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Questions and Answers
What is a characteristic of a mandibular deficiency?
What is a characteristic of a mandibular deficiency?
What type of osteotomy is used for mandibular advancement?
What type of osteotomy is used for mandibular advancement?
What is a possible correction for mandibular deficiency?
What is a possible correction for mandibular deficiency?
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?
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Which of the following is NOT a characteristic of mandibular deficiency?
Which of the following is NOT a characteristic of mandibular deficiency?
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What is the purpose of maxillary impaction osteotomy?
What is the purpose of maxillary impaction osteotomy?
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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?
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What is a possible consequence of a mandibular deficiency?
What is a possible consequence of a mandibular deficiency?
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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?
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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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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.
