1、Dental-facial DeformitiesCai Ming Dept. of OMS, Shanghai 9th peoples hospital, Jiao tong UniversityOrthognathic Surgery Definition Classification Treatment planCLASSIFICATION Vertical Sagittal Transverse Bimaxillary Asymmetric Hyperplasia HypoplasiaAngle 正常正常Angle 错错Angle 错错Angle 错错下颌后缩或下颌后缩或上颌前突上颌前
2、突上颌后缩或上颌后缩或下颌前突下颌前突ETIOLOGY Congenetial AcquiredEXAMINATION History Clinical finding LaboratoryLaterallyFrontally Teeth Dental Mouth opening TMJ X-Ray Model PhotographicCephelometric Analysis1. 硬组织测量标志点硬组织测量标志点颅部颅部蝶鞍点（蝶鞍点（S S）鼻根点（鼻根点（N N）机械耳点机械耳点(P)(P)上颌骨上颌骨前鼻棘前鼻棘(ANS)(ANS)上齿槽座点（上齿槽座点（A A）上中切牙点（上中切牙
3、点（U1U1）下颌骨下颌骨下齿槽座点（下齿槽座点（B B）下中切牙点（下中切牙点（L1L1）颏前点（颏前点（PgPg）颏下点颏下点(Me)(Me)颏顶点颏顶点(Gn(Gn) )额点（额点（G G）鼻小柱点（鼻小柱点（CmCm）鼻下点（鼻下点（SnSn）上唇缘点（上唇缘点（ULUL）下唇缘点（下唇缘点（LLLL）软组织颏前点软组织颏前点(Pgs)(Pgs)软组织颏下点软组织颏下点(Mes(Mes) )颈点（颈点（C C）2. 软组织测量标志点软组织测量标志点Reference Plane and AngelSNA78SNB85 ANB 7 SNABSNABSNA76SNB70 ANB 6 Tre
4、atment PlanExaminationDiagnosisJoint orthognathic & orthodontic assessmentPresurgical OrthodonticsPostsurgical OrthodonticsSurgical PlanOrthognathic SurgeryObjective of Presurgical Orthodontic Decompansation (angulation teeth, accentuate deformities) Alignment Compatibility PREPARATION Caries & Peri
5、dontal disease Visal treament objective Model surgery Computer aided analyzeVTOSURGICAL TREAMENT PHASE Maxilla Mandible Maxillary segmental osteotomy (Anterior / Posterior)Indications: - maxillary protrusion - marked protrusion of maxillary teeth - open bite Le Fort I osteotomy (total or segmental)I
6、ndications: - maxillary deformities - mandibular deformities Le Fort II or III osteotomyIndications: - midface deficiencySagittal split ramus osteotomy, SSROIndications: - mandibular excess - mandibular deficiency - mandibular asymmetryAdbackrotateVertical ramus osteotomyIndications: - mandibular ex
7、cess - mandibular asymmetry (combined with SSRO)back Subapical osteotomyIndications: - bimaxillary protrusion / open bite - leveling the plane of occlusion - uprighting anterior teeth Body osteotomyIndications: - mandibular excess (body) combined with ramus procedure or not - open bite / spees curve reduction GenioplastyIndications: - chin deformitiesPretreatmentModel SurgeryPostLe Fort I &genioplastySNA88SNB81ANB 7SNA84SNB81ANB 3Distraction Osteogenesis3-D CT3-D ModelSimulated OperationSurgeryDistraction OsteogenesisThank You
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