Combined Treatment : Surgery

and Orthodontics Treatment

R. Rama Putranto
1
., Takagi Y
2
.,
Moriyama K.
APDC,20027
For patient whose orthodontic problem are so
severe that neither growth modification nor
camouflage offer a solution
And surgical realignment of the jaws or
repositionng of dentoalveolar segments is the
only possible treatment
Indication
Orthodontcs Surgery could improved and stabilized
the orthodontics treatment
Aims :
Type of Maloclussion :
1. Tooth origin anomali
2. Bone (skeletal) origin Anomali
3. Combined from Tooth and bone (skeletal)
APDC,2007
Type of surgical-orthodontics
Treatment
Correction of anteroposterior
Correction of Vertical Relationships
Correction of Transverse Relationships
Dentofacial anomaly and
TMJ
Mastication
Digestive
Team Work
General doctor, general dentist, Periodontist,
Prosthodontist, Orthodontist and Maxillofacial surgeon
APDC,2007
Surgery indication :
Dentofacial anomaly
1. Mastication function
2. Facial Estethics
3. Stabilitation after treatment
Motivation of
Patient
APDC,2007
Case I.
-Female
-13 years and 11 Months
Chief Complaint :
To corrected the anterior cross bite
Clinical, Model study, and Radiography analysis :
Profil from side was concave
Midline shift to the left 4,5 mm
Molar relation klas III Angle and Left canine relation klas II and right
klas III
Sefalometric Analysis ANB 5
o
APDC,2007
APDC,2007
The Aims of the Treatment
1. Corection of maxilla and madible relations
2. Corection of Skeletal class III relation
3. Corection of Overbite and overjet
4. Corection of midline discrepancy
5. Oclusal adjustment
6. Stabilized of the treatment result
Orthodontics surgery treatment posibility
APDC,2007
Progrees Report
1. Maxilla Arch width expantion
RPE
2. Palatal arch Stability
3. Growth observation
Fixed appliance setting
4. Rediagnosa Surgery indication /no
5. Mandibule surg.
SSRO
6. Orthodontics treatment after surgery
7. Periodic control
APDC,2007
After surgery simulation / prediction
APDC,2007
Pre Orthognatic surgery
Post orthognatic Surgery
APDC,2007
Periodic control of 2 years
Sefalometric analysis before and after surgery
APDC,2007
Cases II.
-female
-23 years
Chief Complaint :
To corection of prognatic mandible and open bite
APDC,2007
Side profil was concave
Anterior teeth lingual inklination and mild crowded
Midline shift to the left 4,5 mm
molar relation class III Angle dan canine relation was class II dan
right class III
Sefalometri analysis ANB 3,5
o
high angle case Openbite
Tomography analysis Clicking
APDC,2007
Clinical, Model study, and Radiography analysis :
1. Corection of maxilla and madible relations
2. Corection of class III angle relation
3. Corection of overbite and overjet
4. Correction of crowded
5. Corecction of oclusal function
6. Correction of clicking
7. Stability of the treatment result
APDC,2007
The Aims of the Treatment
Orthodontics surgery treatment posibility
Progrees Report
1. Maxilla expantion
2. Pembuatan Splint TMJ
3. Fixed app. setting Tooth Correction
4. Rediagnosa
Surgery
5. Mandible surgery SSRO
6. Orthodontic treatment after surgery
7. Periodic control
Crowding etc
Positioning Plate
APDC,2007
APDC,2007
After surgery simulation / prediction
Positioning Plate
APDC,2007
Before treatment
Two years after surgery (control)
APDC,2007
facial change
APDC,2007