Surgical orthodontics diagnosis /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Surgical orthodontics diagnosis /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. SURGICAL ORTHODONTICS – DIAGNOSIS, ORTHODONTIC MANAGEMENT AND PREPARATION OF SURGICAL SPLINT www.indiandentalacademy.com
  3. 3. Surgical Orthodontics v/s Orthognathic Surgery www.indiandentalacademy.com
  4. 4. Scope of the talk 1. A broad outline of the scope of Surgical Orthodontics and the Orthodontist’s role in it. 2. 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
  5. 5. Limitations of Orthodontics – Several conditions which cannot be corrected by Orthodontics alone. Limitations of Surgery www.indiandentalacademy.com
  6. 6. Indications 1. Congenital anomalies www.indiandentalacademy.com
  7. 7. Indications 2. Excessively large or small jaw dimensions www.indiandentalacademy.com
  8. 8. Indications 3. Marked asymmetric jaw growth www.indiandentalacademy.com
  9. 9. Indications 4. Anatomic limitations, which hinder the orthodontic tooth movement. www.indiandentalacademy.com
  10. 10. The spectrum of surgeries a. Osteotomies – • Le fort I, (Le fort II, or III in some cases) www.indiandentalacademy.com
  11. 11. The spectrum of surgeries a. Osteotomies – • Sagittal split osteotomy and osteotomy of the ramus (trans-oral or extra oral, vertical or inverted L) www.indiandentalacademy.com
  12. 12. The spectrum of surgeries Surgically assisted expansion or contraction of the maxilla www.indiandentalacademy.com
  13. 13. The spectrum of surgeries Subapical surgeries www.indiandentalacademy.com
  14. 14. The spectrum of surgeries Chin Surgeries www.indiandentalacademy.com
  15. 15. The spectrum of surgeries Cosmetic surgeries www.indiandentalacademy.com
  16. 16. The spectrum of surgeries Distraction osteogenesis www.indiandentalacademy.com
  17. 17. DIAGNOSIS a. Deciding the need for Surgery b. Deciding where the fault lies. c. Quantifying the extent of the fault www.indiandentalacademy.com
  18. 18. Deciding the need for surgery: a. Congenital or developmental craniofacial anomalies. b. Abnormal jaw growth causing marked visible facial disfigurement. c. Standard deviation as the yardstick www.indiandentalacademy.com
  19. 19. Deciding the need for surgery: d. Orthognathic surgery in most instances is elective. Patient’s opinion plays a decisive role. www.indiandentalacademy.com
  20. 20. Deciding the need for surgery: Excess mandibular growth is considered more obnoxious in our society. www.indiandentalacademy.com
  21. 21. 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
  22. 22. Deciding the need for surgery: e. Age considerations. www.indiandentalacademy.com
  23. 23. Deciding the need for surgery: f. Patient’s self image. www.indiandentalacademy.com
  24. 24. How to locate the fault? • History • Clinical examination • Study models • Photographs • radiographs www.indiandentalacademy.com
  25. 25. The advantages and shortcomings of both orthodontics and cephalometrics should be thoroughly understood. www.indiandentalacademy.com
  26. 26. Clinical examination a. Visual esthetic appraisal . b. Functional analysis. www.indiandentalacademy.com
  27. 27. 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
  28. 28. Visual Esthetic Appraisal- Frontal 1. Assessment of facial proportions. www.indiandentalacademy.com
  29. 29. Visual Esthetic Appraisal - Frontal 2. Facial Symmetry www.indiandentalacademy.com
  30. 30. 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
  31. 31. Visual Esthetic Appraisal - Profile 1. Assessment of angles such as the facial angle of convexity, nasolabial angle, etc. www.indiandentalacademy.com
  32. 32. Visual Esthetic Appraisal - Profile 2. Lips in relation to various esthetic lines www.indiandentalacademy.com
  33. 33. Visual Esthetic Appraisal - Profile 3.Perpendicular distance subnasale and the chin. 4. Cheek – Bone contour. www.indiandentalacademy.com between the
  34. 34. Cephalometric Analysis Precautions while taking cephalograms 1. Condyles properly seated in the fossae. 2. Lips fully relaxed. 3. Recording in the ‘Natural Head Position’ www.indiandentalacademy.com
  35. 35. Cephalometric Analysis Precautions while doing analysis 1. Use of normative values not very appropriate, since they cannot be accurately applied to different ethnic groups, males and females, persons with varying builds, etc. www.indiandentalacademy.com
  36. 36. Cephalometric Analysis Precautions while doing analysis 2. Norms based on hard tissues alone also not appropriate due to the varying thickness of the soft tissues. www.indiandentalacademy.com
