Ortognathic Surgery 1

8/11/2019 Ortognathic Surgery 1

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Ortognathic Surgery;

is the surgical procedures to correct theDentofacial deformities.

And also ortognathic surgery is an reposition

procedures of dental and skeletal component

of face for normal facial function and facialaesthetic by OMFS (Oral maxillofacial

surgeon)


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STEPS OF DENTO-FACIAL DIAGNOSIS

1. DEFINITION AND CLASSIFICATION OF MALOCCLUSION

2. FUNCTIONAL ANALYSIS

3. EVALUATION OF FACIAL PROPOTION

4. EXAMINATION OF GROWTH POTENTIAL5. ETHNICAL AND GENETICAL FACTORS

6. AESTHETIC EVALUATION


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1.Bilateral 1stpremolar Ext.2.Corpus mandible Step ostectomy


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FACIAL DETERMINATION THROUGHCEPHALOMETRIC ANALYSIS

Position of maxilla and mandible relative to cranialbase

Position of maxilla relative to mandible

Position of Maxillary incisors relative to maxilla

Position of mandibular teeth relative to mandible

Position of maxillary incisors relative to mandibularincisors


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CEPHALOMETRIC ANALYSIS

A. THE EVALUATION OF FACIAL PROPORTION

I. ANGULAR VALUES

II. PROPOTIONAL VALUES

III. AESTHETIC ANALYSIS OF SOFT TISSUESB. DENTAL EXAMINATION


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PROCEDURES FOR CORRECTION DYSGNATHIA-1

CONDITION PROCEDURE(S) STABILITY OF RESULT

1.Mandibular protrusion - Bilateral sagittal ramus Excellent(excess or prognathism) osteotomy- or -

- Bilateral vertical ramusosteotomy

2.Mandibular retrusion - Bilateral vertical ramus Excellent(deficiency) osteotomy

3.Mandibular laterognath. -Bilateral sagittal ramus Good to excellentosteotomy - or -

- Combination unilateral Good to excellentsagittal with unilateralvertical osteotomy

4.Mandibular alveolar

process deformity- Retrusion Good to excellent- Protrusion - Anterior for segmental Excellent- Supraeruption alveolar osteotomy Excellent- Infraeruption(open bite) Fair to good


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PROCEDURES FOR CORRECTION DYSGNATHIA-2

CONDITION PROCEDURE(S) STABILITYOF RESULT

1.Microgenia Genioplasty:(genial deficiency) - Inf. border osteotomy Fair to good

- Alloplastic augmentation Fair to good

2.Macrogenia Inf. border ostectomy Excellent(genial excess)

3.Laterognathia Inf. border osteotomy Good to excellent(midline deviation)

4.Apertognathia - Total max. osteotomy Good to excellent(open-bite) (Le Fort I procedure)

- Bilateral post. segmental Fair to goodosteotomy

- Maxillary and mandibular Fair to goodant. seg. alv. osteotomies


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A- CORRECTIVE METHODS

1-MANDIBLES DEFORMITIES AND TREATMENT

- MANDIBULAR PROTRUSION

- MANDIBULAR RETRUSION

- MANDIBULAR LATEROGNATHI- MANDIBULAR ALVEOLAR PROCESS DEFORMITIES

- MICROGENIA

- MACROGENIA

- APERTOGNATHI


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MANDIBULAR PROTRUSION

-Class-3 Deep-Bite

- Class-3 Open-Bite


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Class-3 Deep-bite


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1.BSSRO

2.Partial glossectomy


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Class-3 Open-Bite


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Class-3 Open-Bite


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ASYMMETRIC MANDIBULAR PROGNATHISM


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Facial Asymmetry (lower and middle face)


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Facial Asymmetry (lower and middle face) Maxillarr rotation Right condyler hyperplasia Dental and facial midline deviationTreatment: Le fort I Osteotomy BSSRO Condylectomy Basis Ostectomy


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Le fort I OsteotomyBSSRO

Condylectomy

Basis Ostectomy

F i l A t


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- Facial Asymmetry- Maxillary plane inclination- Agenesis of left condyle and ramus (Osteomyelits sequela)- Dental and facial midline devation

Treatment:- Le Fort I Osteotomy- Unilateral SSRO- Left Coronoidectomy

- Chinoplasty


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DISTRACTION OSTEOGENESIS

(Ankylosis Sequela)


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Right Ramus Distraction Ostheogenesis

Class 2 /


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Class-2 /

Microgenia

BSSRO


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Class-2 / Microgenia

Ortognathic Surgery 1

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