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ORTHODONTIC PERSPECTIVE OF
DISTRACTION OSTEOGENESIS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indian...
The symbiotic relationship between the
Orthodontist and the Oro-Maxillofacial
surgeon is a fairly recent phenomenon
www.in...
While the surgeon can bring about gross
changes (which make dramatic improvement
in facial appearance), the orthodontic
ex...
www.indiandentalacademy.com
Application of Distraction Osteogenesis to the
craniofacial areas is even more recent.
Hence, the role of Orthodontics is ...
DISTRACTION OSTEOGENESIS
Our experiences with distraction
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
Our experiences with distraction
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
Our experiences with distraction
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
Our experiences with distraction
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
Pre-surgical Orthodontic phase
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
SCOPE OF THE TALK
1) How the Orthodontic practice will get
benefited from this surgical procedure
2) How the surgeon can u...
Why is Distraction of interest to an
Orthodontist?
1. It enlarges the envelope in which he/she
operates. It is one step ah...
Why is Distraction of interest to an
Orthodontist?
Envelope of discrepancy
www.indiandentalacademy.com
Why is Distraction of interest to an
Orthodontist?
2. It more or less eliminates the restrictions
imposed by the soft tiss...
Why is Distraction of interest to an
Orthodontist?
3. Early intervention in life helps to restore the
normal growth proces...
Why is Distraction of interest to an
Orthodontist?
4. Reduced morbidiy, reduced need for bone
grafts,improved airway.
www....
Application from an Orthodontist’s point of view
1. Treating craniofacial deformities.
www.indiandentalacademy.com
Application from an Orthodontist’s point of view
2. As an alternative to surgery in less gross
deficiencies.
www.indianden...
Application from an Orthodontist’s point of
view
3. Widening the transverse dimension of the
mandible
www.indiandentalacad...
Application from an Orthodontist’s point of view
4. Surgically assisted RME
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com
Application from an Orthodontist’s point of view
5. Distraction for Orthodontic tooth movements
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
DENTAL DISTRACTION
www.indiandentalacademy.com
DISTRACTION OSTEOGENESIS
DENTAL DISTRACTION
www.indiandentalacademy.com
How will the surgeon benefit by associating
with the Orthodontist?
1. Treatment Planning Amount
Vector
2. Pre and Post-sur...
How will the surgeon benefit by associating
with the Orthodontist?
3. During Surgery – for fixing intra-oral
devices, for ...
Thank you
THANK YOU
www.indiandentalacademy.com
ROLE OF CEPHALOMETRICS IN PLANNING
DISTRACTION PROCEDURES
Prof. Vijay P. Jayade
Chairman and Head,
Department of Orthodont...
Treatment Planning- Consideration of
size, placement, orientation.
Cephalometry – not a perfect science but a
great tool i...
www.indiandentalacademy.com
How to judge the amount of distraction
needed?
1. Use of normative values ?
Not very appropriate, since they cannot be
acc...
2. Norms based on hard tissues alone?
Not appropriate because variable thickness of
soft tissues can compensate for/or
agg...
3. Instead of absolute linear
measurements, their projected values are
more meaningful to judge their true
contribution to...
The best known analysis employing the
co-ordinate reference is the COGS of
Burstone and Legan.
www.indiandentalacademy.com
COGS of Burstone and Legan.
The drawbacks, however, are
1. Small sample
2. Unreliable ‘surrogate’ horizontal plane.
www.in...
4.The best option would be probably the True
horizontal or the True vertical references
as applied to the ‘ Natural Head P...
5.Ratios are more reliable than individual
linear measurements, because they
overcome the differences in the individual
si...
Certain useful ratios are
a) For sagittal measurements
i. Antr. Cranial base/ Max./Mand
= 20/ 14 /21
ii.. Mandibular compo...
www.indiandentalacademy.com
b. For vertical dimension
Post. Face height/Ant.Face height(Jarabak ratio)
= 62-64%
www.indiandentalacademy.com
www.indiandentalacademy.com
6. These help to customize the ‘normal’ values
for maxillary and mandibular sizes in
proportion to the cranial base.
Thus,...
