Objectives /certified fixed orthodontic courses by Indian dental academy

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


OBJECTIVES:
Get an optimal balance between:
1. Aesthetics
2. Function
3. Stability
(Aesthetics should not be sacrificied for
function – but improvement in function will
bring about improvement in Aesthetics)

PATIENT EVALUATION
Gathering diagnostic information involves:
1. Patients concerns: Expectation
2. Clinical Evaluation:
3. Radiographic analysis:
4. Dental study model analysis:
5. Others:
I. Speech
II. Audiometry
III. Psychological
IV. Medical

RADIOGRAPHIC ANALYSIS
1.

2.

CEPHALOMETRIC: Lateral and
anteroposterior: Lips must be in repose,
teeth only lightly touching and in centric
relation
ORTHOPANTOMOGRAM: Check for
position of inferior alveolar canal and
screen for any gross pathology


SEQUENCE OF TREATMENT
PLANNING
1.
2.
3.
4.
5.
6.
7.

Dental & Periodontal treament
Extractions
Pre-surgical orthodontics
Orthognathic surgery
Post-surgical orthodontics
Definitive general dental management and
maintenance
Others: eg. Rhinoplasty

Facial thirds:
1.
2.
3.

Upper third: Forehead
Middle third: between eyebrows and
base of the nose
Lower third: from base of the nose to the
undersurface of the chin


FRONTAL VIEW
1.
2.
3.
4.
5.
6.

ICD to alar base width ( 28 to 34mm)
Dental Vs soft tissue midlines (chin,nose,
upper lip) – to assess facial asymmetry
Lip length: Upper=22±2mm
Upper central incisal display at rest= 2 to
4mm
Gingival display at rest and smiling
Vermillion display

Lateral view
1.
2.
3.
4.
5.

Glabella to base of nose = base of nose
to soft tissue chin
Relationship of globe to surrounding
tissues
Chin throat angle
Nasal tip-upper lip angle
Labiomental fold and lip competence

TREAMENT PLANNING
1.
2.
3.
4.
5.

DENTAL AND PERIODONTAL
TREATMENT
EXTRACTIONS: bicuspids, 8’s
Presurgical Orthodontics:
SURGERY
POST-SURGICAL ORTHODONTICS


Primary goals of Presurgical
orthodontics:
1.
2.
3.
4.
5.
6.

Position the teeth over their respective basal
bone
Align and level the teeth
Adjust for tooth size discrepancies
Correct rotated teeth
Divergence of roots adjacent to surgical sites
Co-ordination of upper and lower arch widths

SURGERY
 Is

Designed to reposition the basal bone
and/or dentoalveolar segments into more
normal interrelationships.

 The

aim is to provide the best functional
and aesthetic result and provide stability of
the achieved results


Post-surgical orthodontics
(after 2 to 6 weeks of surgery)
Objectives:
1. Final tooth alignment and root
parallelism
2. Maximal interdigitation
3. Ideal overjet and overbite
4. Centric relation = centric occlusion


Before

After

Before

After


Investigation
Clinical

Evaluation
Radiographic
Dental Model


Diagnosis
 Clinical

Examination
 Soft tissue measurements
 Radiographic Examination
 Cephlametric analysis
 Computer analysis


Clinical upper 1/3 –
rd

Forehead,

Orbits


Clinical- Middle 1/3rd
Nasal

Morphology
Zygomatic Prominance


Clinical Lower 1/3rd
Upper Lip




Length
Thickness
Nasonabial angle


Competence of lips
 Incisisal show


 Rest
 Smile

Mentolabial Sullus
 Chin Prominence



Cephlometric analysis


 Burstone’s

Analysis

 Hard

Tissue
 Soft Tissue


Dental Model analysis


Problem

List

Hard Tissue
 Soft Tissue



Treatment Plan
 Hard

Tissue Abnormalities
 Soft Tissue Abnormalities
 Patienjts chief complain


Treatment
 Presurgical

Ortho

 Surgery
 Post

surgical Orthodontist


Surgical Procedures
Total Procedure
Segmental Procedure


Total Procedure

Lefort I Osteotomy
Lefort II Osteotomy


Segmental Procedure
 Anterior

Maxillary Osteotomy
 (Cupar’s ) (Premaxilla)
 Posterior Maxillary Osteotomy
 Midline Osteotomy (3 piece maxilla)


Mandible
Total
Bilateral

Sagittal Split Osteotomy
IVRO (Intra oral vertical ramus
osteotomy
• Segmental

•Subapical Osteotomy

Genioplasty
Vertical
Reduction
Advancement

AP
Reduction
Advancement

Complications
Intraoperative

Bleeding
Greater palatine
Inferior Alveolar nerves
Damage to Vital structures
Inferior alveolar nerve
Infra orbital nerve

Post operative
 Pain
 Edema
 Difficulty

in mastication mouth opening
 Parasthesia, Anaesthesia
- Lip, Tongue
• Occlusion
• Patient Satisfaction

Thank you
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Objectives /certified fixed orthodontic courses by Indian dental academy

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Objectives /certified fixed orthodontic courses by Indian dental academy