Orthognathic Surgery

By Kuo Yuet YuenDDS/DEG/10-1/0019

Definition

• ‘Orthognathic ‘comes from the Greek word

• ‘ortho’ - straighten • ‘gnathia’ - jaw.

Definition

• The art and science of diagnosis, treatment planning and execution of treatment by combining orthodontics and oral and maxillofacial surgery to correct musculoskeletal, dento-osseous, and soft tissue deformities of the jaws and associated structures.

Timing for Surgery

• If patient is having severe psychosocial problems, surgery in actively growing patient.

• But resurgery may be required later on. • The best timing for Orthognathic surgery is ---

after the growth potential for the patient is over.

Classification

1. Maxillary Surgeries2. Mandibular Surgeries3. Combined Surgeries

Maxillary Surgeriesa. Segmental osteotomy of the maxilla

i. Single tooth osteotomyii. Corticotomyiii. Anterior segmental maxillary osteotomy• Wassmund technique• Wunderer technique• Epker’s anterior maxillary osteotomy• Cupar’s techniqueiv. Posterior subapical osteotomy of maxilla• Kufner• Schuchardt

b. Total maxillary osteotomyi. Le fort I osteotomyii. Le fort II osteotomyiii. Le fort III osteotomy

Mandibular Surgeriesa. Ramus osteotomy

i. Extraoral vertical ramus osteotomy (EVRO)ii. Intraoral vertical ramus osteotomy (IVRO)iii. Bilateral sagittal split osteotomy (BSSO)

b. Body osteotomy of mandiblec. Subapical body osteotomy

i. Anterior subapical osteotomyii. Posterior subapical osteotomyiii. Total subapical osteotomy

d. Genioplastyi. Horizontal osteotomy with anteroposterior reductionii. Double sliding horizontal osteotomyiii. Vertical reduction genioplastyiv. Tenon techniquev. Alloplastic augmentation