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- This topic has 4 replies, 3 voices, and was last updated 01/07/2011 at 3:11 pm by Drsumitra.
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30/06/2011 at 3:02 pm #12237AnonymousOnlineTopics: 0Replies: 1150Has thanked: 0 timesBeen thanked: 1 time
The word orthognathic comes from the root words “ortho” meaning correct or straight and “gnathos” meaning jaw and those two words actually describe quite well the function of orthognathic surgery. This type of surgery is intended to correct skeletal mismatches. That is, when one jaw is too large, too small, too far forward or too far back in relation to the cranial base (the bones which house and protect the brain). It is not intended to replace orthodontics (braces) which can straighten the teeth out over the existing bone but cannot change the bony relationships however, orthodontics are often needed both before and after orthognathic surgery in order to give the patient the best possible result.
Perhaps you have seen or know someone who can close their back teeth together and yet a space remains open between their front teeth. These people lose the ability to incise their foodThis condition is called apertognathia or open bite and can often be corrected by changing the angle at which the whole upper jaw is attached to the facial skeleton. The name of this surgical procedure is Le Fort I osteotomy.
Or perhaps you know someone with a prognathic mandible, popularly called “an underbite”. The problem may be a mandible (lower jaw) which has grown too large or too far forward. Alternatively, the same problem can be caused by a maxilla (upper jaw) which has failed to develop enough. Depending on the cause, this condition may be corrected by surgery in the lower jaw (“sagittal split” or “intraoral vertical ramus osteotomy”) or surgery in the upper jaw (“Le Fort I”) or both. A discussion of the factors that determine which surgery will be performed is outside of the scope of this presentation.
Or perhaps you have met someone whose smile is just “too gummy”. Now often, particularly in women, showing a bit of gingiva (gums) can be quite attractive but there are times when it is not attractive and it is an indication of a maxilla that has grown too far down. The name of the condition is Vertical Maxillary Excess and the surgical correction is via Le Fort I osteotomy and maxillary intrusion; all fancy ways to say, you move the upper jaw upwards.Probably the most common problem for which orthognathic surgery is performed in the United States is retrognathia, more commonly (though not always correctly) referred to as “overbite”. If you look carefully at the pictures above you may note that in addition to the vertical maxillary excess discussed this patient also had a mandible that was too far back, thus a combination of orthodontics (braces) and orthognathic surgery (Le Fort I and sagittal split with advancement) were utilized to correct the skeletal disharmonies.
30/06/2011 at 3:08 pm #17416DrsumitraOfflineRegistered On: 06/10/2011Topics: 238Replies: 542Has thanked: 0 timesBeen thanked: 0 timesSURGICAL CORRECTION
Superior repositioning of the maxilla via maxillary ostectomy has proved to be useful method of treating patients with vertical maxillary excess. It is indicated primarily in patients with lip incompetence, excessive exposure of maxillary anterior teeth, long lower facial height, contour-deficient chin, and either Class I or Class II malocclusion. We have used this procedure as routine treatment for vertical maxillary excess over the past 5 years. Timing of the surgery is not so important in non-open-bite patients, and the procedure can be done with equal success before any orthodontic intervention, during orthodontic treatment, and following all orthodontic procedures. Timing is primarily dependent upon the orthodontist’s desires. Since the surgery can produce a much simpler orthodontic problem, thus reducing treatment time and allowing a better over-all result, we recommend that it be done as early in treatment as possible. Clinically, the over-all improvement in facial appearance and the predictability and stability of the results have made this a most versatile and effective procedure when carried out with good planning, proper execution and attention to detail.
30/06/2011 at 4:15 pm #17420drmittalOfflineRegistered On: 06/11/2011Topics: 39Replies: 68Has thanked: 0 timesBeen thanked: 0 timesIn a bilateral saggital split osteotomy (BSSO) surgery, cuts are made on the lower jaw, again all from inside the mouth, to allow the lower jaw to slide forward into a normal occlusion.
As shown here, the malocclusion is a class 3, retrognathia. If the lower jaw is more prominent than the upper jaw, then the same operation can be used except the jaw bones will slide back backward into a normal occlusion. The BSSO operation sometimes requires making a very small two-millimeter incision on the skin of the face just below the ear. This small incision helps us place three screws into the jawbone on each side. The screws hold the bones in there new position. Again the screws are imperceptible.
30/06/2011 at 4:18 pm #17421drmittalOfflineRegistered On: 06/11/2011Topics: 39Replies: 68Has thanked: 0 timesBeen thanked: 0 times01/07/2011 at 3:11 pm #17428DrsumitraOfflineRegistered On: 06/10/2011Topics: 238Replies: 542Has thanked: 0 timesBeen thanked: 0 timeshttp://edentalmagazine.com/orthognathic-maxillofacial-surgery-lefort-1-2/5247
VISIT THIS LINK TO VIEW A SURGERY FOR LE FORT 1 OSTEOTOMY
Its a well made video -
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