Orthognathic surgery from the orthodontist's perspective!! Role of orthodontist for orthognathic cases

1. DR.DASHRATH KAFLE, ASSISTANT PROFESSOR, KUSMS

2. • Dr.Dashrath Kafle,
Assistant Professor, Kathmandu University
School of Medical Sciences,
Consultant Orthodontist, Dhulikhel Hospital.
dashrath07@yahoo.com

3. Dhulikhel Hospital
3

4. Situation 1

6. Situation 2

7. Situation 3

9. Problems
• A
• B
• C
• D
• .
• .
• .
• .
Solutions
• A
• B
• C
• D
• .
• .
• .
• .

10. Treatment options

11. Growth Modification
Initial
VTO
5 months after Twin Block

12. CAMOUFLAGE

13. Camouflage with mini implants

14. ORTHOGNATHIC SURGERIES

15. BECAUSE :
A.
B.
C.
D.
E.

17. FREESH Approach
• Function
•
•
•
•
Relaiability
Esthestics
Economic
Stability
• Health

18. Orthognathic surgery
Mini-implant anchorage
Growth modification
Orthodontics

19. Treatment planning Phase:
• Impression and Model Analysis
• OPG, Lateral Cephalograph, Frontal Ceph.
• Photographic Analysis

21. It’s a
Approach
ORTHODONTISTS
MAX.FAC.SURGERONS
TEAM
PEDODONTISTS
RESTORATIVE DENTISTS
PSYCHOLOGISTS
PERIODONTISTS
Usually patients come to orthodontists for irregular teeth and jaw.

22. Comprehensive orthodontic treatment
ARCH
COORDINATION
ORTHODONTIC
DECOMPENSATION
ORTHODONTIC
ALIGNMENT
STIFFER ARCH
WIRES TO
WITSTAND JAW
FIXATION

23. Surgical Phase
Preparation
Coordination
• Stiff wires on both
the jaws with
fixation points
• With surgeon and
Periodontist
• Surgical splints
• With patient and
patient parties
Guidance
• Of Occlusion intra
operatively

24. Post surgical Orthodontics
Fine tuning of the occlusion
Closure of spaces if any
Occlusal adjustment
Retention planning

25. Case 1
23 years old, F
Engineering student, well motivated
Long face
Concave facial profile
Facial asymmetry
Midline deviation

26. •Deviated midline
•Anterior and posterior
crossbite
•Naturally compensated
dentition

27. At the end of the pre-surgical Orthodontic Phase

28. At the end of the pre-surgical Orthodontic Phase

29. At the end of the post-surgical Orthodontic Phase

30. At the end of the post-surgical Orthodontic Phase

32. Case 2

33. Case 3
Ready for surgery

34. Case 4
Case 7
Case 6
Case 5

35. Part II
Dr.Chandan Upadhaya