Dental-maxillofacial Deformities

Dept. of Oral & Maxillofacial Surgery

School of Stomatology

LI Qing-yun

Phase I

Presurgical treatment
Orthodontics Surgical plan

Phase II

Surgical treatment
Mandible Maxilla

Phase III

Postsurgical treatment
Orthodontics restorative/prosthetic treatment follow-up

Presurgical Treatment Phase

Presurgical orthodontics Final surgical planning

Objectives Presurgical orthodontics

Decompensation dental compensation for skeletal deformity angulation of teeth accentuate the deformity

Objectives Presurgical orthodontics

Alignment of the arches Compatibility of the arches

Final Surgical Planning

Visual Treatment Objective, VTO

Final Surgical Planning

Computerized imaging CASSOS

Final Surgical Planning

Model Surgery Exact surgical movements (distance, direction) Postoperative occlusion articulator

Face-bow

Surgical Treatment Phase

Surgeries for maxillary deformity Surgeries for mandibular deformity

Surgeries for maxillary deformity

Segmental osteotomy (Anterior / Posterior)

Indications: - maxillary protrusion

- marked protrusion of
maxillary teeth - open bite

Surgeries for maxillary deformity

Le Fort I osteotomy (total or segmental)

Indications: - maxillary deformities - mandibular deformities

Surgeries for maxillary deformity

Le Fort I osteotomy Le Fort II or III osteotomy Indications: - midface deficiency

Surgeries for mandibular deformity

Sagittal split ramus osteotomy, SSRO Indications: - mandibular excess - mandibular deficiency - mandibular asymmetry

back rotate

Ad

Surgeries for mandibular deformity

Vertical ramus osteotomy

Indications: - mandibular excess - mandibular asymmetry (combined with SSRO)

back

Surgeries for mandibular deformity

Subapical osteotomy Indications: - bimaxillary protrusion / open bite - leveling the plane of occlusion - uprighting anterior teeth

Surgeries for mandibular deformity

Body osteotomy Indications: - mandibular excess (body) combined with ramus procedure or not - open bite / spees curve reduction

Surgeries for mandibular deformity

genioplasty Indications: - chin deformities

Perioperative complications
Airway obstructionedema / bleeding / displacement Bleeding

Infection
Necrosis of teeth / bone Healing Injury of nerve

Postsurgical Treatment Phase

Completion of orthodontics Postsurgical restorative/prosthetic treatment Follow-up

Pre treatment

SNA SNB ANB

88 81 7

Post Le Fort I & genioplasty

SNA SNB ANB

84 81 3

Pre treatment

SNA SNB ANB

88 92 4

Pre operation & after presurgical orthodontic treatment

SNA SNB ANB

88 92 -4

Post Sagittal Split Ramus Osteotomy

SNA SNB ANB

88 86 2

Post treatment

SNA SNB ANB

88 86 2