牙颌面畸形小讲课蔡鸣.ppt

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牙颌面畸形小讲课蔡鸣

Thank You Vertical ramus osteotomy Indications: - mandibular excess - mandibular asymmetry (combined with SSRO) back Subapical osteotomy Indications: - bimaxillary protrusion / open bite - leveling the plane of occlusion - uprighting anterior teeth Body osteotomy Indications: - mandibular excess (body) combined with ramus procedure or not - open bite / spee’s curve reduction Genioplasty Indications: - chin deformities Pre treatment * * Dental-facial Deformities Cai Ming Dept. of OMS, Shanghai 9th people’s hospital, Jiao tong University Orthognathic Surgery Definition Classification Treatment plan CLASSIFICATION Vertical Sagittal Transverse Bimaxillary Asymmetric Hyperplasia Hypoplasia Angle分类 Angle Ⅰ正常 Angle Ⅰ错 Angle Ⅱ错 Angle Ⅲ错 下颌后缩或 上颌前突 上颌后缩或 下颌前突 ETIOLOGY Congenetial Acquired EXAMINATION History Clinical finding Laboratory Laterally Frontally Teeth Dental Mouth opening TMJ X-Ray Model Photographic Cephelometric Analysis 硬组织测量标志点 颅部 蝶鞍点(S)  鼻根点(N) 机械耳点(P) 上颌骨 前鼻棘(ANS) 上齿槽座点(A) 上中切牙点(U1) 下颌骨 下齿槽座点(B) 下中切牙点(L1) 颏前点(Pg) 颏下点(Me) 颏顶点(Gn)  额点(G) 鼻小柱点(Cm) 鼻下点(Sn) 上唇缘点(UL) 下唇缘点(LL) 软组织颏前点(Pgs) 软组织颏下点(Mes) 颈点(C) 软组织测量标志点 Reference Plane and Angel Case SNA 78° SNB 85 ° ANB 7 ° S N A B S N A B SNA 76° SNB 70 ° ANB 6 ° Treatment Plan Examination Diagnosis Joint orthognathic orthodontic assessment Presurgical Orthodontics Postsurgical Orthodontics Surgical Plan Orthognathic Surgery Objective of Presurgical Orthodontic Decompansation (angulation teeth, accentuate deformities) Alignment Compatibility PREPARATION Caries Peridontal disease Visal treament objective Model surgery Computer aided analyze VTO SURGICAL 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) Indications: - ma

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