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6
Final Surgical Planning
Computerized imaging
CASSOS
7
8
9
10
11
Final Surgical Planning
Model Surgery Exact surgical movements
(distance, direction) Postoperative occlusion
24
Pre treatment
25
SNA 88° SNB 81° ANB 7°
26
Post Le Fort I & genioplasty
27
SNA 84° SNB 81° ANB 3°
28
4
Objectives —— Presurgical orthodontics
Alignment of the arches Compatibility of the arches
5
Final Surgical Planning
Visual Treatment Objective, VTO
back
19
Surgeries for mandibular deformity
Subapical osteotomy Indications:
- bimaxillary protrusion / open bite - leveling the plane of occlusion - uprighting anterior teeth
back
Ad
rotate
18
Surgeries for mandibular deformity
Vertical ramus osteotomy
Indications: - mandibular excess - mandibular asymmetry (combined with SSRO)
• Orthodontics • Surgical plan
Surgical treatment
• Mandible • Maxilla
Postsurgical treatment
• Orthodontics • restorative/prosthetic treatment • follow-up
Le Fort I osteotomy (total or segmental) Indications:
- maxillary deformities - mandibular deformities
16
Surgeries for maxillary deformity
Le Fort I osteotomy Le Fort II or III osteotomy
Dental-maxillofacial Deformities
Dept. of Oral & Maxillofacial Surgery School of Stomatology
LI Qing-yun
1
Phase I Phase II Phase III
Presurgical treatment
articulator
Face-bow
12
13
Surgical Treatment Phase
Surgeries for maxillary deformity Surgห้องสมุดไป่ตู้ries for mandibular deformity
14
Surgeries for maxillary deformity
21
Surgeries for mandibular deformity
genioplasty Indications:
- chin deformities
22
Perioperative complications
Airway obstructionedema / bleeding / displacement… …
Bleeding Infection Necrosis of teeth / bone Healing Injury of nerve
23
Postsurgical Treatment Phase
Completion of orthodontics Postsurgical restorative/prosthetic treatment Follow-up
2
Presurgical Treatment Phase
Presurgical orthodontics Final surgical planning
3
Objectives —— Presurgical orthodontics
Decompensation dental compensation for skeletal deformity angulation of teeth accentuate the deformity
20
Surgeries for mandibular deformity
Body osteotomy Indications:
- mandibular excess (body) combined with ramus procedure or not
- open bite / spee’s curve reduction
Indications: - midface deficiency
17
Surgeries for mandibular deformity
Sagittal split ramus osteotomy, SSRO
Indications: - mandibular excess - mandibular deficiency - mandibular asymmetry
Segmental osteotomy (Anterior / Posterior)
Indications: - maxillary protrusion - marked protrusion of maxillary teeth - open bite
15
Surgeries for maxillary deformity
Final Surgical Planning
Computerized imaging
CASSOS
7
8
9
10
11
Final Surgical Planning
Model Surgery Exact surgical movements
(distance, direction) Postoperative occlusion
24
Pre treatment
25
SNA 88° SNB 81° ANB 7°
26
Post Le Fort I & genioplasty
27
SNA 84° SNB 81° ANB 3°
28
4
Objectives —— Presurgical orthodontics
Alignment of the arches Compatibility of the arches
5
Final Surgical Planning
Visual Treatment Objective, VTO
back
19
Surgeries for mandibular deformity
Subapical osteotomy Indications:
- bimaxillary protrusion / open bite - leveling the plane of occlusion - uprighting anterior teeth
back
Ad
rotate
18
Surgeries for mandibular deformity
Vertical ramus osteotomy
Indications: - mandibular excess - mandibular asymmetry (combined with SSRO)
• Orthodontics • Surgical plan
Surgical treatment
• Mandible • Maxilla
Postsurgical treatment
• Orthodontics • restorative/prosthetic treatment • follow-up
Le Fort I osteotomy (total or segmental) Indications:
- maxillary deformities - mandibular deformities
16
Surgeries for maxillary deformity
Le Fort I osteotomy Le Fort II or III osteotomy
Dental-maxillofacial Deformities
Dept. of Oral & Maxillofacial Surgery School of Stomatology
LI Qing-yun
1
Phase I Phase II Phase III
Presurgical treatment
articulator
Face-bow
12
13
Surgical Treatment Phase
Surgeries for maxillary deformity Surgห้องสมุดไป่ตู้ries for mandibular deformity
14
Surgeries for maxillary deformity
21
Surgeries for mandibular deformity
genioplasty Indications:
- chin deformities
22
Perioperative complications
Airway obstructionedema / bleeding / displacement… …
Bleeding Infection Necrosis of teeth / bone Healing Injury of nerve
23
Postsurgical Treatment Phase
Completion of orthodontics Postsurgical restorative/prosthetic treatment Follow-up
2
Presurgical Treatment Phase
Presurgical orthodontics Final surgical planning
3
Objectives —— Presurgical orthodontics
Decompensation dental compensation for skeletal deformity angulation of teeth accentuate the deformity
20
Surgeries for mandibular deformity
Body osteotomy Indications:
- mandibular excess (body) combined with ramus procedure or not
- open bite / spee’s curve reduction
Indications: - midface deficiency
17
Surgeries for mandibular deformity
Sagittal split ramus osteotomy, SSRO
Indications: - mandibular excess - mandibular deficiency - mandibular asymmetry
Segmental osteotomy (Anterior / Posterior)
Indications: - maxillary protrusion - marked protrusion of maxillary teeth - open bite
15
Surgeries for maxillary deformity