Podcast
Questions and Answers
What is a characteristic of a mandibular deficiency?
What is a characteristic of a mandibular deficiency?
- Protruded position of chin
- Class I molar and canine relationships
- Normal throat form
- Retruded position of chin (correct)
What type of osteotomy is used for mandibular advancement?
What type of osteotomy is used for mandibular advancement?
- BSSO lower jaw osteotomy (correct)
- Subapical osteotomy
- Le Fort I osteotomy
- Inferior border osteotomy
What is a possible correction for mandibular deficiency?
What is a possible correction for mandibular deficiency?
- Vertical ramus osteotomy and iliac crest bone grafting via an intraoral approach
- Le Fort I osteotomy and maxillary impaction osteotomy
- BSSO lower jaw osteotomy and inferior border osteotomy
- Vertical ramus osteotomy and iliac crest bone grafting via an E/O approach (correct)
What is a possible consequence of an elongated lower third of the face?
What is a possible consequence of an elongated lower third of the face?
Which of the following is NOT a characteristic of mandibular deficiency?
Which of the following is NOT a characteristic of mandibular deficiency?
What is the purpose of maxillary impaction osteotomy?
What is the purpose of maxillary impaction osteotomy?
What may be necessary to correct an elongated lower third of the face?
What may be necessary to correct an elongated lower third of the face?
What is a possible consequence of a mandibular deficiency?
What is a possible consequence of a mandibular deficiency?
Which of the following is a type of osteotomy used for maxillary correction?
Which of the following is a type of osteotomy used for maxillary correction?
Why may the maxillary occlusal plane need to be leveled surgically?
Why may the maxillary occlusal plane need to be leveled surgically?
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Study Notes
Orthognathic Deformities
- Orthognathic deformities are conditions associated with jaw discrepancies, resulting from different rates of growth of the maxilla, mandible, or both.
- They can present at birth and become more apparent as the patient grows older.
Types of Orthognathic Deformities
- Maximillary excess: protrusion of maxilla and upper lip, incisor protrusion, Class II occlusal relationship
- Correction: 1- or 3-piece maxillary osteotomy
- Maximillary deficiency: deficiency at the prenasal and infraorbital rim areas, retruded upper lip, inadequate tooth exposure during smile, Class III relationship, reverse anterior overjet
- Correction: Le Fort I osteotomy, maxillary advancement
- In severe midface deficiency: Le Fort II or Le Fort III advancement may be required
Combination of Deformities and Asymmetries
- Combination of abnormalities in the maxilla and mandible
- Correction: combination of maxillary and mandibular osteotomies, standard osteotomy procedures in both jaws, complex E/O procedures, bone graft
Complications of Orthognathic Surgery
- Relapse
- Nerve injuries
- Postoperative infection
- TMJ problems
- Unanticipated fractures
- Teeth injury
Prevalence of Dentofacial Deformities
- 2.7% of the population in the USA has severe dentofacial deformity that requires surgical treatment
Etiology of Dentofacial Deformities
- Inherited tendencies
- Syndromic conditions
- Acquired causes:
- Cleft palate surgery
- Trauma
- Abnormal tongue position or size
- Mouth breathing
- During childbirth
- Reactive or neoplastic growth
Evaluation of Patients with Dentofacial Deformity
- Initial interview: chief complaint, current health status, psychological problems
- Clinical examination:
- Frontal view evaluation: vertical and transverse dimensions, overall facial balance, proportional relationship, symmetry
- Profile evaluation: vertical and anteroposterior relationships, morphology and relationships of the lips, chin, throat, nose, and cheeks
- Complete dental examination
- Periodontal examination
- TMJ examination
- Initial investigations:
- Dental model: occlusal analysis and treatment planning
- OPG x-ray
- Periapical x-ray for segmental osteotomies
- Lateral cephalometric radiographs: analysis of skeletal, dentoalveolar, and ST relationships
- Photographic documentation
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