Surgical and correction of dentofacial deformations

Question 1

What is the purpose of the psychologist

Answer 1

o Identify any psychological problems
o Understand real motivation for surgery (e.g bullying, we require the motivation to come from the patient themselves)
o Post-surgical depression/psychological adaption to the new face
 Need to get used to their new appearance

Question 2

What is the purpose of the technologist

Answer 2

o Model surgery planning
o Provide occlusal wafer to guide the surgery
o Digital prediction of final occlusion

Question 3

What is the purpose of the orthodontist

Answer 3

o Early recognition of dentofacial deformities
o Orthodontic preparations before and after surgery
o Follow up

Question 4

What are the possible maxillary diagnoses

Answer 4

 Prognathic
 Retrognathic
 Vertical excess
 Vertical deficiency

Question 5

What are the mandibular diagnoses

Answer 5

 Prognathic
 Retrognathic

Question 6

What are the chin diagnoses

Answer 6

 Progenia
 Retrogenia
 Vertical deficiency
 Vertical excess

Question 7

What are the differnet tx options

Answer 7

o Orthodontic treatment only
o Combined ortho & surgical tx
o Only surgical treatment

Question 8

What does combined tx consist of

Answer 8

 Tooth alignment, eliminating crowding, spaces and cross bite
 Alteration and coordination of the arches
 Correction of incisor inclination (decompensation)
 Flattening occlusal plane
 Surgical fixation
 Post surgical orthodontic fine tuning

Question 9

What does extra oral examination consist of

Answer 9

o Aesthetic proportions
o Vertical asymmetry
o Lip and nose morphology
o Horizontal asymmetry (mediolateral)
o Anteroposterior relationship

Question 10

What does intra oral examination consist of

Answer 10

o General dental assessment
o Occlusal relationship
o Central line discrepancy relative to face
o Overjet/overbite
o Crossbite
o Occlusal canting
o Incisors inclination
o Crowding and spacing
o Tongue size, mobility, speech pattern
o Cleft cases and velopharyngeal incompetence

Question 11

What is the use of study models

Answer 11

o Impressions, facebow, wax bite, articulator
 Mounted using facebow
o Study the occlusion
o Orthodontic analysis
o Orthognathic surgery planning
o Model the surgery
o Occlusal wafer for surgery
o Assess surgical changes
o Assess long term stability and relapse

Question 12

What photographs are taken

Answer 12

o Full face at rest and smiling
o Right and left profiles
o Teeth in occlusion

Question 13

What radiographs are taken

Answer 13

OPT
ceph
PA
occlusal
CBCT

Question 14

What are the maxillary surgical prcoedures

Answer 14

o Le fort I osteotomy
o Anterior maxillary osteotomy

Question 15

What are the mandibular surgical procedures

Answer 15

o Advancement
o Set back

Question 16

What are the chin surgical procedures

Answer 16

o Advancement
o Set back
o Rotation
o Augmentation
o Reduction