asymmetrical movements
2. Genioplasty - movement of the chin point
3. Total sub-apical osteotomy - correction of dento-alveolar retrusion

Question 4

What is used to fixate all osteotomies?

Answer 4

Titanium plates and screws

Question 5

What is a main risk with orthodontic surgery?

Answer 5

Damage to ID nerve which is irreversible

Question 6

Give 3 things to expect post-operatively for orthodontic surgery:

Answer 6

1. Expected swelling and pain of mouth
2. Bleeding and limited opening
3. Changes in profile and appearance

Question 7

How long does orthodontic treatment continue after surgery?

What is critical to avoid relapse?

Answer 7

Continues up to 6 months post surgery

An excellent retention regime is crucial in avoiding relapse

Question 8

Give 3 reasons why you would take a ceph radiograph:

Answer 8

1. Part of pre-tret record
2. Monitor progress of treatment and growth in patient
3. Planning orthognathic surgery