1. Dept. of Oral & Maxillofacial Surgery
Dental-maxillofacial Deformities
Dept. of Oral & Maxillofacial Surgery
School of Stomatology
LI Qing-yun

2. Phase I Phase II Phase III Presurgical treatment Surgical treatment
Orthodontics
Surgical plan
Phase II
Surgical treatment
Mandible
Maxilla
Phase III
Postsurgical treatment
Orthodontics
restorative/prosthetic treatment
follow-up

3. Presurgical Treatment Phase
Presurgical orthodontics
Final surgical planning

4. Objectives —— Presurgical orthodontics
Decompensation dental compensation for skeletal deformity angulation of teeth accentuate the deformity

5. Objectives —— Presurgical orthodontics
Alignment of the arches
Compatibility of the arches

6. Final Surgical Planning
Visual Treatment Objective, VTO

7. Final Surgical Planning
Computerized imaging CASSOS

12. Final Surgical Planning
articulator
Model Surgery
Exact surgical movements
(distance, direction)
Postoperative occlusion
Face-bow

14. Surgical Treatment Phase
Surgeries for maxillary deformity
Surgeries for mandibular deformity

15. Surgeries for maxillary deformity
Segmental osteotomy (Anterior / Posterior)
Indications:
- maxillary protrusion
- marked protrusion of maxillary teeth
- open bite

16. Surgeries for maxillary deformity
Le Fort I osteotomy (total or segmental)
Indications:
- maxillary deformities
- mandibular deformities

17. Surgeries for maxillary deformity
Le Fort I osteotomy
Le Fort II or III osteotomy
Indications:
- midface deficiency

18. Surgeries for mandibular deformity
Sagittal split ramus osteotomy, SSRO
Indications:
- mandibular excess
- mandibular deficiency
- mandibular asymmetry
back Ad
rotate

19. Surgeries for mandibular deformity
Vertical ramus osteotomy
Indications:
- mandibular excess
- mandibular asymmetry (combined with SSRO)
back

20. Surgeries for mandibular deformity
Subapical osteotomy
Indications:
- bimaxillary protrusion / open bite
- leveling the plane of occlusion
- uprighting anterior teeth

21. Surgeries for mandibular deformity
Body osteotomy
Indications:
- mandibular excess (body) combined with ramus procedure or not
- open bite / spee’s curve reduction

22. Surgeries for mandibular deformity
genioplasty
Indications:
- chin deformities

23. Perioperative complications
Airway obstructionedema / bleeding / displacement… …
Bleeding
Infection
Necrosis of teeth / bone
Healing
Injury of nerve

24. Postsurgical Treatment Phase
Completion of orthodontics
Postsurgical restorative/prosthetic treatment
Follow-up

25. Pre
treatment

26. SNA 88°
SNB 81°
ANB 7°

27. Post
Le Fort I &
genioplasty

28. SNA 84°
SNB 81°
ANB 3°

29. Pre
treatment

30. SNA 88°
SNB 92°
ANB 4°

31. orthodontic treatment
Pre operation
& after presurgical
orthodontic treatment

32. SNA 88°
SNB 92°
ANB -4°

33. Post Sagittal Split Ramus Osteotomy

34. SNA 88°
SNB 86°
ANB 2°

35. Post
treatment

36. SNA 88°
SNB 86°
ANB 2°