  37. 37. Cephalometric Analysis Precautions while doing analysis 3. It is better to consider as many measurements related to a particular structure. For ex: To evaluate the maxillomandibular relationship, measurements such as LNAPog, Wits, projections of points A and B on FH and palatal plane etc. alongwith the customary LANB www.indiandentalacademy.com
  38. 38. Cephalometric Analysis Precautions while doing analysis 4. Instead of relying on absolute linear measurements, projected values are more meaningful. www.indiandentalacademy.com
  39. 39. Cephalometric Analysis Precautions while doing analysis a. Size b. Placement c. Orientation www.indiandentalacademy.com
  40. 40. Cephalometric Analysis Precautions while doing analysis 6. Effect of vertical displacements on the sagittal relationship must be taken into account. www.indiandentalacademy.com
  41. 41. Cephalometric Analysis Useful readings - Sagittal Maxilla: 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
  42. 42. Cephalometric Analysis Useful readings - Sagittal Mandible: 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 Down’s facial angle. www.indiandentalacademy.com
  43. 43. Cephalometric Analysis Useful readings - Vertical a) Jarabak ratio b) Mandibular plane wrt SN and FH c) Linear measurements of the incisors to their corresponding jaw bases www.indiandentalacademy.com
  44. 44. Cephalometric Analysis Useful readings - Vertical d) Basal plane angle. e) Maxillary inclination angle f) PNS-Ethmoid point and ANS-Nasion. www.indiandentalacademy.com
  45. 45. Cephalometric Analysis Transverse dimension Grummon’s 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
  46. 46. 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 Cephalometrics www.indiandentalacademy.com
  47. 47. Quantification of the fault Cephalometric Assessment a) Comparison with normative values b) Assessment using certain established ratios c) Surgical VTO www.indiandentalacademy.com
  48. 48. Quantification of the fault Cephalometric Assessment a) Comparison with normative values. Burstone and Legan’s analysis www.indiandentalacademy.com
  49. 49. Quantification of the fault Cephalometric Assessment Drawbacks of Burstone and Legan’s analysis: 1) Data was derived from a small sample belonging to the Caucasian population. 2) The ‘surrogate’ horizontal plane may give erroneous inferences. 3) Mean values applicable to the average size individuals only. www.indiandentalacademy.com
  50. 50. Quantification of the fault Cephalometric Assessment B) Useful ratios: 1) SN: Maxilla: Mandible = 20:14:21 2)Corpus:Ramus = 7:5 3) Middle face : Lower face = 45 % : 55% 4) Postr : Antr face height(Jarabak)=62– 64% 5) Nasal : Labial = 1:4( Nasolabial angle ) www.indiandentalacademy.com
  51. 51. Surgical VTO Softwares 1) Dentofacial Planner 2) Vistadent www.indiandentalacademy.com
  52. 52. Pre-Surgical Orthodontics A. Decompensating the incisor positions www.indiandentalacademy.com
  53. 53. Pre-Surgical Orthodontics B. Alignment of teeth by decrowding. Extraction pattern differs from that in camouflage. www.indiandentalacademy.com
  54. 54. Pre-Surgical Orthodontics C. Incisor intrusion done pre-surgically if an increase in the anterior face height is not desirable www.indiandentalacademy.com
  55. 55. Pre-Surgical Orthodontics D. Arch forms are corrected so that the arches are compatible with each other when surgically repositioned. www.indiandentalacademy.com
  56. 56. Pre-Surgical Orthodontics E. In case of segmental procedures, apices of teeth on either side of the cut are divergent or parallel. F. Extraction spaces not closed completely. www.indiandentalacademy.com
  57. 57. Pre-Surgical Orthodontics Appliance Selection 1) Edgewise ( Standard or Pre-adjusted ) 2) Tip-edge 3) Begg appliance ( Good quality brackets ) www.indiandentalacademy.com
  58. 58. Pre-Surgical Orthodontics Other Considerations A. Third molar extractions B. Stabilizing wires C. Model surgery and splint preparation www.indiandentalacademy.com
  59. 59. Post-Surgical Orthodontics Correction of minor deficiencies can be tried immediately after the surgery using elastic forces. Eg: Uneven midlines, Minor canting of occlusal plane www.indiandentalacademy.com
  60. 60. Post-Surgical Orthodontics a) Closure of remaining spaces b) Acheivement of proper interdigitation c) Finishing and detailing to functional occlusal criteria. www.indiandentalacademy.com satisfy the
  61. 61. Preparation of Surgical Splints Surgical splints Intermediate Final www.indiandentalacademy.com
  62. 62. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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