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Deformities Endoscopic Surgery Bone Distraction

Dentofacial and maxillofacial deformities are common in the general population, ranging from mild abnormalities of the teeth to extensive and widespread deformities involving the entire face and skull. Perhaps no other area in plastic surgery yields as gratifying and as outstanding aesthetic and functional results than the treatment of dentofacial and maxillofacial deformities. The plastic surgical treatment of deformities of the teeth and jaws requires a multidisciplinary team approach, often involving an orthodontist and other dental specialists.

Although many deformities of the teeth can be corrected by orthodontic treatment alone, more extensive deformities require a surgical approach to treating dentofacial and maxillofacial deformities requires special expertise in the care of jaw problems, as well as in the treatment of soft tissue deformities of the face. Typically, both the soft and hard tissues of the face, along with the teeth and bite, need to be considered in formulating a definitive treatment plan, which will lead to the best outcome. Surgeons
Fernando D. Burstein, M.D. Joseph K Williams, M.D.

Dentofacial and Maxillofacial Deformities

Conditions Treated Upper Jaw
Lower Jaw

Long face with gummy smile Upper jaw deficiency Short face deformity Open bite Upper and lower jaw asymmetry Cleft lip and palate Craniofacial deformities and trauma Maxillofacial deformities and traum

Lower jaw protru Lower jaw recess Chin deform s Sleep apnea Lower jaw fractu

Systematic Evaluation of the Patient with Dentofacial and Maxillofacial Deformities

Seeing a patient with extensive deformities of the teeth and jaws requires a systematic evaluation.The normal proportions of the face, the orbital region, as well as the nose, lips, and mouth, must all be evaluated (Fig. 1).In addition, functional problems with the bite (Fig. 2), problems with dental hygiene such as recession of gums, abnormalities of the teet and functional compromise of the airway, such as sleep apnea, must be accounted for during the initia patient consultation. Computerized facial imaging may be recommended to assess the potential treatment modalities and their relative benefits. Together with the orthodontist and dental specialist if necessary, a formal treatment plan is established.

Fig. 2: Definitions of the normal and abnormal bite (occulusion). Class I: normal Class II: lower teeth too far behind upper teeth;usually associated with a recessed lower jaw. class III: lower teeth in front of upper teeth; usually associated with a recessed upper or protrusive lower jaw.

Associated Aesthetic Facial Concerns

Frequently patients with abnormalities of the teeth and jaws present with associated aesthetic facial problems. One of the most common complaints is related to the appearance of the nose. Older patient also present with a variety of aesthetic concerns. In patients with small recessed lower jaws and chins, appearance of the neck is often the presenting complaint. Extra tissue and skin gathers earlier in such patients and may be dramatically improved by simply advancing the lower jaw or chin. Often, however, additional soft tissue surgery such as suction-assisted lipectomy, endoscopic face and ne lift, and conventional facelift procedures may be necessary. Computer Imaging

Computer imaging is available to "picture" anticipated postoperative changes in facial appearance. At Plastic Surgery & Craniofacial Associates, a state-of-art computer imaging system is available to give better idea of the results that might be achieved by surgical intervention.

Chin Deformities Upper Jaw Deformities Lower Jaw Deformities Combined Upper and Lower Jaw Deformities

Trauma to the Jaws Pre-Prosthetic Surgery Distraction Ostogenesis

Employment

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Pediatric Plastic Surgery and Craniofacial Associates (PPSCA), a division of Atlanta Plastic Surgery P.C.