Orthognathic Surgery Flashcards
What is Orthognathic Surgery?
The diagnosis, prediction, planning and surgical correction of dentofacial deformities
What are the fundamentals of orthognathic surgery?
Team approach
History
Careful comprehensive clinical examination
Investigations
Prediction planning
Stable surgical techniques
Why must a patient see a clinical psychologist prior to commencement of treatment?
Early recognition of psychological problems (dysmorphophobia- hate their appearance & neurosis)
Understand real motivation for surgery
Postsurgical depression
Psychological adaptation to the new face
If there is any previous psychiatric problems
Existing disorders- anxiety, depression, sleeping patterns
What is included in a history of a patient before orthognathic surgery?
Deformity could run in family- Crouzon’s syndrome, Apert’s syndrome
Hormonal (acromegaly- increased growth hormone)
Trauma- fractures healing in wrong place
Cysts or tumours in the jaw
Racial characteristics (asian populations have naturally flat face)
What is included in an intra-oral exam for orthognathic surgery?
Occlusal relationship
Central line discrepancy relative to the face
Overjet and overbite
Crossbite
Occlusal canting
Incisors inclination
Crowding and spacing
Tongue size, mobility, speech pattern
What is included in an extra-oral exam (front) for orthognathic surgery?
Vertical asymmetry
Lip and nose morphology
Is one eye higher than the other (vertical symmetry)
Horizontal symmetry- does the nose sit to one side, does the chin sit to one side
Eyes- orbital dystopia
What is included in an extra-oral exam (profile) for orthognathic surgery?
Antero-posterior relationship from maxilla to mandible to base of the skull
Class II- convex facial profile
Class III- concave facial profile
Para nasal hollowing- maxilla needs correction
What is the treatment for orthognathic surgery?
Ortho treatment only
Combined ortho/orthognathic treatment (most common)
Surgical only
What is genioplasty?
Chin movement- advancement, set-back and rotation
What is a sagittal split mandibular osteotomy?
Separate ramus from body of the mandible
Can move mandible in any direction that you want
Mandible slides
What in involved in a combination orthodontic and surgical treatment?
Tooth alignment, eliminating crowding, spaces and cross bite
Alteration and co-ordination of the arches
Correction of incisors’ inclination (de-compensation)
Flattening the occlusal plane
Surgical fixation
Post surgical orthodontic treatment
What is a Le Fort I Osteotomy?
Corrects maxillary problem
Cutting the maxilla, disarticulating maxilla from the base of the skull and move to a position that is pre planned and screwed in
