Download PowerPoint 演示文稿

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
Face-bow
articulator
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
Ad
rotate
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 / spee’s 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
88°
SNB
81°
ANB
7°
Post
Le Fort I &
genioplasty
SNA
84°
SNB
81°
ANB
3°
Pre
treatment
SNA
88°
SNB
92°
ANB
4°
Pre operation
& after presurgical
orthodontic treatment
SNA
88°
SNB
92°
ANB
-4°
Post Sagittal Split Ramus Osteotomy
SNA
88°
SNB
86°
ANB
2°
Post
treatment
SNA
88°
SNB
86°
ANB
2°