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Orthognathic Surgery, An Issue of Oral and Maxillofacial Clinics of North America, E-Book

Orthognathic Surgery, An Issue of Oral and Maxillofacial Clinics of North America, E-Book

Daniel Spagnoli

(2014)

Additional Information

Book Details

Abstract

Editors Daniel B. Spagnoli, Brian B. Farrell, and Myron R. Tucker review important areas in Orthognathic Surgery. Articles will include: Timing of Three-Dimensional Virtual Treatment Planning of Orthognathic Surgery: a Prospective Single-Surgeon Evaluation on 350 Consecutive Cases; Orthodontic Preparation for Orthognathic Surgery; Applications of Navigation for Orthognathic Surgery; Mandibular Surgery: Technologic and Technical Improvements; Maxillary Orthognathic Surgery; Surgical Assistance for Rapid Orthodontic Treatment and Temporary Skeletal Anchorage; Management of Cleft Lip and Palate and Cleft Orthognathic Considerations; Orthognathic Surgery and the TMJ Patient; Complications in Orthognathic Surgery: Report of 1000 Cases; Orthognathic Surgery in the Office Setting; Esthetic Adjuncts with Orthognathic Surgery; Virtual Surgical Planning in Orthognathic Surgery; and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Orthognathic Surgery i
Copyright\r ii
Contributors iii
Contents v
Oral And Maxillofacial Surgery\rClinics Of North America\r\r viii
Preface\r\r ix
Orthodontic Preparation for Orthognathic Surgery 441
Key points 441
Introduction 441
Presurgical goals 441
Decompensation of Dentition 441
Alignment of Arches 442
Coordinate Arches 442
Full Closure of All Spaces 442
Perfect Occlusion of Surgical Models 442
Leveling of Arches 442
Three concepts and a corollary for orthodontic preparation 442
Whenever Possible, Treatment Should Be Planned so that the Orthodontic and Surgical Relapse Tendencies Are in Opposite Dire ... 442
Incisors Should Be Positioned Relative to Their Respective Skeletal Bases Rather than External References 443
Tooth Movement in Preparation for Surgery is Usually in the Opposite Direction to that for Nonsurgical Treatment 443
Technique/Procedure 443
Class II: High or Normal Mandibular Plane Angle Treated with Surgical Mandibular Advancement 443
Treatment results and impact of orthodontic preparation 443
Class II: Low Mandibular Plane Angle Treated with Surgical Mandibular Advancement 445
Treatment results and impact of orthodontic preparation 447
Class III: Treated with Surgical Maxillary Advancement and/or Mandibular Setback 448
Treatment results and impact of orthodontic preparation 449
Vertical Maxillary Excess Treated with Surgical Maxillary Impaction 450
Treatment results and impact of orthodontic preparation 451
Maxillary Transverse Deficiency Treated with Surgical Expansion 452
Treatment results and impact of orthodontic preparation 452
Common pitfalls in preparing surgical setups 453
Treatment simulation 455
Summary 457
References 458
Virtual Surgical Planning in Orthognathic Surgery 459
Key points 459
Introduction 459
Data collection and presurgical work-up 460
Virtual surgical planning 464
Intraoperative efficiency 467
Accuracy/outcomes 470
Summary 473
References 473
Timing of Three-Dimensional Virtual Treatment Planning of Orthognathic Surgery 475
Key points 475
Patients 476
Step-by-step integrated 3D virtual treatment planning 476
Results 477
The advantages and limits of 3D-VPS1 and 3D-VPS2 478
The potential of 3D-VPS3 and 3D-VPS4 479
The clinical relevance of 3D-VPS5 481
Summary 484
References 484
Mandibular Surgery 487
Key points 487
Introduction 487
History of advancements 488
Technologic and technical improvements 488
Altering the posterior aspect of the distal segment in the sagittal split mandibular osteotomy 496
Fixation 501
Distraction 504
Genioplasty 507
Correcting mandibular vertical asymmetry at the mandibular body 507
Temporary anchorage devices 507
Virtual surgical planning 509
Mandible First or Maxilla First 510
Summary 513
References 519
Maxillary Orthognathic Surgery 523
Key points 523
Background 523
Segmental maxillary surgery 523
Surgically Assisted Rapid Palatal Expansion 523
Segmental LeFort Osteotomy 525
Anterior openbite closure 526
Differential Impaction 526
Multipiece Lefort Osteotomies 526
Treating vertical maxillary excess 528
