The Retrospective Study Of Orthognathic Surgery For Dentofacial Deformity

Dentofacial deformities is the abnormity of the jaw's volume and form, the abnormal relationship between the mandible and maxilla, the abnormal relationship among the other cranio-facial bone, and concomitant abnormity of the occlusal relatioship, the stomatognathic system's function, and the facial configuration, causing by jaw's developmental abnormity. The etiological factor iscongenital, or acquired causes. Clinical situation is malocclusion and severe enough to affect facial proportions, influencing not only appearance, but also cause masticatory and speaking dysfunction, temporomandibular joint and psychological problem.Over the last few decades, with the significant advances in the study of dentofacial deformities, Orthognathic surgery have been emerged from maxillofacial surgery, providing a wide range of possibilities for the treatment of dentofacial deformities. The aim of orthognathic surgery is using combined orthodontic and sugical procedures to correct dentofacial malformations and provide improvement in oral function and facial aesthetics. With the development of anesthesiology, antibiotic, operative instrument and custodial equipment, the risk of operation is relative low. Because of the complexity of orthognathic and the other reasons, such as impropriate preoperative design, fault of anesthesia management or intraoperative procedure, negligence of postoperative nursing, numerous complications have also been reported, some of them may even cause serious results.The objectiove of this study is to investigate the methods of treatment for dentofacial deformity to achieve satisfactory facial appearance and occlusal relationship in the patients who were treated by orthognathic surgery, summarize the process of orthoganthic surgery in our department, study the prevention of postoperative complications. To investigate the classification, the methods of treatment for the mandibular asymmetry, to analyse the clinical importance of combined orthognathic surgery and orthodontics to get good corrective result and prevent the reoccurrence. To evaluate the ratio between soft and hard tissue on the horizontal plane and the postoperative skeletal stability in the patients who were treated bybilateral ramus sagittal split osteotomies (BSSRO) to setback the mandible.The study consists of three parts:Part one The Retrospective Study of Orthognathic Surgery for Dentofacial Deformitiy in 289 Patients289 cases of dentofacail deformity from 1985 to 2003, which have intact data in our department were analysed. The classification and diagnosis of the deformity, and the effects of therapy were investigated. Clinical examination and radiographs were taken before surgery and after surgery, temporomandibular joint (TMJ) function, and inferior alveolar nerve function were evaluated.As a result, 449 operations were used to correct dentofacial deformity, because of the complexity of the deforimity, most of the patients were treated by more than one kind of operation to get satisfactory appearance and function. Looking up 124 cases which have intact preoperative and posterative radiograph, 37 cases(29.8%) were treated by rigid fixation, 58 cases(46.8%) by steel wires, 21 cases (16.9%) were treated by combined rigid fixation and transosseous wiring, whereas 8 cases were treated by maxillomandibular fixation, not by inerosseous fixation. The wound of 282(282/289) cases were obtained first healing, the other cases got good results after dressing change or operation again. Life threatening complications were not enountered. The most frequent complication was impairment of inferior alveolar nerve(12/289), the second was malocclusion(10/289), Other complications were rare.Part two The Diagnosis and Surgical Treatment of Mandibular Asymmetry116 cases of mandibular asymmetry have been treated since 1985. The classification and diagnosis of the deformity, and the effects of therapy were evaluated. 116 cases was classified by 91 cases of developmental deformity and 25 cases of acquired deformity. 58 cases of developmental...