1. Dental-maxillofacial Deformities Dept. of Oral & Maxillofacial Surgery School of Stomatology LI Qing-yun

2. Phase I Presurgical treatment • Orthodontics • Surgical plan Phase II Surgical treatment • Mandible • Maxilla Phase III Postsurgical treatment • Orthodontics • restorative/prosthetic treatment • follow-up

3. Presurgical Treatment Phase Presurgical Treatment Phase • Presurgical orthodontics • Final surgical planning

4. Objectives —— Presurgical orthodontics • Decompensationdental compensation for skeletal deformity angulation of teeth accentuate the deformity

5. Objectives —— Presurgical orthodontics • Alignment of the arches • Compatibility of the arches

6. Final Surgical Planning • Visual Treatment Objective, VTO

7. Final Surgical Planning • Computerized imaging CASSOS

12. Final Surgical Planning articulator • Model Surgery Exact surgical movements (distance, direction) Postoperative occlusion Face-bow

14. Surgical Treatment Phase • Surgeries for maxillary deformity • Surgeries for mandibular deformity

15. Surgeries for maxillary deformity • Segmental osteotomy (Anterior / Posterior) Indications: - maxillary protrusion - marked protrusion of maxillary teeth - open bite

16. Surgeries for maxillary deformity • Le Fort I osteotomy (total or segmental) Indications: - maxillary deformities - mandibular deformities

17. Surgeries for maxillary deformity • Le Fort I osteotomy • Le Fort II or III osteotomy Indications: - midface deficiency

18. SNA 88° SNB 92° ANB 4°

19. Surgeries for mandibular deformity • Sagittal split ramus osteotomy, SSRO Indications: - mandibular excess - mandibular deficiency - mandibular asymmetry back Ad rotate

20. Surgeries for mandibular deformity • Vertical ramus osteotomy Indications: - mandibular excess - mandibular asymmetry (combined with SSRO) back

21. Surgeries for mandibular deformity • Subapical osteotomy Indications: - bimaxillary protrusion / open bite - leveling the plane of occlusion - uprighting anterior teeth

22. Surgeries for mandibular deformity • Body osteotomy Indications: - mandibular excess (body) combined with ramus procedure or not - open bite / spee’s curve reduction

23. Surgeries for mandibular deformity • genioplasty Indications: - chin deformities

24. Perioperative complications • Airway obstruction edema / bleeding / displacement… … • Bleeding • Infection • Necrosis of teeth / bone • Healing • Injury of nerve

25. Postsurgical Treatment Phase • Completion of orthodontics • Postsurgical restorative/prosthetic treatment • Follow-up

26. SNA 88° SNB 81° ANB 7°

27. SNA 84° SNB 81° ANB 3°

28. SNA 88° SNB 92° ANB -4°

29. SNA 88° SNB 86° ANB 2°

30. SNA 88° SNB 86° ANB 2°