scholarly journals Alteration of Occlusal Plane in Orthognathic Surgery: Clinical Features to Help Treatment Planning on Class III Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Daniel Amaral Alves Marlière ◽  
Tony Eduardo Costa ◽  
Saulo de Matos Barbosa ◽  
Rodrigo Alvitos Pereira ◽  
Henrique Duque de Miranda Chaves Netto
Keyword(s):  
Treatment Planning ◽  
Clinical Features ◽  
Orthognathic Surgery ◽  
Occlusal Plane ◽  
Definitive Treatment ◽  
Class Iii ◽  
Lower Lip ◽  
Dentofacial Deformities ◽  
Bimaxillary Orthognathic Surgery ◽  
Nasolabial Folds

Dentofacial deformities (DFD) presenting mainly as Class III malocclusions that require orthognathic surgery as a part of definitive treatment. Class III patients can have obvious signs such as increasing the chin projection and chin throat length, nasolabial folds, reverse overjet, and lack of upper lip support. However, Class III patients can present different facial patterns depending on the angulation of occlusal plane (OP), and only bite correction does not always lead to the improvement of the facial esthetic. We described two Class III patients with different clinical features and inclination of OP and had undergone different treatment planning based on 6 clinical features: (I) facial type; (II) upper incisor display at rest; (III) dental and gingival display on smile; (IV) soft tissue support; (V) chin projection; and (VI) lower lip projection. These patients were submitted to orthognathic surgery with different treatment plannings: a clockwise rotation and counterclockwise rotation of OP according to their facial features. The clinical features and OP inclination helped to define treatment planning by clockwise and counterclockwise rotations of the maxillomandibular complex, and two patients undergone to bimaxillary orthognathic surgery showed harmonic outcomes and stables after 2 years of follow-up.

scholarly journals Orthodontic camouflage of skeletal Class III malocclusion with miniplate: a case report

2016 ◽  
Vol 21 (4) ◽  
pp. 89-98 ◽  
Author(s):  
Marcel Marchiori Farret ◽  
Milton M. Benitez Farret ◽  
Alessandro Marchiori Farret
Keyword(s):  
Orthognathic Surgery ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Lower Lip ◽  
Facial Profile ◽  
Skeletal Class ◽  
Mandibular Teeth ◽  
One Year ◽  
Angle Class Iii Malocclusion

ABSTRACT Introduction: Skeletal Class III malocclusion is often referred for orthodontic treatment combined with orthognathic surgery. However, with the aid of miniplates, some moderate discrepancies become feasible to be treated without surgery. Objective: To report the case of a 24-year-old man with severe skeletal Angle Class III malocclusion with anterior crossbite and a consequent concave facial profile. Methods: The patient refused to undergo orthognathic surgery; therefore, orthodontic camouflage treatment with the aid of miniplates placed on the mandibular arch was proposed. Results: After 18 months of treatment, a Class I molar and canine relationship was achieved, while anterior crossbite was corrected by retraction of mandibular teeth. The consequent decrease in lower lip fullness and increased exposure of maxillary incisors at smiling resulted in a remarkable improvement of patient's facial profile, in addition to an esthetically pleasing smile, respectively. One year later, follow-up revealed good stability of results.

scholarly journals Changes in occlusal plane through orthognathic surgery

2012 ◽  
Vol 17 (4) ◽  
pp. 160-173 ◽  
Author(s):  
Lucas Senhorinho Esteves ◽  
Carolina Ávila ◽  
Paulo José Medeiros
Keyword(s):  
Surgical Treatment ◽  
Functional Outcomes ◽  
Orthognathic Surgery ◽  
Functional Results ◽  
Clinical Results ◽  
Occlusal Plane ◽  
Functional Disorders ◽  
Dentofacial Deformities ◽  
Treatment Objective ◽  
Surgical Manipulation

INTRODUCTION: A conventional ortho-surgical treatment, although with good clinical results, does not often achieve the desired functional outcomes. Patients with dentofacial deformities, especially those with increased occlusal planes (OP), are also affected by muscle, joint and breathing functional disorders, as well as facial esthetic involvement. The surgical manipulation of the OP in orthognathic surgery is an alternative to overcome the limitations of conventional treatment. OBJECTIVE: To report the importance of assessing the occlusal plane during diagnosis, planning and ortho-surgical treatment of patients with facial skeletal deformities and its main advantages. CONCLUSION: Although both philosophies of ortho-surgical treatment (conventional and by surgical manipulation of the OP) have presented good results, the selective correction of the OP allows a full treatment of these patients, providing better esthetic and functional results.

scholarly journals The Accuracy of Jaws Repositioning in Bimaxillary Orthognathic Surgery with Traditional Surgical Planning Compared to Digital Surgical Planning in Skeletal Class III Patients: A Retrospective Observational Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1840
Author(s):  
Martina Barone ◽  
Alberto De Stefani ◽  
Ugo Baciliero ◽  
Giovanni Bruno ◽  
Antonio Gracco
Keyword(s):  
Orthognathic Surgery ◽  
Surgical Planning ◽  
Class Iii ◽  
Skeletal Class ◽  
Bimaxillary Orthognathic Surgery ◽  
Cad Cam ◽  
Treatment Objective ◽  
Digital Methods ◽  
Cephalometric Measurements ◽  
Group D