Bone grafting at the time of maxillary surgery 531
Treating arch length incompatibility and maxillary protrusion 533
Computer-assisted planning and splint fabrication 534
References 537
Recommended reading 537
Surgical Assistance for Rapid Orthodontic Treatment and Temporary Skeletal Anchorage 539
Key points 539
Introduction 539
Historical perspectives 540
Surgical techniques and materials 541
Case presentations 545
Case Number 1 545
Case Number 2 547
Case Number 3 548
Case Number 4 549
Summary 550
References 550
Orthognathic Surgery and the Temporomandibular Joint Patient 551
Key points 551
History 552
Physical Examination 552
Radiologic Examination 552
Laboratory Evaluation 552
Surgical considerations unique to specific skeletal malocclusions 555
Class III Malocclusion 555
Class II Malocclusion—Progressive/Idiopathic Condylar Resorption 555
Combined orthognathic surgery and alloplastic Temporomandibular Joint reconstruction 557
Virtual surgical planning 558
Summary 562
References 562
Management of Cleft Lip and Palate and Cleft Orthognathic Considerations 565
Key points 565
Management of the cleft patient and treatment sequence 565
Brief History of Cleft Lip and Palate Repair 565
Embryology 566
Incidence, Genetics, and Cause 566
Classification 567
The Cleft and Craniofacial Team 567
Timeline of Surgical Treatment 567
General approaches to cleft orthognathics 570
Epidemiology 570
Phases of Orthognathic Surgical Treatment 570
Velopharyngeal Insufficiency Considerations 571
References 571
Aesthetic Adjuncts with Orthognathic Surgery 573
Key points 573
Introduction 573
Procedures Performed at the Time of Orthognathic Surgery 574
Procedures Performed Perioperatively to Orthognathic Surgery 574
Procedures Performed Temporally Distant to Orthognathic Surgery 574
Camouflage Cosmetic Surgery 575
Initial evaluation 575
Physical Examination and Diagnosis 575
Hard Tissue Deformity Only: Soft Tissue Deformities Primarily Caused by Skeletal Deformities 575
Soft Tissue Deformities 576
Combined Hard and Soft Tissue Deformities 576
Photography 576
Anatomy 576
Facial Adipose 576
Retaining Ligaments of the Face 576
Changes Associated with the Aging Face 577
Treatment planning 577
Soft Tissue Changes Associated with Orthognathic Surgery 577
Mandibular Surgery 577
Maxillary Surgery 577
Treatment planning rhinoplasty 577
Treatment planning adjunctive lip surgery 579
Long Lip/Inadequate Incisal Display 579
Excess Gingival Display 579
Facial Augmentation or Recontouring 579
Solid Implant Materials 580
Solid silicone rubber 580
Porous polyethylene 580
Polytetrafluoroethylene 581
Injectable materials 581
Hyaluronic acid 581
Calcium hydroxyapatite 582
Polymethyl methacrylate 582
Placement of injectables 582
Tear Trough 582
Cervicoplasty, Platysmaplasty, and Rhytidectomy 582
Sequence for Closed Submental Liposuction 583
Iatrogenic Deformities Created as a Result of Orthognathic Surgery 583
Facial asymmetries 583
Bony notching 583
Motion abnormalities 583
Discussion 584
References 584
Applications of Navigation for Orthognathic Surgery 587
Key points 587
Introduction 587
Basics of surgical navigation 588
Registration 589
Applications of navigation in orthognathic surgery 591
Transfer Surgical Plan to the Patient 591
Verifying Surgical Outcome Matches Surgical Plan 592
Avoiding Critical Structures 593
Combination 594
Augmenting the Surgeon’s Visualization of the Surgical Field 594
Drawbacks of navigation 596
Summary 597
References 597
Complications in Orthognathic Surgery 599
Key points 599
Complications resulting from preoperative planning errors 599
Intraoperative complications 600
Hemorrhage 600
Neurosensory Disturbance 601
The Unfavorable Split of Sagittal Ramus Osteotomies 602
Oro–Antral Communication 604
Postoperatve complications 605
Infection 605
Vascular Compromise 605
Endodontic Therapy 606
Nasal Abnormalities 607
Malocclusion 607
Temporomandibular Joint Dysfunction 608
Fixation Failure 608
Summary 609
References 609
Orthognathic Surgery in the Office Setting 611
Key points 611
Health care landscape 611
Insurance 611
Hospitalization charges 613
Outpatient surgery 614
Office operating suite 614
Costs 615
Anesthesia 615
Recovery 618
Autonomy 619
Summary 620
References 620
Index 621