7. Placement of the maxilla and mandible with
respect to the cranial base (sella) can
compensate or aggravate the size
abn...
www.indiandentalacademy.com
8. Orientation of the maxillary base or the
mandibular corpus would affect the final
position of the anterior limits of ma...
www.indiandentalacademy.com
9. These are assessed in relation to the
thickness of the soft tissue drape to arrive
at the final estimate of maxillary a...
10. As of now, there is some uncertainty about
the exact quantum of soft tissue
displacement which follows hard tissue
cha...
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
THANK YOU
www.indiandentalacademy.com
For more details please visit
www.indiandentalacademy.com
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Distraction osteogenesis /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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Distraction osteogenesis /certified fixed orthodontic courses by Indian dental academy

  1. 1. ORTHODONTIC PERSPECTIVE OF DISTRACTION OSTEOGENESIS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. The symbiotic relationship between the Orthodontist and the Oro-Maxillofacial surgeon is a fairly recent phenomenon www.indiandentalacademy.com
  3. 3. While the surgeon can bring about gross changes (which make dramatic improvement in facial appearance), the orthodontic expertise is needed in fine-tuning the results. www.indiandentalacademy.com
  4. 4. www.indiandentalacademy.com
  5. 5. Application of Distraction Osteogenesis to the craniofacial areas is even more recent. Hence, the role of Orthodontics is now getting properly defined. www.indiandentalacademy.com
  6. 6. DISTRACTION OSTEOGENESIS Our experiences with distraction www.indiandentalacademy.com
  7. 7. DISTRACTION OSTEOGENESIS Our experiences with distraction www.indiandentalacademy.com
  8. 8. DISTRACTION OSTEOGENESIS Our experiences with distraction www.indiandentalacademy.com
  9. 9. DISTRACTION OSTEOGENESIS Our experiences with distraction www.indiandentalacademy.com
  10. 10. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  11. 11. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  12. 12. DISTRACTION OSTEOGENESIS Pre-surgical Orthodontic phase www.indiandentalacademy.com
  13. 13. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  14. 14. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  15. 15. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  16. 16. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  17. 17. SCOPE OF THE TALK 1) How the Orthodontic practice will get benefited from this surgical procedure 2) How the surgeon can utilise the Orthodontist’s expertise to improve the quality of treatment. www.indiandentalacademy.com
  18. 18. Why is Distraction of interest to an Orthodontist? 1. It enlarges the envelope in which he/she operates. It is one step ahead of Orthognathic surgery. www.indiandentalacademy.com
  19. 19. Why is Distraction of interest to an Orthodontist? Envelope of discrepancy www.indiandentalacademy.com
  20. 20. Why is Distraction of interest to an Orthodontist? 2. It more or less eliminates the restrictions imposed by the soft tissues. Hence, chances of relapse reduce drastically www.indiandentalacademy.com
  21. 21. Why is Distraction of interest to an Orthodontist? 3. Early intervention in life helps to restore the normal growth process. www.indiandentalacademy.com
  22. 22. Why is Distraction of interest to an Orthodontist? 4. Reduced morbidiy, reduced need for bone grafts,improved airway. www.indiandentalacademy.com
  23. 23. Application from an Orthodontist’s point of view 1. Treating craniofacial deformities. www.indiandentalacademy.com
  24. 24. Application from an Orthodontist’s point of view 2. As an alternative to surgery in less gross deficiencies. www.indiandentalacademy.com
  25. 25. Application from an Orthodontist’s point of view 3. Widening the transverse dimension of the mandible www.indiandentalacademy.com
  26. 26. Application from an Orthodontist’s point of view 4. Surgically assisted RME www.indiandentalacademy.com
  27. 27. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  28. 28. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  29. 29. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  30. 30. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  31. 31. DISTRACTION OSTEOGENESIS www.indiandentalacademy.com
