orthognathic surgery Flashcards
indications for orthgnathic surgery
functional
- speech
- mastication
- TMJ
- OSA
dental
esthetic
tx planning
clinical exam
- pt history
- exam
radiographic
cephalometric
most important radiogrpah
lateral ceph
base surgery movements off this xray
- amount of movement from this
- actual measurements coming from clinical exam
model surgery
simulate movement of surgery to generate surgical guides
generally based on clinical exam and diagnoiss, but guided by cephalometric analysis
Points on a lateral ceph
A and B
position of the maxilla and mandible
and where these points intersect the hoizontal plane
how much tooth do you show at rest
- incisally
- maxillary A-P position
- mandibular A-P position
- occlusal plane
- maxillary tooth show at rest
Maxillary A-P position is usually?
mandibular?
90 degrees
so if pt is 83 – tells you that it is back
normal b - plane is usually 88
so if this is lower – its back as well
normal tooth show at rest
2-3 mm
normal occlusal plane angle
8
only thing you can really control in the surgery
amount of tooth show at the end
make incision where
above the mucogingival junction
do one side at a time
cut down to bone
important to keep what tissue in tact
the palatal mucosal tissue
- if not just free bone
whole palate is in tact
sagital split stay in what bone
the cortical bone – not into the softer cancellous bone
sagital split done on
mandible
nerve location in sagital split
stays in the ssegment that is moving
- distal segment
- protected
amount of screws for stability of sagital split
3
