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Dental-maxillofacial DeformitiesDental-maxillofacial Deformities
Dept. of Oral & Maxillofacial SurgeryDept. of Oral & Maxillofacial Surgery
School of StomatologySchool of Stomatology
LI Qing-yunLI Qing-yun
Phase IPhase I Presurgical treatment
• Orthodontics• Surgical plan
Phase IIPhase II Surgical treatment
• Mandible• Maxilla
Phase IIIPhase III Postsurgical treatment
• Orthodontics• restorative/prosthetic treatment• follow-up
Presurgical Treatment PhasePresurgical Treatment Phase
Presurgical orthodontics
Final surgical planning
Objectives —— Presurgical orthodontics
Decompensation
dental compensation for skeletal deformity
angulation of teeth
accentuate the deformity
Objectives —— Presurgical orthodontics Alignment of the arches Compatibility of the arches
Final Surgical Planning Visual Treatment Objective, VTO
Final Surgical Planning
Computerized imaging CASSOS
Final Surgical Planning
Model Surgery
Exact surgical movements
(distance, direction)
Postoperative occlusion
Face-bowFace-bow
articulator
Surgical Treatment Phase
Surgeries for maxillary deformity
Surgeries for mandibular deformity
Surgeries for maxillary deformity
Segmental osteotomy (Anterior / Posterior)
Indications:
- maxillary protrusion
- marked protrusion of
maxillary teeth
- open bite
Surgeries for maxillary deformity
Le Fort I osteotomy
(total or segmental)
Indications:
- maxillary deformities
- mandibular deformities
Surgeries for maxillary deformity
Le Fort I osteotomy
Le Fort II or III osteotomy
Indications:
- midface deficiency
Surgeries for mandibular deformity
Sagittal split ramus osteotomy,
SSRO
Indications:
- mandibular excess
- mandibular deficiency
- mandibular asymmetry
Adback
rotate
Surgeries for mandibular deformity
Vertical ramus osteotomy
Indications:
- mandibular excess
- mandibular asymmetry
(combined with SSRO)
back
Surgeries for mandibular deformity
Subapical osteotomy
Indications:
- bimaxillary protrusion / open bite
- leveling the plane of occlusion
- uprighting anterior teeth
Surgeries for mandibular deformity
Body osteotomy
Indications:
- mandibular excess (body)
combined with ramus procedure or not
- open bite / spee’s curve reduction
Surgeries for mandibular deformity
genioplasty
Indications:
- chin deformities
Perioperative complications
Airway obstructionedema / blee
ding / displacement… …
Bleeding
Infection
Necrosis of teeth / bone
Healing
Injury of nerve
Postsurgical Treatment Phase Completion of orthodontics
Postsurgical restorative/prosthetic treatment
Follow-up
Pretreatment
SNA 88°
SNB 81°
ANB 7°
PostLe Fort I &genioplasty
SNA 84°
SNB 81°
ANB 3°
Pretreatment
SNA 88°
SNB 92°
ANB 4°
Pre operation& after presurgical
orthodontic treatment
SNA 88°
SNB 92°
ANB -4°
Post Sagittal Split Ramus Osteotomy
SNA 88°
SNB 86°
ANB 2°
Posttreatment
SNA 88°
SNB 86°
ANB 2°