  32. 32. Application from an Orthodontist’s point of view 5. Distraction for Orthodontic tooth movements www.indiandentalacademy.com
  33. 33. DISTRACTION OSTEOGENESIS DENTAL DISTRACTION www.indiandentalacademy.com
  34. 34. DISTRACTION OSTEOGENESIS DENTAL DISTRACTION www.indiandentalacademy.com
  35. 35. How will the surgeon benefit by associating with the Orthodontist? 1. Treatment Planning Amount Vector 2. Pre and Post-surgical Orthodontics for facilitating surgery and for optimum post- surgical occlusal function www.indiandentalacademy.com
  36. 36. How will the surgeon benefit by associating with the Orthodontist? 3. During Surgery – for fixing intra-oral devices, for adjusting the vector of extra- oral devices. 4. For maintaining or improving the results of surgery – use of functional appliances or headgears, elastics - ‘Bone moulding’ 5. Post-op followups, records, measurements etc. www.indiandentalacademy.com
  37. 37. Thank you THANK YOU www.indiandentalacademy.com
  38. 38. ROLE OF CEPHALOMETRICS IN PLANNING DISTRACTION PROCEDURES Prof. Vijay P. Jayade Chairman and Head, Department of Orthodontics SDM Dental College www.indiandentalacademy.com
  39. 39. Treatment Planning- Consideration of size, placement, orientation. Cephalometry – not a perfect science but a great tool if used properly (also could totally mislead if used without proper understanding) www.indiandentalacademy.com
  40. 40. www.indiandentalacademy.com
  41. 41. How to judge the amount of distraction needed? 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
  42. 42. 2. Norms based on hard tissues alone? Not appropriate because variable thickness of soft tissues can compensate for/or aggravate the hard tissue relations. www.indiandentalacademy.com
  43. 43. 3. Instead of absolute linear measurements, their projected values are more meaningful to judge their true contribution to the skeletal dysplasia in a horizontal or vertical direction www.indiandentalacademy.com
  44. 44. The best known analysis employing the co-ordinate reference is the COGS of Burstone and Legan. www.indiandentalacademy.com
  45. 45. COGS of Burstone and Legan. The drawbacks, however, are 1. Small sample 2. Unreliable ‘surrogate’ horizontal plane. www.indiandentalacademy.com
  46. 46. 4.The best option would be probably the True horizontal or the True vertical references as applied to the ‘ Natural Head Position’. The values for Indian population are currently being established. www.indiandentalacademy.com
  47. 47. 5.Ratios are more reliable than individual linear measurements, because they overcome the differences in the individual size. www.indiandentalacademy.com
  48. 48. Certain useful ratios are a) For sagittal measurements i. Antr. Cranial base/ Max./Mand = 20/ 14 /21 ii.. Mandibular components Corpus/ Ramus = 7 / 5 www.indiandentalacademy.com
  49. 49. www.indiandentalacademy.com
  50. 50. b. For vertical dimension Post. Face height/Ant.Face height(Jarabak ratio) = 62-64% www.indiandentalacademy.com
  51. 51. www.indiandentalacademy.com
  52. 52. 6. These help to customize the ‘normal’ values for maxillary and mandibular sizes in proportion to the cranial base. Thus, individual specific norms (as against population specific) can be derived. www.indiandentalacademy.com
  53. 53. 7. Placement of the maxilla and mandible with respect to the cranial base (sella) can compensate or aggravate the size abnormality www.indiandentalacademy.com
  54. 54. www.indiandentalacademy.com
  55. 55. 8. Orientation of the maxillary base or the mandibular corpus would affect the final position of the anterior limits of maxilla and mandible. www.indiandentalacademy.com
  56. 56. www.indiandentalacademy.com
  57. 57. 9. These are assessed in relation to the thickness of the soft tissue drape to arrive at the final estimate of maxillary and mandibular alterations needed. www.indiandentalacademy.com
  58. 58. 10. As of now, there is some uncertainty about the exact quantum of soft tissue displacement which follows hard tissue changes. www.indiandentalacademy.com
  59. 59. www.indiandentalacademy.com
  60. 60. www.indiandentalacademy.com
  61. 61. www.indiandentalacademy.com
  62. 62. www.indiandentalacademy.com
  63. 63. www.indiandentalacademy.com
  64. 64. THANK YOU www.indiandentalacademy.com For more details please visit www.indiandentalacademy.com

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