Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dental > Orthognathic Surgery > Flashcards

Orthognathic Surgery Flashcards

1
Q

List the 3 treatment objectives for orthognathic surgery.

A

To improve:

  • function
  • aesthetics
  • stability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List some functional issues.

A
  • Cheek bite
  • Malocclusion
  • Sleep apnoea
  • Breathing problems in young patients
  • Difficulty chewing and speaking in syndromal patients (e.g.: CL/CP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List some common aesthetic issues.

A
  • Weak chin
  • Strong lower jaw
  • Gummy smile/Mx excess
  • Down-tipped nose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In terms of stability, which procedures are the most stable and most unstable?

A

Most stable:
- Mx impaction

Most unstable:
- Mx down-graft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do you ask in the patient assessment?

A
  • P/C
  • What would they like improved
  • How is their bite
  • Are you happy with your facial profile?
  • Do you have any functional difficulties (e.g.: OSA)?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do you assess in the clinical evaluation?

A
  • Facial form (frontal and lateral profile, long/short, concave/convex, asymmetry)
  • Facial proportions (thirds and fifths)
  • Anatomical harmony (midface, nose, lip, smile line)
  • Clinical measurements (AP dimension, transverse, intra-arch, vertical)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What other investigations do you conduct in an assessment for orthognathic surgery?

A
  • Radiographs (OPG, Lateral ceph)
  • Study models
  • Speech, audiometry, psychological, medical (if required)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the sequence of treatment planning for orthognathic surgery.

A
  1. General dental and periodontal treatment
  2. Extractions
  3. Presurgical orthodontics
  4. Orthognathic surgery
  5. Postsurgical orthodontics
  6. Definitive general dental management and maintenance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens in the presurgical orthodontics phase?

A
  • Tooth alignment
  • Correct rotated teeth
  • Adjust for tooth size discrepancy
  • Coordinate upper and lower arch widths
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does surgical treatment attempt to correct excess or deficiency of the jaw?

A
  • Advancing
  • Widening
  • Set-back
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which planes can one or both jaws have a Dx of excess or deficiency?

A
  • Transverse
  • Vertical
  • Antero-posterior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ideal surgery aims to achieve which class occlusion?

A

Class 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should the patient be aware of (and have) preoperatively?

A
  • Full informed consent
  • Realistic expectations
  • Full understanding of postop regimens for feeding and oral care
  • Fit and well
  • Normal Hb
  • Bilateral patent airways
  • Non-smoker
  • Emotionally prepared for long surgical journey
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the ideal tooth and gingiva show to be seen when smiling fully?

A

Full crown to 2mm gingiva show

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the ideal length for lips at rest?

A

0-3 apart at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What will a Mx impaction do?

A
  • Reduce gummy smile/Mx excess
  • Reduce upper lip length
  • Shortens the lower face
  • Makes the chin more prominent
  • Elevates the nasal tip
17
Q

What will a Mx advancement do?

A
  • Increase upper lip fullness
  • Increase paranasal fullness
  • Elevate nasal tip
  • Decrease chin prominence
18
Q

What will a Mx down-graft do?

A
  • Increase upper lip length
  • Increase upper teeth exposure
  • Increase upper lip prominence
  • Makes Md less prominent
  • Increase lower third facial height
19
Q

What will a Md advancement do?

A
  • Increase chin prominence
  • Increase lower lip fullness
  • Increase lower third facial height
20
Q

What will a Md setback do?

A
  • Decrease Md prominence
  • Increase lower lip fullness
  • Decrease lower third facial height
21
Q

What are Henderson’s 3 classifications of different types of jaw deformities?

A
  1. Symmetrical jaw disproportion
  2. Asymmetrical jaw disproportion
  3. CL/CP
22
Q

What are Henderson’s subtypes for symmetrical jaw disproportion?

A
  1. Mx enlargement
  2. Mx deficiency
  3. Md enlargement
  4. Md deficiency
  5. Bimaxillary disproportion
23
Q

What are common syndromes associated with CL/CP?

A
  • Pierre-Robin’s syndrome
  • Treacher-Collins syndrome
  • Apert’s syndrome
24
Q

What are common syndromes associated with facial asymmetry?

A
  • Hemifacial atrophy
  • Hemifacial microsomia
  • Neurofibromatosis (von Recklinghausen’s disease)
25
Q

What are common syndromes associated with Md prognathism?

A
  • Gorlin-Goltz syndrome
  • Osteogenesis imperfecta
  • Marfan’s syndrome
  • Klinefelter syndrome
26
Q

List some surgical techniques.

A
  • SAME
  • Bilateral Sagittal Split Osteotomy
  • Le Fort 1 Osteotomy
27
Q

What is Mx impaction indicated for?

A
  • VME with open bite or no open bite

- Dolichofacial

28
Q

What is Mx down graft indicated for?

A
  • Vertical Mx deficiency
  • Brachyfacial
  • Mx atrophy due to prolonged edentulism
  • Poor incisal display + other aesthetic problems
29
Q

What is Mx advancement indicated for?

A
  • AP Mx deficiency (Mx hypoplasia)

- Class III malocclusion

30
Q

When would a bone graft be needed for a Mx advancement?

A

If the advancement is greater than 5mm.

grafting helps accelerate bone healing b/w segments

31
Q

What are the indications for a Md advancement?

A
  • Md deficiency (often characterised by C2 skeletal pattern), weak chin
32
Q

What are the indications for a Md setback?

A
  • Md prognathism (usually C3 skeletal patterns) with bilateral posterior crossbites
33
Q

Explain a Le Fort 1 OSTEOTOMY

A

A surgical procedure where the surgeon creates a fracture in the upper jaw to either move it up (impact) or forwards (advance).

The altered jaw will be fixed into plates with titanium mini-plates and mini-screws.

34
Q

Explain a BSSO

A

A surgical procedure used to correct lower jaw deformities by either lengthening (advance) or shortening (setback).

The split will be fixed into plates with titanium mini-plates and mini-screws.

35
Q

List intraoperative complications of orthognathic surgery.

A
  • Nerve damage (IAN_
  • Tooth damage
  • Vascular compromise (esp. in FL1)
  • Haemorrhage
  • Visual damage (LF1 - bleeding into optic canal)
  • Hemarthrosis of the TMJ)
  • Unfavourable osteotomy split
36
Q

List some postoperative complications of orthognathic surgery.

A
  • Infection
  • Oroantral fistulas
  • Malocclusion
  • Relapse due to fixation problems
  • Nerve damage
  • Md dysfunction
  • Secondary haemorrhage
  • Malunion
  • Devitalised teeth
  • Mx sinusitis
37
Q

What postoperative advice is given to the patient?

A
  • Soft diet for the first few days + good OH
  • IV fluids in first 24 hrs
  • Post 24 hrs = nasogastric feeds
  • High calorie fluid diet up to 7 days
  • Blended diet for minimum 6 weeks
  • May require tracheostomy if airway is swelling
    May require foley catheter
38
Q

What timeframe is defined as early relapse of surgical treatment?

A

3-6 months postop

Dental (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions