surgical orthodontics diagnosis / orthodontic courses by indian dental academy

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  • INDIAN DENTAL ACADEMY

    Leader in continuing dental education www.indiandentalacademy.comwww.indiandentalacademy.com

    www.indiandentalacademy.com

  • SURGICAL ORTHODONTICS DIAGNOSIS,ORTHODONTIC MANAGEMENT AND PREPARATION OF SURGICAL SPLINT www.indiandentalacademy.com

    www.indiandentalacademy.com

  • Surgical Orthodontics v/s Orthognathic Surgery www.indiandentalacademy.com

    www.indiandentalacademy.com

  • Scope of the talkA broad outline of the scope of Surgical Orthodontics and the Orthodontists role in it.Suggestions to avoid the pitfalls in planning the treatment and executing its orthodontic management

    3. Preparation of a surgical splint using a new gadget.

    www.indiandentalacademy.com

    www.indiandentalacademy.com

  • Limitations of Orthodontics Several conditions which cannot be corrected by Orthodontics alone.Limitations of Surgery www.indiandentalacademy.com

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  • Indications1. Congenital anomalies www.indiandentalacademy.com

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  • Indications2. Excessively large or small jaw dimensions www.indiandentalacademy.com

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  • Indications3. Marked asymmetric jaw growth www.indiandentalacademy.com

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  • Indications4. Anatomic limitations, which hinder the orthodontic tooth movement.www.indiandentalacademy.com

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  • The spectrum of surgeriesOsteotomies Le fort I, (Le fort II, or III in some cases)

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  • The spectrum of surgeriesOsteotomies Sagittal split osteotomy and osteotomy of the ramus (trans-oral or extra oral, vertical or inverted L)

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  • The spectrum of surgeriesSurgically assisted expansion or contraction of the maxilla www.indiandentalacademy.com

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  • The spectrum of surgeriesSubapical surgeries www.indiandentalacademy.com

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  • The spectrum of surgeriesChin Surgeries www.indiandentalacademy.com

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  • The spectrum of surgeriesCosmetic surgeries www.indiandentalacademy.com

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  • The spectrum of surgeriesDistraction osteogenesiswww.indiandentalacademy.com

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  • DIAGNOSIS

    Deciding the need for SurgeryDeciding where the fault lies.Quantifying the extent of the fault

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  • Deciding the need for surgery: Congenital or developmental craniofacial anomalies.Abnormal jaw growth causing marked visible facial disfigurement.Standard deviation as the yardstick

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  • Deciding the need for surgery: d. Orthognathic surgery in most instances is elective. Patients opinion plays a decisive role. www.indiandentalacademy.com

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  • Deciding the need for surgery: Excess mandibular growth is considered more obnoxious in our society.www.indiandentalacademy.com

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  • Deciding the need for surgery: Persons with mild prognathism often seek treatment, while those with moderate mandibular deficiency may refuse surgical correction. www.indiandentalacademy.com

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  • Deciding the need for surgery: e. Age considerations.www.indiandentalacademy.com

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  • Deciding the need for surgery: f. Patients self image.www.indiandentalacademy.com

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  • How to locate the fault?HistoryClinical examinationStudy modelsPhotographsradiographs

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  • The advantages and shortcomings of both orthodontics and cephalometrics should be thoroughly understood. www.indiandentalacademy.com

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  • Clinical examinationVisual esthetic appraisal .Functional analysis.

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  • Visual Esthetic Appraisal Relationship of facial structures with respect to their balance, symmetry, and proportions in all the three planes of space. www.indiandentalacademy.com

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  • Visual Esthetic Appraisal- Frontal 1. Assessment of facial proportions.www.indiandentalacademy.com

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  • Visual Esthetic Appraisal - Frontal 2. Facial Symmetrywww.indiandentalacademy.com

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  • Visual Esthetic Appraisal - Frontal 3. Canting of bilateral structues, specially the lips and the dentition 4.Lip Competence, exposure of upper incisors www.indiandentalacademy.com

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  • Visual Esthetic Appraisal - Profile 1. Assessment of angles such as the facial angle of convexity, nasolabial angle, etc.www.indiandentalacademy.com

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  • Visual Esthetic Appraisal - Profile 2. Lips in relation to various esthetic lineswww.indiandentalacademy.com

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  • Visual Esthetic Appraisal - Profile 3.Perpendicular distance between the subnasale and the chin. 4. Cheek Bone contour.www.indiandentalacademy.com

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  • Cephalometric Analysis Precautions while taking cephalogramsCondyles properly seated in the fossae.Lips fully relaxed.Recording in the Natural Head Position

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  • Cephalometric Analysis Precautions while doing analysisUse of normative values not very appropriate, since they cannot be accurately applied to different ethnic groups, males and females, persons with varying builds, etc.

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  • Cephalometric Analysis Precautions while doing analysis2. Norms based on hard tissues alone also not appropriate due to the varying thickness of the soft tissues.www.indiandentalacademy.com

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  • Cephalometric Analysis Precautions while doing analysis3. It is better to consider as many measurements related to a particular structure. For ex: To evaluate the maxillo-mandibular relationship, measurements such as LNAPog, Wits, projections of points A and B on FH and palatal plane etc. alongwith the customary LANBwww.indiandentalacademy.com

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  • Cephalometric Analysis Precautions while doing analysis4. Instead of relying on absolute linear measurements, projected values are more meaningful.www.indiandentalacademy.com

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  • Cephalometric Analysis Precautions while doing analysisSizePlacementOrientation

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  • Cephalometric Analysis Precautions while doing analysis6. Effect of vertical displacements on the sagittal relationship must be taken into account.www.indiandentalacademy.com

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  • Cephalometric Analysis Useful readings - SagittalMaxilla: L SNA, A perpendicular to N perp.on the true horizontal, Size of maxilla in relation to the SN length, placement of its posterior limit with respect to sella.www.indiandentalacademy.com

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  • Cephalometric Analysis Useful readings - SagittalMandible: L SNB, B perpendicular to N perp.on the true horizontal, Size of corpus in relation to the SN length, ratio of ramus to corpus angle, placement of condyles, chin placement with respect to point B and Downs facial angle.www.indiandentalacademy.com

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  • Cephalometric Analysis Useful readings - VerticalJarabak ratioMandibular plane wrt SN and FHLinear measurements of the incisors to their corresponding jaw bases

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  • Cephalometric Analysis Useful readings - Verticald) Basal plane angle.e) Maxillary inclination anglef) PNS-Ethmoid point and ANS-Nasion.www.indiandentalacademy.com

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  • Cephalometric Analysis Transverse dimensionGrummons analysis is a useful analysis to assess transverse dysplasia. Normative data for the Indian population is being worked out in our institution.www.indiandentalacademy.com

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  • Quantification of the fault This step involves the determination of the precise magnitude of surgical alteration of the jaw bases in a 3-dimensional perspective. Quantification

    Clinical exam Cephalometricswww.indiandentalacademy.com

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  • Quantification of the faultCephalometric AssessmentComparison with normative valuesAssessment using certain established ratiosSurgical VTO

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  • Quantification of the faultCephalometric AssessmentComparison with normative values.

    Burstone and Legans analysiswww.indiandentalacademy.com

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  • Quantification of the faultCephalometric AssessmentDrawbacks of Burstone and Legans analysis:Data was derived from a small sample belonging to the Caucasian population.The surrogate horizontal plane may give erroneous inferences.Mean values applicable to the average size individuals only.

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