Orthognathic surgery is a process in which dentofacial deformities and malocclusions are corrected. Orthodontics and surgical operations of the facial skeleton accompanied by soft tissue procedures can significantly correct many of these disordes.
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What is a dentofacial deformity?
However, the term dentofacial deformity describes an array of dental and maxillo-mandibular abnormalities, often presenting with a malocclusion, which is not amenable to orthodontic treatment alone and definitive treatment needs surgical alignment of upper/lower jaws or both ( orthognathic surgery ).
What is the history of dentofacial surgery?
Surgical correction of dentofacial deformities started around 1849 in the USA by S. R. Hullihan, a general surgeon, and was limited to the correction of the mandible ( prognathism ).
How common is orthodontic treatment for malocclusions?
It is estimated that nearly 30% of the general population present with malocclusions that are in great need of orthodontic treatment.
What is a Dentofacial anomaly?
However, the term dentofacial deformity describes an array of dental and maxillo-mandibular abnormalities, often presenting with a malocclusion, which is not amenable to orthodontic treatment alone and definitive treatment needs surgical alignment of upper/lower jaws or both (orthognathic surgery).
What are the three diagnostic classifications for orthodontics?
In the diagnostic category labeled Occlusion, we subdivide the occlusion of the teeth into the three dimensions; Sagittal, Vertical and Transverse. The information in each of these categories is obtained from the study casts and measurements of the lateral headfilm.
What is the purpose of the headgear tube?
Headgear is used to correct tooth and jaw misalignment and tooth overcrowding. This, in turn, can enhance facial aesthetics by correcting the profile. It can also, of course, improve the appearance of your child's smile. Headgear works by exerting force on the upper or lower jaw.
What are three anomalies that affect the number of teeth?
Numerical anomalies include supernumerary teeth or hyperdontia, and, hypodontia or congenitally missing teeth. [2] A supernumerary tooth is one that is present in addition to the normal number of teeth.
What kind of treatment is braces?
Braces exist in different types, and they comprise metal braces, clear braces, and self-ligating braces, among others. Braces are mainly used as orthodontic treatment, and unlike the past; they are modernized, and when worn, people aren't likely to notice. Additionally, braces can either be fixed or removable.
What is the name of the classification system used during an orthodontic assessment?
The IOTN is used to assess the need and eligibility of children under 18 years of age for NHS orthodontic treatment on dental health grounds.
What are the two components of a headgear appliance?
There are two main components of a protraction headgear: intraoral setup and extraoral setup.
When do you use cervical headgear?
Cervical-Pull & High-Pull Headgear These appliances can also be used for adults who need help maintaining a proper bite and correcting tooth spacing after tooth extraction. Generally, these types of headgear are meant to be worn 12 - 14 hours a day.
How does a cervical headgear work?
Cervical (SER-vi-cle) headgear is an orthodontic appliance (device) worn to move upper teeth and jaw bones into the proper position. The headgear moves the front teeth and jaw backward and closer to the lower teeth.
What causes tooth abnormalities?
Genetic mouth/dental abnormalities (anomalies) are problems, dysfunctions and diseases of oral tissues and dentition caused by defective genes. Many genetic dental/oral abnormalities indicate more complex disorders and are linked to inherited traits and defects, or result from spontaneous genetic mutations.
What are the possible abnormalities arising from the disturbances during tooth development?
Other dental abnormalities include hyperplastic upper labial frenulum, peg-shaped front teeth, and small teeth, enamel hypoplasia, conical-shaped teeth, shortened roots, taurodontism, and delayed eruption.
How common are dental anomalies?
Dental anomalies are relatively common, with 36.7% to 40.3% of nonsyndromic patients presenting with at least one dental anomaly, depending on the population evaluated. They are caused by both genetic and environmental factors.
What is facial skeletal deformity?
Facial skeletal deformity can be in the form of maxillary prognathism /retrognathism (pushed out or deficient upper jaw), mandibular prognathism /retrognathism (pushed out or deficient lower jaw/receding chin), open bite (upper and lower front teeth do not meet), transverse discrepancies and asymmetry of the Jaws (very narrow/wide upper or lower jaws, shifting upper/lower jaws to right/left side), and long/short faces.
What percentage of people have malocclusions?
It is estimated that nearly 30% of the general population present with malocclusions that are in great need of orthodontic treatment. However, the term dentofacial deformity describes an array of dental and maxillo-mandibular abnormalities, often presenting with a malocclusion, which is not amenable to orthodontic treatment alone and definitive treatment needs surgical alignment of upper/lower jaws or both ( orthognathic surgery ). Individuals with dentofacial deformities often present with lower quality of life and compromised functions with respect to breathing, swallowing, chewing, speech articulation, and lip closure/posture. It is estimated that about 5% of general population present with dentofacial deformities that are not amenable to orthodontic treatment only.
