Dental-maxillofacial Deformities

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Dental-maxillofacial Deformities
Dept. of Oral Maxillofacial Surgery School of
Stomatology
LI Qing-yun
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Phase I
Presurgical treatment

• Orthodontics
• Surgical plan

Phase II
Surgical treatment

• Mandible
• Maxilla

Phase III
Postsurgical treatment

• Orthodontics
• restorative/prosthetic treatment
• follow-up

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Presurgical Treatment Phase

• Presurgical orthodontics
• Final surgical planning

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Objectives Presurgical orthodontics

• Decompensation dental compensation for
  skeletal deformity angulation of teeth
  accentuate the deformity

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Objectives Presurgical orthodontics

• Alignment of the arches
• Compatibility of the arches

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Final Surgical Planning

• Visual Treatment Objective, VTO

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Final Surgical Planning

• Computerized imaging CASSOS

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Final Surgical Planning
articulator

• Model Surgery

Exact surgical movements (distance,
direction) Postoperative occlusion
Face-bow
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Surgical Treatment Phase

• Surgeries for maxillary deformity
• Surgeries for mandibular deformity

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Surgeries for maxillary deformity

• Segmental osteotomy (Anterior / Posterior)

Indications - maxillary protrusion -
marked protrusion of maxillary teeth -
open bite
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Surgeries for maxillary deformity

• Le Fort I osteotomy (total or segmental)

Indications - maxillary deformities -
mandibular deformities
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Surgeries for maxillary deformity

• Le Fort I osteotomy

• Le Fort II or III osteotomy

Indications - midface deficiency
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Surgeries for mandibular deformity

• Sagittal split ramus osteotomy, SSRO

Indications - mandibular excess -
mandibular deficiency - mandibular asymmetry
Ad
back
rotate
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Surgeries for mandibular deformity

• Vertical ramus osteotomy

Indications - mandibular excess -
mandibular asymmetry (combined with SSRO)
back
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Surgeries for mandibular deformity

• Subapical osteotomy

Indications - bimaxillary protrusion / open
bite - leveling the plane of occlusion -
uprighting anterior teeth
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Surgeries for mandibular deformity

• Body osteotomy

Indications - mandibular excess (body)
combined with ramus procedure or not - open
bite / spees curve reduction
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Surgeries for mandibular deformity

• genioplasty

Indications - chin deformities
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Perioperative complications

• Airway obstructionedema / bleeding /
  displacement
• Bleeding
• Infection
• Necrosis of teeth / bone
• Healing
• Injury of nerve

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Postsurgical Treatment Phase

• Completion of orthodontics
• Postsurgical restorative/prosthetic treatment
• Follow-up

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Pre treatment
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SNA 88 SNB 81 ANB 7
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Post Le Fort I genioplasty
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SNA 84 SNB 81 ANB 3
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Pre treatment
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SNA 88 SNB 92 ANB 4
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Pre operation after presurgical orthodontic
treatment
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SNA 88 SNB 92 ANB -4
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Post Sagittal Split Ramus Osteotomy
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SNA 88 SNB 86 ANB 2
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Post treatment
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SNA 88 SNB 86 ANB 2
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