Category Archives: Correction of Dentofacial Deformities

SURGICAL TREATMENT PHASE Mandibular Excess Dentofacial abnormalities can frequently be’ treated IJ~ isolated procedures in the mandible or max ill.t and midface area, Because abnormalities can obviouslv OCCtI.-in both the maxilla and the niamlible, surgir;l! ‘correction frequently requires a combination of ~lIrgicill’procedtll’l’S, -Ihe following sections describe a variety of ~urg

Final Treatment Planning After tile completion of the presurgical periodontics, restorative dentistry, and orthodontics, the patient returns to the oral and maxillofacial surgeon’ for final presurgical planning. The evaluation completed at the initial patient examination is repeated. The patient’s facial structure and the malocclusion are reexamined. Presurgical photographs, radiographs, and presu

Presurgical Orthodontic Considerations align the arches individually, achieve compatibility of the arches or arch segments, and establish the proper anteroposterior and vertical position of the incisors. The amount of presurgical orthodontics’ can vary, rangin,g from only appliance placement in a few patients to . approximately 12 months of appliance therapy in those with severe crowding and incisor malp

Restorative Considerations evaluated for carious lesions and faulty restorations. Teeth should be evaluated endodontically and periodontally for restorability, and any nonrestorable teeth should be extracted before surgical intervention. All carious lesions must be restored early inthe presurgical treatment phase, Existing restorations must function for 18 to 24 months during the orthodontic and surgical trea

PRESURGICAL TREATMENT PHASE Periodontal Considerations As the first step in treatment, gingival inflammation mustbe controlled and  the’ patient’s cooperation ensured. In patients who are unwilling or unable to clean their teeth properly before the placement of orthodontic appliances, oral hygiene procedures will be even less effective when complicated by orthodontic band placement. FIG. 25-5 A, Pre

EVALUATION OF PATIENTS WITH DENTOFAICAL DEFORMITY   In the past. individual practitioners often treated patients with dentofacial deformities. Some patients have been treated with orthodontics alone. with a resultant acceptable occlusion but a compromise in facial esthetics. Other patients have had surgery without orthodontics in ‘In attempt to correct a skeletal deformity, which resulted In improved f

GenetIic and Environmental Influence Genetic Influence certainly plays a role in dentofacial deformities. Patterns of inheritance, such as a familial tendency toward a prognathic or deficient mandible, are often seen in a patient with a dentofacial deformity. However, the multifactorial nature of facial development precludes the prediction of an inherited pattern of a particular facial abnormality. FIG. 25-1 A

General Principles of Facial Growth The development of proper facial form and function is a complex process af ected- by many factors. The primary sites of growth in the face and cranium are the free mar- ‘gins of the bony’ surfaces, sutures, synchondroses, and . mandibular condyle. In the area of the craniofacial complex,  reas exist’ that appear to have their own intrinsic growth potential,

CAUSES OF DENTOFACIAl  DEFORMITY , lalocclusion and associated abnormalities ofthe skeletal components of the face can be classified as either acquired or devciopmcntat. Acquired deformities result from trauma or other external influences that alter facial morphology. Developmental deformities result from abnormal growth of facial structures. Although it is not within the scope of this book to present a detai

CHAPTER OUTLINE ‘CAUSES OF DENTOFACIAl DEFORMITY General Principles of Facial Growth Genetic and Environmental Influence EVALUATION OF PATIENTS WITH DENTOFACIAl DEFORMITY PRESURGICAL T~EATMENT PHASE Periodontal Considerations Restorative Considerations Presurgical Orthodontic Considerations Treatment Timing Orthodontic Treatment Objectives Final Treatment Planning SURGICAL TREATMENT PHASE Mandibular ElEcess M