Orthognathic Surgery Treatment Timeframes

Question 1

What are the stages of Orthognathic Surgery?

Answer 1

•Assessment
• Trt Planning
• Risks
• Pre Ortho
• Surgery
• Post Ortho Trt
• Retention

Question 2

What happens at the Assessment stage?

Answer 2

• MH, PCO
• IO - Disease and Dento Alveolar Compensation
• EO - Skeletal Pattern
• Records
• Special Tests

Question 3

Radiographs used for Orthognathic Treatment?

Answer 3

1. OPG - presence, position and pathology
2. Ceph Analysis
3. Upper Standard Occlusal
4. Post Anterior skull - Asymmetry

Question 4

What does a Ceph analysis look at:

Answer 4

• max/ mand dentition
• naso - max complex
• cranium and cranial base - (S-N Line)

Question 5

What happens at the diagnosis?

Answer 5

Classification of malocclusion and skeletal pattern?

Question 6

What happens at the treatment planning stage?

Answer 6

1. Assess
2. Problem list
3. Aims of trt
4. Joint clinic
5. Considerations

Question 7

What considerations are considered at the treatment planning stage?

Answer 7

1. Decompensation of Dento Alveolar compensation
2. Soft tissue/ hard tissues are equal

Question 8

Why are aids used during trt planning?

Answer 8

To show positions and predictions

Question 9

What aids are used during planning treatment?

Answer 9

• Photographs
• ceph and tracings
• Transparacies
• computer software

Question 10

What are the risk associated with Orthognathic Surgery?

Answer 10

• swelling/bruising
• Nerve damage
• Infection and Relapse

Question 11

What nerve can get damaged with maxilla surgery?

Answer 11

Infra Orbit Nerve

Question 12

What nerve can get damaged with mandible surgery?

Answer 12

Inferior alveolar/ dental nerve

Question 13

How long does pre ortho trt take?

Answer 13

12 - 18 months

Question 14

What happens during pre ortho trt?

Answer 14

• xlas - crowding, levelling and 3rd molars
• level and align
• arch coordination
• Decompensation
• Creates spaces for cuts
• Maintains curve of spee

Question 15

What type of mechanics are used during pre ortho trt?

Answer 15

Fixed appliance with:
•SS wires
•surgical hooks

Question 16

When are the face-bow readings and wafers constructed?

Answer 16

After Pre Ortho trt has been completed

Question 17

Surgery timeframe?

Answer 17

2/4 days

Question 18

What happens during the surgery process?

Answer 18

• Titanium plates and screws
• Jaws closed
• Inter maxillary fixation

Question 19

Post surgery diet?

Answer 19

• liquid foods 1/2 days
• soft food 4/6 wks

Question 20

Post surgery swelling?

Answer 20

Rapid reduction = 2/3 weeks
Gradual reduction = 6/9 months

Question 21

What is the Timeframe for Post surgery Ortho trt?

Answer 21

6/9 months

Question 22

What happens during post surgery ortho treatment?

Answer 22

• Maintain correction
• complete any further movements
• root paralleling @ the segmental sites

Question 23

What mechanics are used during post Surgery Orthodontics?

Answer 23

Fixed
Flexible wires and elastics

Question 24

What are the risks associated with retention with a surgical case?

Answer 24

1. Surgical
2. Orthodontic
3. Patient

Question 25

What are the increased surgical retention risks?

Answer 25

• Inadequate fixation
• maxilla > 5mm
• mandibular > 8mm
• condylar head displaced

Question 26

What are the increased orthodontic risks?

Answer 26

Extrusion movements - relapse

Question 27

Increased patient retention risks?

Answer 27

• Habits
• AOB
• soft tissue tension
• CLP - scar tissue
• compliance