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Orthognathic
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ORTHOGNATHIC SURGERYITS EVOLUTION
S.R.Hullihan (1849)A General Surgeon
Anterior sub apical osteotomy to correct anterior open bite and mandibular dento alveolar protrusion
ORTHOGNATHIC SURGERYITS EVOLUTION
VILARY BLAIR & EDWARD ANGLE1898 - 1906Osteoctomy of horizontal ramusHorizontal osteotomy of the ramusV.shaped osteotomy for open bite
ORTHOGNATHIC SURGERYITS EVOLUTION
Blairs contributions to orthognathic surgeryPioneer in orthognathic surgeryRacial differences in planningClassification of jaw deformitiesCo-operation between surgeon & orthodontist
ORTHOGNATHIC SURGERYITS EVOLUTION
Blairs single significant contribution (1907)Treating of skeletal deformities is really surgical work, but the earlier a competent, congenial orthodontist is associated with the case, the better it will be for both the surgeon and the patient
ORTHOGNATHIC SURGERY ITS EVOLUTION Modern era Central Europe 1950s Vienna, Graz, North Berlin, Hamburg.
ORTHOGNATHIC SURGERYITS EVOLUTION
Trauners contributions (1955)Inagurator of several procedures trained Heinz Kole & Hugo Obwegeser
ORTHOGNATHIC SURGERYITS EVOLUTION
Martin Wassmund (Berlin)Developed anterior maxillary osteotomy Described lefort I osteotomy (1927)Trained Karl Schuchhardt
ORTHOGNATHIC SURGERYITS EVOLUTION
Karl Schuchhardt (1955)Posterior maxillary osteotomy
Improved by Kufner to enable total mobilisation of the segment
ORTHOGNATHIC SURGERYITS EVOLUTION
Heinz Kole (1959) Graz
Several innovationsBimaxillary alveolar surgeryDeep bite correctionOpen bite closureGenioplastyExtensive literature contribution
ORTHOGNATHIC SURGERYITS EVOLUTION
Hugo Obwegeser (Zurich)Sagittal split of the mandible (1955) opened new dimension in mandibular surgery
Dal Pont (1958) improved the method
ORTHOGNATHIC SURGERYITS EVOLUTION
Hugo Obwegeser (Zurich)Undoubtedly single greatest contributor to orthognathic surgery in the world
ORTHOGNATHIC SURGERYITS EVOLUATION
Hugo Obwegeser
Numerous contributionsSagittal split osteotomyLarge series of Le fort I ostetomy (1969)Le fort I osteotomy in cleft casesTotal maxillary & mandibular osteotomies
ORTHOGNATHIC SURGERYITS EVOLUTION
Paul Tessier (France 1967)Developed craniofacial surgery in europe. Particularly Le fort III osteotomy
ORTHOGNATHIC SURGERYITS EVOLUTIONApplication of rigid, semi rigid fixation of bony segments.
B.spiessl was the first to apply rigid fixation in orthognathic surgery (1974)
ORTHOGNATHIC SURGERYITS EVOLUTION
Caldwell & Letterman (1954)Vertical sub sigmoid osteotomy
ORTHOGNATHIC SURGERYITS EVOLUTION
H.Luhr (1979)H. Luhr introduced mini bone plates in orthognathic surgery
ORTHOGNATHIC SURGERYITS EVOLUTION
What are the advantages of rigid fixation ?More rapid & easierStabilization of segments betterPatient convenience is greater because no intermaxillary fixationLess danger for the patient
ORTHOGNATHIC SURGERYITS EVOLUTION
What did plastic surgeons contribute ?BlepharoplastyRhinoplastyRhitidectomyLiposuctionLip corrections
ORTHOGNATHIC SURGERYITS EVOLUTION
Which way is the pendulum of progress ? swung back to the United States of America where orthognalthic surgery started about 100 years ago
ORTHOGNATHIC SURGERYITS EVOLUTION
Current scenarioIt is a grown up speciality and an important part of oral, maxillofacial and facial plastic surgery
ORTHOGNATHIC SURGERYITS EVOLUTION
Indian situationProf. M.S.N.Ginwalla started orthognathic surgery in india in early sixities and credited as father of orthognathic surgery in India
ORTHOGNATHIC SURGERYITS EVOLUTION
Maxillary procedureLangenbeck (1859) did first maxillary osteotomy for removal of nasopharyngeal polyp, the next 70 years it was used only for pathological conditions
ORTHOGNATHIC SURGERYITS EVOLUTION
K.H.Thoma (1883-1972)Oblique osteotomy of the ramus
Father of oral pathology, defender of oral surgery, and great teacher of oral medicine, raised the standards, originated several surgical techniques.
ORTHOGNATHIC SURGERYITS EVOLUTION
William H. BellProvided biologic evidence for the success of maxillary osteotomies with his research on vascularity of maxilla.
ORTHOGNATHIC SURGERYITS EVOLUTION
Bruce N. Epkar (Texas, U.S.A.)Interested in the dynamics of bone metabolism and facial skeletal surgery - more than 200 scientific contributions
Created Fort worth cleft palate programJohn Peer Smith hospital centre for correction of facial deformities
ORTHOGNATHIC SURGERYITS EVOLUTION
Deric HendersonSt. Thomas Hospital (London)Greatest contributor in the United Kingdom
ORTHOGNATHIC SURGERYITS EVOLUTION
Norman RoweQueen Mary Hospital (Roehampton )
ORTHOGNATHIC SURGERYITS EVOLUTIONHarold Hargis coined the term orthognathic previously referred to as orthodontic corrective jaw surgery
Every man owes some of his time to the upbuilding of the profession to which he belongs
Theodore Roosevelt
ORTHOGNATHIC SURGERYITS EVOLUTION
Prof. C.Bhasker RaoDirectorCraniofacial SurgeryS.D.M.C.D.S., Dharwad
ORTHOGNATHIC SURGERYITS EVOLUTION
Developments which contributed to the growth of orthognathic surgery
ORTHOGNATHIC SURGERYITS EVOLUTION
Rigid, semirigid fixationVascular studiesBone graftsAntibioticsAnaesthetic techniques