When was orthognathic surgery first performed?
R. Hullihan, a general surgeon, and was limited to the correction of the mandible ( prognathism ). Later on, around the turn of the twentieth century, early orthognathic surgery was born, when in St. Louis Edward Angle (orthodontist) and Vilray Blair (surgeon) started to work together and Blair stressed the importance of collaboration between surgeon and orthodontist. However, modern orthognathic surgery started to develop in central Europe by surgeons such as R. Trauner (Graz), Martin Wassmund (Berlin), Heinz Köle (Graz) and Hugo Obwegeser (Zurich).
What causes a tooth to move?
premature loss of primary teeth due to caries, trauma, ectopic eruption, or other causes may lead to undesirable tooth move-ments of primary and/or permanent teeth including loss of arch length. Arch length deficiency can produce or increase the severity of malocclusions with crowding, rotations, ectopic eruption, crossbite, excessive overjet, excessive overbite, and unfavorable molar relationships.87 The dental profession has re- commended the use of space maintainers to reduce the preva-lence and severity of malocclusion following premature loss of primary teeth.17,88,89 Space maintenance may be a consideration in the primary dentition after early loss of a maxillary incisor when the child has an active digit habit. An intense habit may reduce the space for the erupting permanent incisor.
What is EE in dental?
eruption (EE) of permanent first molars occurs due to the molar’s abnormal mesioangular eruption path, resulting in an impaction at the distal prominence of the primary second molar’s crown. EE can be suspected if asymmetric eruption is observed or if the mesial marginal ridge is noted to be under the distal prominence of the second primary molar. EE of permanent molars can be diagnosed from bitewing or panoramic radiographs in the early mixed dentition. This condition occurs in up to 0.75% of the population,54 but is more common in children with cleft lip and palate.554 The maxillary canine appears in an impacted position in 1.5% to 2% of the population,56,57 while maxillary incisors can erupt ectopically or be impacted from supernumerary teeth in up to 2% of the population.47 Incisors also can have altered eruption due to pulp necrosis (following trauma or caries) or pulpal treatment of the primary incisor.58EE of permanent molars is classified into 2 types. There are those that self correct or “jump” and others that remain impact-ed. In 66% of the cases, the molar jumps.59 A permanent molar that presents with part of its occlusal surface clinically visible and part under the distal of the primary second molar normally does not jump and is the impacted type.60 Nontreatment can result in early loss of the primary second molar and space loss. Maxillary canine impaction should be suspected when the canine bulge is not palpable or when asymmetric canine eruption is evident. Panoramic radiographs would show the canine has an abnormal inclination and/or overlaps the lateral incisor root. EE of permanent incisors can be suspected after trauma to primary incisors, with pulpally-treated primary incisors, with asymme-tric eruption, or if a supernumerary incisor is diagnosed.Treatment considerations: Treatment depends on how severe the impaction appears clinically and radiographically. For mild-ly impacted first permanent molars, where little of the tooth is impacted under the primary second molar, elastic or metal orthodontic separators can be placed to wedge the permanent first molar distally.16 For more severe impactions, distal tipping of the permanent molar is required. Tipping action can be accomplished with brass wires, removable appliances using springs, fixed appliances such as sectional wires with openand coilpalpation. Radiographic examination also may reveal the springs, sling shot-type appliances,
What causes space loss in the arch?
the more common causes of space loss within an arch are (1) primary teeth with interproximal caries; (2) ectopically erupting teeth; (3) alteration in the sequence of eruption; (4) ankylosis of a primary molar; (5) dental impaction; (6) transposition of teeth; (7) loss of primary molars without proper space manage-ment; (8) congenitally missing teeth; (9) abnormal resorption of primary molar roots; (10) premature and delayed eruption of permanent teeth; and (11) abnormal dental morphology.17,87,97 Loss of space in the dental arch that interferes with the desired eruption of the permanent teeth may require evaluation.Space loss may occur unilaterally or bilaterally and may result from teeth tipping, rotating, extruding, being ankylosed, or translating or from extrusion of teeth and the deepening of the curve of Spee.98The degree to which space is affected varies according to the arch affected, site in the arch, and time elapsed since tooth loss. The quantity and incidence of space loss also are depen-dent upon which adjacent teeth are present in the dental arch and their status.17,87 The amount of crowding or spacingthe dental arch will determine the degree to which spacehas a significant consequence.