CASE PRESENTATIONORTHOGNATHIC SURGERY

PRESENTED BY

Dr. RAHUL TIWARI

3RD YEAR MDS - PG Student

DEPT. OF ORAL & MAXILLOFACIAL SURGERY

SIBAR INSTITUTE OF DENTAL SCIENCES

1

PRELIMNARY DATA

Patient name – D SRINU Date – 23/07/2016

Age / sex – 22/M O.P.No. – 730541

Occupation – STUDENT Religion – HINDU

Marital status – UNMARRIED Blood group – O +VE

Date of birth – 20/6/1992 Socioeconomic status – GOOD

Address – CHIRALA GUNTUR Contact no. – 0961887515

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PATIENT CHIEF COMPLAINT

UNAESTHETIC APPEARENCE

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HISTORY OF PRESENT ILLNESS

2002- CONDYLECTOMY – 10 YRS AGE- CHENNAI

07/12/2015- SIDS- LE FORT 1, UNI. SAG RT. , IVRO LT. SIDE

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HISTORY

Past Medical History – NRH

Past Dental History – ORTHOGNATHIC SURGERY

Family History – NRH

Personal History – NRH

Drug History - NRH

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GENERAL PHYSICAL EXAMINATION

Height – 5’9” Weight – 68KG

Gait – NAD Built – AVERAGE

Nourishment – FAIR Signs of Clubbing – NO

Pulse – 78 Resp. Rate – 22

Blood Pressure- 130/84 Temperature – AFEBRILE

P.I.C.K.L.E. - NO

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EXTRA ORAL EXAMINATION 7

EXTRA ORAL EXAMINATION 8

OCCLUSION9

R.S- 26

OTHER FINDINGS 10

OVERJET & OVERBITE

INTRA ORAL EXAMINATION 11

ANALYSIS 12

ASYMMETRIC FACE

INNER INTER CANTHAL- 32MM

INTER PUPILARY – 67MM

ALAR BASE WIDTH- 31MM

NOSE DORSUM LENGTH- 43MM

COLLUMELLA HEIGHT0- 10 MM

MOUTH WIDTH- 48MM

MOUTH OPENING – 52MM

UPPER FACE- 55MM

MIDDLE FACE- 49MM

LOWER FACE – 73MM

FACAIL FIFTHS – DISSIMMILAR

C CURVE – ONE BREAK

NASAL CONTOUR – CONVEX

NASOLABIAL ANGLE- ACUTE

UPPER LIP – 17MM

LOWER LIP – 46MM

LIP POSTURE- INCOMPITENT

LIP CONTOUR- EVERTED

LIP TEXTURE – FISSURED

ANALYSIS13

INCISAL SHOW AT SMILE – 4MM

INCISAL SHOW AT REST- 2MM

GINGIVAL EXPOSURE – 0MM

CHIN FORM – RECESSIVE

MENTOLABIAL SULCUS- SHALLOW

MENTALIS ACTIVITY – ABSENT

CHI THROAT ANGLE- OBTUSE

DENTAL MIDLINE – 2MM DEVIATED RT. SIDE

OVERJET – 11MM

OVERBITE- 10 MM

MOLAR RELATION- ABSENT

CANNINE REALTION- CLASS I

BRACHYCEPHALIC HEAD

LEPTOPROSCOPIC FACE

INVESTIGATIONS- RADIOLOGICAL 14

INVESTIGATIONS- RADIOLOGICAL 15

INVESTIGATIONS- RADIOLOGICAL16

INVESTIGATIONS- RADIOLOGICAL 17

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PRE OPERATIVE POST OPERATIVE

19

PRE-OPERATIVE

ANALYSIS20

POST -OPERATIVE

RO

CK

Y M

OU

NTA

IN A

NA

LYSIS

21

11.5 mm

10.8 mm

0 mm

0.7 mm

85.8 mm 72.1 mm66.2 mm 65.2 mm

85.8-66.2 =19.6

72.1-65.2 = 6.719.6-6.9 = 12.7

(1.27 cm.)

VTO22

INVESTIGATIONS-HEAMATOLOGICAL

CBP

GRBS

VIRAL MARKERS

OTHERS - PAC

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PROBLEM LIST

ASYMMETRIC FACE

ASYMMETRIC CHIN

TEETH SHOWN DURING REST

ANTERIOR PROCLAINED TEETH

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DIAGNOSIS

FACIAL ASYMMETRY

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PREVIOUS SURGERIES

CONDYLECTOMY ON LEFT SIDE

LE FORT 1 OSTEOTOMY

UNILATERAL SSRO ON RIGHT SIDE

IVRO ON LEFT SIDE OF MANDIBLE

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TREATEMENT PLAN

ILEAC CREST GRAFTING FROM ANGLE TO BODY ON RIGHT SIDE

PROPELLAR GENIOPLASTY ON THE ANTERIOR MANDIBLE

ANTERIOR MAXILLARY OSTEOTOMY OF SETBACK OF 4MM

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ILEAC GRAFT HARVESTING28

PROPELLER GENIOPLASTY29

ANTERIOR MAXILLARY OSTEOTOMY30

THANK YOU

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