Orthognathic Surgery Treatment Timeframes Flashcards
What are the stages of Orthognathic Surgery?
•Assessment
• Trt Planning
• Risks
• Pre Ortho
• Surgery
• Post Ortho Trt
• Retention
What happens at the Assessment stage?
• MH, PCO
• IO - Disease and Dento Alveolar Compensation
• EO - Skeletal Pattern
• Records
• Special Tests
Radiographs used for Orthognathic Treatment?
- OPG - presence, position and pathology
- Ceph Analysis
- Upper Standard Occlusal
- Post Anterior skull - Asymmetry
What does a Ceph analysis look at:
- max/ mand dentition
- naso - max complex
- cranium and cranial base - (S-N Line)
What happens at the diagnosis?
Classification of malocclusion and skeletal pattern?
What happens at the treatment planning stage?
- Assess
- Problem list
- Aims of trt
- Joint clinic
- Considerations
What considerations are considered at the treatment planning stage?
- Decompensation of Dento Alveolar compensation
- Soft tissue/ hard tissues are equal
Why are aids used during trt planning?
To show positions and predictions
What aids are used during planning treatment?
• Photographs
• ceph and tracings
• Transparacies
• computer software
What are the risk associated with Orthognathic Surgery?
• swelling/bruising
• Nerve damage
• Infection and Relapse
What nerve can get damaged with maxilla surgery?
Infra Orbit Nerve
What nerve can get damaged with mandible surgery?
Inferior alveolar/ dental nerve
How long does pre ortho trt take?
12 - 18 months
What happens during pre ortho trt?
• xlas - crowding, levelling and 3rd molars
• level and align
• arch coordination
• Decompensation
• Creates spaces for cuts
• Maintains curve of spee
What type of mechanics are used during pre ortho trt?
Fixed appliance with:
•SS wires
•surgical hooks
When are the face-bow readings and wafers constructed?
After Pre Ortho trt has been completed
Surgery timeframe?
2/4 days
What happens during the surgery process?
• Titanium plates and screws
• Jaws closed
• Inter maxillary fixation
Post surgery diet?
• liquid foods 1/2 days
• soft food 4/6 wks
Post surgery swelling?
Rapid reduction = 2/3 weeks
Gradual reduction = 6/9 months
What is the Timeframe for Post surgery Ortho trt?
6/9 months
What happens during post surgery ortho treatment?
• Maintain correction
• complete any further movements
• root paralleling @ the segmental sites
What mechanics are used during post Surgery Orthodontics?
Fixed
Flexible wires and elastics
What are the risks associated with retention with a surgical case?
- Surgical
- Orthodontic
- Patient
What are the increased surgical retention risks?
• Inadequate fixation
• maxilla > 5mm
• mandibular > 8mm
• condylar head displaced
What are the increased orthodontic risks?
Extrusion movements - relapse
Increased patient retention risks?
• Habits
• AOB
• soft tissue tension
• CLP - scar tissue
• compliance
