dento maxilofacial deformaties

8/13/2019 dento maxilofacial deformaties

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Dental-maxillofacial Deformities

Dept. of Oral & Maxillofacial Surgery

School of Stomatology

LI Qing-yun


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Phase I Presurgical treatment

Orthodontics

Surgical plan

Phase II Surgical treatment

Mandible

Maxilla

Phase III Postsurgical treatment

Orthodontics

restorative/prosthetic treatment

follow-up


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Presurgical Treatment Phase

Presurgical orthodontics

Final surgical planning


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ObjectivesPresurgical orthodontics

Decompensation

dental compensation for skeletal deformity

angulation of teeth

accentuate the deformity


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ObjectivesPresurgical orthodontics

Alignment of the arches

Compatibility of the arches


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Final Surgical Planning

Visual Treatment Objective, VTO


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Computerized imaging CASSOS


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Model Surgery

Exact surgical movements

(distance, direction)

Postoperative occlusion

Face-bow

articulator


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Surgical Treatment Phase

Surgeries for maxillary deformity

Surgeries for mandibular deformity


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Segmental osteotomy (Anterior / Posterior)

I ndications:

- maxillary protrusion

- marked protrusion ofmaxillary teeth

- open bite


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Le Fort I osteotomy

(total or segmental)

I ndications:

- maxillary deformities- mandibular deformities


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Le Fort I osteotomy

Le Fort II or III osteotomy

I ndications:

- midface deficiency


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Sagittal split ramus osteotomy,

SSRO

I ndications:

- mandibular excess

- mandibular deficiency

- mandibular asymmetry

Adback

rotate


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Vertical ramus osteotomy

I ndications:

- mandibular excess

- mandibular asymmetry(combined with SSRO)

back


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Subapical osteotomy

I ndications:

- bimaxillary protrusion / open bite

- leveling the plane of occlusion

- uprighting anterior teeth


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Body osteotomy

I ndications:

- mandibular excess (body)

combined with ramus procedure or not

- open bite / spees curve reduction


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genioplasty

I ndications:

- chin deformities


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Perioperative complications

Airway obstructionedema/

bleeding / displacement

Bleeding

Infection

Necrosis of teeth / bone

Healing

Injury of nerve


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ostsurgical Treatment hase Completion of orthodontics

Postsurgical restorative/prosthetic treatment

Follow-up


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Pretreatment


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SNA 88

SNB 81

ANB 7


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PostLe Fort I &

genioplasty


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SNA 84

SNB 81

ANB 3


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Pretreatment


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SNA 88

SNB 92

ANB 4


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Pre operation& after presurgical

orthodontic treatment


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SNA 88

SNB 92

ANB -4


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Post Sagittal Split Ramus Osteotomy


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SNA 88

SNB 86

ANB 2


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Posttreatment


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SNA 88

SNB 86

ANB 2


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dento maxilofacial deformaties