Introduction to orthognathic surgery, the assessment of facial disproportion, and orthognathic treatment planning

2021 ◽  
pp. 831-840
Author(s):  
Claire Bates ◽  
Trevor Hodge ◽  
Christopher J. Mannion ◽  
Lachlan M. Carter
Keyword(s):  
Treatment Planning ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Facial Deformity ◽  
Facial Skeleton ◽  
Careful Assessment

Facial deformity associated with jaw malalignment and malocclusion can be addressed with orthognathic surgery to reposition the maxilla or mandible, or both, in combination with dental alignment with orthodontic treatment. Careful assessment of facial proportion and treatment planning allows precise repositioning of the facial skeleton and teeth to restore appearance and occlusion.

Orthodontics

2020 ◽  
pp. 121-172
Keyword(s):  
Treatment Planning ◽  
Distraction Osteogenesis ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Open Bite ◽  
Diagnosis And Treatment ◽  
Anterior Open Bite ◽  
Treatment Need ◽  
The Face ◽  
Structured Approach

This chapter discusses the growth of the face, development of the dentition, and prevention and correction of occlusal anomalies, providing a concise overview of the fundamentals of orthodontics. Definitions relevant to orthodontics are outlined as well as a structured approach to orthodontic assessment. The Index of Orthodontic Treatment Need is explained, and its implications highlighted. The chapter also simplifies cephalometrics before detailing the management of increased overbite, anterior open bite, increased overjet, and various other dental and skeletal malocclusions. A further area included in this chapter is orthognathic surgery. The section includes diagnosis and treatment planning in these cases, surgery, and distraction osteogenesis.

scholarly journals Current Trends in Orthognathic Surgery in Poland—A Retrospective Analysis of 124 Cases

2021 ◽  
Vol 11 (14) ◽  
pp. 6439
Author(s):  
Ewa Zawiślak ◽  
Szymon Przywitowski ◽  
Anna Olejnik ◽  
Hanna Gerber ◽  
Paweł Golusiński ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Corrective Osteotomy ◽  
University Hospital ◽  
Class Iii ◽  
Facial Skeleton ◽  
Skeletal Class ◽  
Skeletal Malocclusion ◽  
Current Trends ◽  
Maxillary Osteotomy ◽  
Skeletal Class Ii

The analysis aims at assessing the current trends in orthognathic surgery. The retrospective study covered a group of 124 patients with skeletal malocclusion treated by one team of maxillofacial surgeons at the University Hospital in Zielona Góra, Poland. Various variables were analysed, including demographic characteristics of the group, type of deformity, type of osteotomy used, order in which osteotomy was performed and duration of types of surgery. The mean age of the patients was 28 (ranging from 17 to 48, SD = 7). The group included a slightly bigger number of females (59.7%), with the dominant skeletal Class III (64.5%), and asymmetries were found in 21.8% of cases. Types of osteotomy performed during surgeries were divided as follows: LeFort I, segmental LeFort I, BSSO, BSSO with genioplasty, LeFort I with BSSO, LeFort I with BSSO and genioplasty, segmental LeFort I with BSSO, isolated genioplasty. Bimaxillary surgeries with and without genioplasty constituted the largest group of orthognathic surgeries (49.1%), and a slightly smaller percentage were one jaw surgeries (46.7%). A statistically significant correlation was found between the type of surgery and the skeletal class. In patients with skeletal Class III, bimaxillary surgeries were performed significantly more often than in patients with skeletal Class II (57.5% vs. 20.0%; p = 0.0002). The most common type of osteotomy in all surgeries was bilateral osteotomy of the mandible modo Obwegeser–Epker in combination with Le Fort I maxillary osteotomy (42.7%). The order of osteotomies in bimaxillary surgeries was mandible first in 61.3% of cases. The longest surgery was bimaxillary osteotomy with genioplasty (mean = 265 min), and the shortest surgery was isolated genioplasty (mean = 96 min). The results of the analysis show a significant differentiation between the needs of orthognathic surgery and the types of corrective osteotomy applied to the facial skeleton.

scholarly journals Treatment of a Patient with Multiple Impacted Teeth

2007 ◽  
Vol 77 (4) ◽  
pp. 735-741 ◽  
Author(s):  
Richard Scott Conley ◽  
Scott B. Boyd ◽  
Harry L. Legan ◽  
Christopher C. Jernigan ◽  
Craig Starling ◽  
...  
Keyword(s):  
Case Report ◽  
Treatment Planning ◽  
Orthodontic Treatment ◽  
Primary Teeth ◽  
Permanent Tooth ◽  
Permanent Teeth ◽  
Treatment Sequence ◽  
Impacted Teeth ◽  
Case Complexity ◽  
Multiple Primary

Abstract An impacted or missing permanent tooth can add significant complications to an otherwise straightforward case. When multiple impacted teeth are present, the case complexity increases further. Developing a treatment sequence, determining appropriate anchorage, and planning and executing sound biomechanics can be a challenge. The following case report illustrates a patient reportedly diagnosed with mild scleroderma as an adolescent. He presented for orthodontic treatment as an adult with multiple retained primary teeth and multiple impacted teeth. Diagnosis, treatment planning, and various methods of managing guided eruption of impacted teeth will be discussed. Following orthodontic treatment that required extraction of multiple primary and permanent teeth as well as exposure and ligation of multiple permanent teeth by an oral surgeon, the patient finished with a significantly improved functional and esthetic result.