Background: Technological progress has led to the transition to digital methods to perform surgical planning and to obtain surgical splints with CAD/CAM technologies. The present study aimed to compare the accuracy of jaw repositioning in bimaxillary orthognathic surgery using traditional and digital surgical planning in skeletal class III patients. Methods: This study included 60 skeletal class III patients divided into two groups based on the method used to perform surgical planning: traditional (T, n = 30) and digital (D, n = 30). For each patient, a 2D presurgical Visual Treatment Objective (VTO) was prepared and the outcome of the surgery was compared with that planned by using determined cephalometric measurements (ANB, SNA, SNB, Ar-Go-Me, S-Ar-Go). Statistical analysis showed that the measurements planned and those obtained after surgery were equivalent in Group D. For Group T, the analysis showed equivalence only for one of the considered measurements (ANB). By comparing the results of the two groups, Group D presented a lower level of error than Group T. Conclusions: Digital surgical planning performed significantly better in terms of accuracy of jaw repositioning than the traditional protocol.

scholarly journals Dimensional changes of maxillary sinuses and pharyngeal airway in Class III patients undergoing bimaxillary orthognathic surgery

2013 ◽  
Vol 83 (5) ◽  
pp. 824-831 ◽  
Author(s):  
Eleni Panou ◽  
Melih Motro ◽  
Mustafa Ateş ◽  
Ahu Acar ◽  
Nejat Erverdi
Keyword(s):  
Orthognathic Surgery ◽  
Class Iii ◽  
Cross Sectional ◽  
Dimensional Changes ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Bimaxillary Orthognathic Surgery ◽  
Significant Change ◽  
The Relationship ◽  
Maxillary Sinuses

ABSTRACT Objective: To evaluate the pharyngeal airway and maxillary sinus volume changes after mandibular setback surgery combined with maxillary advancement and/or impaction surgery. Materials and Methods: Seventeen Class III skeletal patients (11 females, 6 males) who required bimaxillary orthognathic surgery were selected. Volumetric measurements were performed using cone beam computed tomography (CBCT) scans preoperatively and 3.9 ± 0.87 months postoperatively. All the CBCT scans were assessed and analyzed using MIMICS 14.0 software. Preoperative and postoperative volumes of pharyngeal airway and maxillary sinuses and the relationship between the amounts of surgical movement of the jaws and the above volumes were statistically evaluated. Results: The pharyngeal airway area presented no significant change except for the lower and total pharyngeal airway volumes in males, in whom a significant decrease was observed (4196.27 ± 2061.11 mm3 and 3375.53 ± 3624.67 mm3, respectively). No significant change was observed in the minimal cross-sectional area of the pharyngeal airway. There was a significant decrease in the volume of the maxillary sinuses after the surgery by 3448.09 ± 3315.56 mm3. No correlation was found between the amount of skeletal movement and the change in the volume of pharyngeal airway or maxillary sinuses. Conclusion: There was a significant decrease only for lower and total pharyngeal airway volumes in males and a significant decrease in the volume of the maxillary sinuses.

scholarly journals A New Approach to Set the Absolute Midsagittal Plane of the Mandible Using a Similarity Index in Skeletal Class III Patients with Facial Asymmetry

2020 ◽  
Vol 10 (23) ◽  
pp. 8550
Author(s):  
Woo-Jin Han ◽  
Jae Joon Hwang ◽  
Yun-Hoa Jung ◽  
Bong-Hae Cho ◽  
Kee-Joon Lee ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Similarity Index ◽  
Facial Asymmetry ◽  
Class Iii ◽  
Midsagittal Plane ◽  
New Approach ◽  
Skeletal Class ◽  
Computed Tomography Images ◽  
Bimaxillary Orthognathic Surgery ◽  
Anterior Segments

This study sought to test the feasibility of a newly developed plane called computed modified absolute mandibular midsagittal plane (cmAMP) based on the similarity index (SI) for evaluating the stereoscopical symmetry of the mandible by comparison with other proposed midsagittal planes. This study involved 29 adult patients (15 men, 14 women; average age, 23.1 ± 6.9 years) with skeletal Class III facial asymmetry who underwent bimaxillary orthognathic surgery. Using cone-beam computed tomography images taken before and 1 year after surgery, cmAMP with the highest SI value between the two anterior segments of the hemi-mandible was set by a computer algorithm. Results show that the SI using cmAMP had the highest value (0.83 ± 0.04) before surgery compared to the other midsagittal planes, and was not significantly different from the SI (0.80 ± 0.05) using a facial midsagittal plane (MSP) after surgery. The distance (1.15 ± 0.74 mm) and angle (2.02 ± 0.82°) between MSP and cmAMP after surgery were significantly smaller than those between MSP and other midsagittal planes. In conclusion, the cmAMP plane best matches the two anterior segments of hemi-mandible symmetrically and is the closest to MSP after orthognathic surgery in skeletal Class III patients with facial asymmetry.

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