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Orthodontic Diagnosis and Correction
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Orthodontic Diagnosis and Correction

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Questions and Answers

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?

  • BSSO lower jaw osteotomy (correct)
  • Subapical osteotomy
  • Le Fort I osteotomy
  • Inferior border osteotomy
  • 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?

    <p>Gummy smile</p> Signup and view all the answers

    Which of the following is NOT a characteristic of mandibular deficiency?

    <p>Class I molar and canine relationships</p> Signup and view all the answers

    What is the purpose of maxillary impaction osteotomy?

    <p>To allow mandibular autorotation</p> Signup and view all the answers

    What may be necessary to correct an elongated lower third of the face?

    <p>Genioplasty</p> Signup and view all the answers

    What is a possible consequence of a mandibular deficiency?

    <p>Lip incompetence</p> Signup and view all the answers

    Which of the following is a type of osteotomy used for maxillary correction?

    <p>Le Fort I osteotomy</p> Signup and view all the answers

    Why may the maxillary occlusal plane need to be leveled surgically?

    <p>To reposition the maxilla in segments</p> Signup and view all the answers

    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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    Description

    Identify and correct maxillary excess and deficiency in orthodontic patients, including anteroposterior, vertical, and transverse plane issues, and their impact on tooth exposure and occlusal relationships.

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