Changes in the Complexity of Orthodontic Treatment for Patients Referred to a Teaching Hospital

1988 ◽  
Vol 15 (1) ◽  
pp. 27-32 ◽  
Author(s):  
C. D. Stephens ◽  
N. W. Harradine
Keyword(s):  
General Practitioner ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Further Training ◽  
Fixed Appliance ◽  
Dental Hospital ◽  
Orthodontic Patients ◽  
Specialist Treatment ◽  
Fixed Appliances ◽  
Removable Appliance

The records of 200 orthodontic patients accepted for treatment by the Orthodontic Department of the Bristol Dental Hospital in 1977 were compared with 200 taken on in 1985 in order to determine whether there had been any change in the proportion of referred cases requiring more complex procedures. Within each sample, cases were categorized as follows: (a) suitable for removable appliance treatment by an undergraduate or general practitioner; (b) requiring simple one arch fixed appliance treatment such as might he attempted by a general practitioner after a period of further training; (c) needing specialist treatment such as full multibracketed fixed appliances or orthognathic surgery. It was found that there had been no change in the proportions of simple and complex cases referred during the 8-year period although the proportion of patients now receiving complex treatment had increased greatly. Possible explanations and implications are discussed.

Video Imaging—a Computer Facilitated Approach to Communication and Planning in Orthognathic Surgery

1993 ◽  
Vol 20 (3) ◽  
pp. 187-191 ◽  
Author(s):  
David M. Sarver
Keyword(s):  
Case Report ◽  
Treatment Planning ◽  
Orthognathic Surgery ◽  
Imaging Techniques ◽  
Video Image ◽  
Video Imaging ◽  
The Aesthetic

A case report is presented in order to illustrate the benefits of computerized video imaging in orthognathic surgery. It is suggested that superimposition of the cephalogram on the video image is helpful in treatment planning and in communication with the patient. Computerized video imaging techniques help clinicians and patients discuss the aesthetic impact of orthognathic surgery. The superimposition of the cephalogram and profile image, coupled with algorithmic predictions, allow the clinician to plan the surgery to closely match the desired result. This paper presents the planning and counselling of a patient using contemporary computerized video imaging techniques.

Cone-beam computed tomography for routine orthodontic treatment planning: A radiation dose evaluation

2008 ◽  
Vol 133 (5) ◽  
pp. 640.e1-640.e5 ◽  
Author(s):  
Maria Alves Garcia Silva ◽  
Ulrich Wolf ◽  
Frank Heinicke ◽  
Axel Bumann ◽  
Heiko Visser ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Treatment Planning ◽  
Cone Beam Computed Tomography ◽  
Orthodontic Treatment ◽  
Cone Beam ◽  
Dose Evaluation

scholarly journals A New Orthodontic-Surgical Approach to Mandibular Retrognathia

2021 ◽  
Vol 8 (11) ◽  
pp. 180
Author(s):  
Francisco Vale ◽  
Joana Queiroga ◽  
Flávia Pereira ◽  
Madalena Ribeiro ◽  
Filipa Marques ◽  
...  
Keyword(s):  
Stainless Steel ◽  
Orthognathic Surgery ◽  
Growth Disorders ◽  
Facial Skeleton ◽  
Mandibular Bone ◽  
Gonial Angle ◽  
Lower Canine ◽  
Bone Segment ◽  
Free Solder ◽  
Mandibular Retrognathia

(1) Background: Mandibular deficiency is one of the most common growth disorders of the facial skeleton. Recently, distraction osteogenesis has been suggested as the treatment of choice for overcoming the limitations of conventional orthognathic surgery; (2) Methods: A new custom-manufactured dental-anchored distractor was built and anchored in the first molar and lower canine. It consists of a stainless-steel disjunction screw, adapted and welded to the orthodontic bands through two 1.2 mm diameter connector bars with a universal silver-based and cadmium-free solder; (3) Results: The distractor described can be a useful tool to correct mandibular retrognathia and is better tolerated by patients, especially in severe cases; (4) Conclusions: The dental-anchored distractor increases the anterior mandibular bone segment without affecting the gonial angle or transverse angulation of the segments and avoids posterior mandibular rotation, overcoming the limitations of conventional surgical treatment.

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