口腔颌面外科学 口腔颌面外科学 第十三章dentofacialdeformity3_口腔颌面外科学_ff808081-2a596ced-012a-596dd75b-2e35.pptVIP

Capter 13 Dento-facial deformities(第3次授课 3学时) 戚孟春 Depart. Dental Science North-China Coal Medical College Intraoral oblique ramus osteotomy (IVRO) Sagittal split ramus osteotomy(SSRO) Genioplasty Angloplasty 3---Postsurgical orthodontic phase The postsurgical orthodontic phase typically begins 4-8 weeks after surgery. If used, remove the surgical splint and instruct the patient in increasing the maxillary-mandibular range of motion (limited up until this point) and in gradually returning to his or her usual diet. Return the patient to the orthodontist for finishing dental alignment with the relative position of the skeletal bases in their final position. Close any remaining interdental spaces and bring the dentition into maximum intercuspal relationship. This phase typically lasts for approximately 4-6 months and formally ends with the removal of the orthodontic braces; instruct the patient to use a retainer to maintain long-term stability. Obtain photographs, radiographic studies, and dental models at debanding of the orthodontic braces and at 1 year postoperatively. 4---Prosthodontic treatment phase The final phase includes placement of dental implants, prosthetic and periodontal treatment, and dental restoration to improve the final dental esthetics. Section 6 Post-operative nursing and complications Post-operative nursing ICU (intensive caring unit) Airway caring Incision caring Antibiotics Nutrition Prevention of asphyxia (dexamethason) Post-operative complications Common to all procedures Airway obstruction Hardware exposure Unanticipated fractures Bleeding Postoperative infection Dento-osteonecrosis Malunion or/and nonunion of bone segments Nerve injury Outcome and prognosis Outcome depends on the surgical procedure, on a multitude of factors that begin long before the actual surgery, and on control of the variables long after the surgical procedure. Whether the desired long-term outcome is achieved in terms of occlusal function and esthetics o