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Dental-maxillofacial Deformities

Dental-maxillofacial Deformities. Dept. of Oral & Maxillofacial Surgery School of Stomatology. LI Qing-yun. Phase I. Presurgical treatment. Orthodontics Surgical plan. Phase II. Surgical treatment. Mandible Maxilla. Phase III. Postsurgical treatment. Orthodontics

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Dental-maxillofacial Deformities

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  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 orthodontics • Final surgical planning

  4. Objectives —— Presurgical orthodontics • Decompensation dental 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

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

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

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

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

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

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

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

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

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

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

  18. Perioperative complications • Airway obstructionedema / bleeding / displacement… … • Bleeding • Infection • Necrosis of teeth / bone • Healing • Injury of nerve

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

  20. Pre treatment

  21. SNA 88° SNB 81° ANB 7°

  22. Post Le Fort I & genioplasty

  23. SNA 84° SNB 81° ANB 3°

  24. Pre treatment

  25. SNA 88° SNB 92° ANB 4°

  26. Pre operation & after presurgical orthodontic treatment

  27. SNA 88° SNB 92° ANB -4°

  28. Post Sagittal Split Ramus Osteotomy

  29. SNA 88° SNB 86° ANB 2°

  30. Post treatment

  31. SNA 88° SNB 86° ANB 2°

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