orthognathic surgery –
DESCRIPTION
orthognathic surgeryTRANSCRIPT
Orthognathic surgery – maxillary deformities , maxillary repositioning procedures and complications
Presented by : Dr. ShwetaModerator : Dr. Anuradha Navaneetham
Facial disproportion
Symmetrical disproportion maxillary enlargement
maxillary deficiency Asymmetrical disproportion
Maxillary deficiency
Supra-apical maxillary hypoplasia Vertical maxillary deficiency Nasomaxillary hypoplasia Lateral maxillary deficiency Total midface hypoplasia Crouzen’s syndrome Apert’s syndrome
Middle face assymetries
Cleft lip and cleft palate syndrome Localized maxillary pathology Secondary maxillary assymetries Hemifacial atrophy Hemifacial hypoplasia Hemifacial hypertrophy
Vertical maxillary excess
long lower facial height lip incompetence excessive incisor display at rest excessive gingival display on smile
Vertical maxillary deficiencies
Short lower facial third Diminished maxillary incisor display
at rest Diminished incisor display on smile
History
1859 Von Langenbeck 1867 Cheever 1901 Le Fort 1927 Wassmund 1934 Axhausen 1942 Schuchardt 1949 Moore and Ward 1965 Obwegeser
Segmental alveolar maxillary osteotomies
Anterior maxillary osteotomies Posterior maxillary osteotomies Combined procedures
Surgical technique
Surgical exposure, osteotomy cuts, pterygomaxillary dysjunction
Mobilization & advancement Fixation Bone grafting
Indications
Low mid face hypoplasia Maxillary hyperplasia Cant in occlusion Cleft patients Open bite
Lefort I osteotomy
Variation I : with midline narrowing Variation II : with midline widening Variation III : with superior
repositioning Variation IV : with inferior
repositioning
Lefort II osteotomy
Variation I : with inferior repositioning Variation II : with naso-orbital
maxillary advancement of converse Variation III : kufner’s modification Variation IV : with lateral extensions
Lefort III osteotomy
Variation I : with inferior repositioning Variation II : with transverse frontal
crescent Variation III : lefort III + I
Anterior segmentl osteo.
Corticotomy with interradicular osteotomy
Anterior maxillary osteotomy wassumand method wundrer’s method cupar’s method