surgery combo

Question 1

indications for surgery

Answer 1

1. dentofacial imbalce that exceeds orthodontic limits
2. esthetic and psychosocial considerations
3. potential for improvement

• when the skeletal discrepency exceeds our ability or desire to compensate the tooth position

Question 2

why ortho tx?

Answer 2

creating a occlusion

by optimizing health and esthetics

Question 3

role of ortho in surgical tc

Answer 3

position the teeth in arch ideally on each jaw

make dental discrepency = the skeletal discrepency

enable achievement of ideal oclusion once surgery is done

Question 4

pschological reaction to orthognathic surgery

Answer 4

high then low at immediate pre and 1 week post then goes higher than started at 1 yesr

90% satisfied
80% would recommend tx

Question 5

pre-operative ortho

Answer 5

achieve good alignment

usually level the arches

coordinate arch forms

REMOVE ANY COMPENSATIONS

• A-P like incisor flaring or uprighting
• transverse - buccal tipping of max posterior teeth, lingual tipping of mandibular

Question 6

most important pre op orthodontic step

Answer 6

remove compensations

Question 7

why do we decompensate

Answer 7

place upper and lower incisors in the proper positions

enable ideal occlusion after surgery

Question 8

surgery before puberty?

Answer 8

progressive deformity caused by restirction of growth

- ankylosis of andible post condylar injury or severe infection

Question 9

tools to diangose surgical requirement

Answer 9

1. complete ortho evaluation
   - need for esthetic and functional improvement
   - severity of dentofacial imbalance

radiographic
- lateral and AP cephs
Pano

visSualization
- model surgery
ceph surgery

Question 10

early vs later surgery

Answer 10

delaed until growth is COMPLETE

- early surgery does not produce a subsequent normal growth pattern

Question 11

hand and wrist films?

Answer 11

indirect method to assess growth status

1 ,2 3, 4, 5 - when fuse / cap / width becomes same as phalyx - when puberty is going to pass or passed not that long ago

but fully fused and appearance of cethamoid bone and fusion means puberty came

Question 12

T/F pre ortho for surgery can make bite worse

Answer 12

yes - decompensating and idealizing for when jaws are moved

Question 13

Bilateral sagital split used in

Answer 13

mandibular advancement or set back

Question 14

inverted vertical ramus osteotomy

Answer 14

mandibular setback only

Question 15

genioplasty

Answer 15

chin reduction or augmentatino

Question 16

orthognathic mainly for

Answer 16

skeletal correction

orthopedic (growht modificatins)

Question 17

2. which of the following represents the therapeutic limit for retraction of the maxillary incisor using ortho correction in the adult patient?

Answer 17

5= mandibular w. ortho

7 = maxillary with ortho

increases with ortho + growth and increases more with ortho surgery up to
12 and 15 respectfully

usually at 2

mandibular goes 3, 5 , 25

Question 18

therapeutic limit for the retraction of the mandibular incisor using surgical ortho correction in the adult patient

Answer 18

25

Question 19

5. Which of the following surgical procedures would be appropriate for correction of mandibular retrognathia?

Answer 19

sagital split