evolution of orthognathic surgery

ORTHOGNATHIC SURGERYITS EVOLUTION

S.R.Hullihan (1849)A General Surgeon

Anterior sub apical osteotomy to correct anterior open bite and mandibular dento alveolar protrusion


VILARY BLAIR & EDWARD ANGLE1898 - 1906Osteoctomy of horizontal ramusHorizontal osteotomy of the ramusV.shaped osteotomy for open bite


Blairs contributions to orthognathic surgeryPioneer in orthognathic surgeryRacial differences in planningClassification of jaw deformitiesCo-operation between surgeon & orthodontist


Blairs single significant contribution (1907)Treating of skeletal deformities is really surgical work, but the earlier a competent, congenial orthodontist is associated with the case, the better it will be for both the surgeon and the patient

ORTHOGNATHIC SURGERY ITS EVOLUTION Modern era Central Europe 1950s Vienna, Graz, North Berlin, Hamburg.


Trauners contributions (1955)Inagurator of several procedures trained Heinz Kole & Hugo Obwegeser


Martin Wassmund (Berlin)Developed anterior maxillary osteotomy Described lefort I osteotomy (1927)Trained Karl Schuchhardt


Karl Schuchhardt (1955)Posterior maxillary osteotomy

Improved by Kufner to enable total mobilisation of the segment


Heinz Kole (1959) Graz

Several innovationsBimaxillary alveolar surgeryDeep bite correctionOpen bite closureGenioplastyExtensive literature contribution


Hugo Obwegeser (Zurich)Sagittal split of the mandible (1955) opened new dimension in mandibular surgery

Dal Pont (1958) improved the method


Hugo Obwegeser (Zurich)Undoubtedly single greatest contributor to orthognathic surgery in the world

ORTHOGNATHIC SURGERYITS EVOLUATION

Hugo Obwegeser

Numerous contributionsSagittal split osteotomyLarge series of Le fort I ostetomy (1969)Le fort I osteotomy in cleft casesTotal maxillary & mandibular osteotomies


Paul Tessier (France 1967)Developed craniofacial surgery in europe. Particularly Le fort III osteotomy

ORTHOGNATHIC SURGERYITS EVOLUTIONApplication of rigid, semi rigid fixation of bony segments.

B.spiessl was the first to apply rigid fixation in orthognathic surgery (1974)


Caldwell & Letterman (1954)Vertical sub sigmoid osteotomy


H.Luhr (1979)H. Luhr introduced mini bone plates in orthognathic surgery


What are the advantages of rigid fixation ?More rapid & easierStabilization of segments betterPatient convenience is greater because no intermaxillary fixationLess danger for the patient


What did plastic surgeons contribute ?BlepharoplastyRhinoplastyRhitidectomyLiposuctionLip corrections


Which way is the pendulum of progress ? swung back to the United States of America where orthognalthic surgery started about 100 years ago


Current scenarioIt is a grown up speciality and an important part of oral, maxillofacial and facial plastic surgery


Indian situationProf. M.S.N.Ginwalla started orthognathic surgery in india in early sixities and credited as father of orthognathic surgery in India


Maxillary procedureLangenbeck (1859) did first maxillary osteotomy for removal of nasopharyngeal polyp, the next 70 years it was used only for pathological conditions


K.H.Thoma (1883-1972)Oblique osteotomy of the ramus

Father of oral pathology, defender of oral surgery, and great teacher of oral medicine, raised the standards, originated several surgical techniques.


William H. BellProvided biologic evidence for the success of maxillary osteotomies with his research on vascularity of maxilla.


Bruce N. Epkar (Texas, U.S.A.)Interested in the dynamics of bone metabolism and facial skeletal surgery - more than 200 scientific contributions

Created Fort worth cleft palate programJohn Peer Smith hospital centre for correction of facial deformities


Deric HendersonSt. Thomas Hospital (London)Greatest contributor in the United Kingdom


Norman RoweQueen Mary Hospital (Roehampton )

ORTHOGNATHIC SURGERYITS EVOLUTIONHarold Hargis coined the term orthognathic previously referred to as orthodontic corrective jaw surgery

Every man owes some of his time to the upbuilding of the profession to which he belongs

Theodore Roosevelt


Prof. C.Bhasker RaoDirectorCraniofacial SurgeryS.D.M.C.D.S., Dharwad


Developments which contributed to the growth of orthognathic surgery


Rigid, semirigid fixationVascular studiesBone graftsAntibioticsAnaesthetic techniques

evolution of orthognathic surgery

Documents

orthognathic surgerypioneer

shaped osteotomy

anterior open bite

craniofacial surgery

orthognalthic surgery

advantages of rigid

mandibular surgerydal

plastic surgeons