[Skeletal discrepancies: could we avoid surgical procedures?]

[Dental complications during orthodontic preparation and orthognathic surgery]

INTRODUCTION

Orthodontic-surgical treatment can present risks to the dental organ and the periodontium. Despite the low incidence of such cases, these complications can compromise a treatment plan. Practitioners should be aware of these potential complications, take them into account during treatment in order to reduce their negative impact and, if necessary, manage them by orthodontic-surgical collaboration.

MATERIALS AND METHODS

In this article, the authors present several potential complications that can occur during treatment.

CONCLUSION

The information given to the patient about the risks inherent in the implementation of an orthodontic-surgical protocol must necessarily include the risks of lesion to the dental organ and the periodontium.

[Orthognathic surgery: the incisor decompensation and its effect on articulation]

INTRODUCTION

The surgical protocols are based on arches preparation before or immediately after the surgical phase. Incisor guides normalization is achieved by incisor decompensation in three dimensions. Place and extend of surgical movements depend on the incisor position obtained at the end of orthodontic preparation. Extraction versus non extraction depends on incisor position planning. Orthognathic surgery induces muscular and temporo-mandibular joint stress which can cause temporo mandibular dysfunction (TMD).

OBJECTIVES

This article studies relations between incisor decompensation amplitude, orthognathic surgical procedures and risk to create or to increase TMD.

CONCLUSIONS

Sagittal, vertical and transversal incisor decompensation impact to place and amplitude of surgical movements. Incisor decompensation does not seem to induce TMD during orthodontic preparation even if occlusal guide controls are lost. Temporo mandibular dysfunction degrees define surgical movements area, moderate specially mandibular surgical movements and incisor decompensation objectives.

[Aesthetic success in genioplasties procedures criteria]

Maxillomandibular dysmorphia may be associated with structural chin pathologies. Three-dimensional jaws displacements have limits. Specific genioplasty is an additional surgical mean for soft tissues profile normalization. Osteotomy line is examined according an incline angle and a possible lateral extension, as chin wing technique, improves facial shape. Cephalometric set-up with R line analyzes surgical chin movements and impact of lower incisors labial inclination on lower lip and mentolabial fold after advancement genioplasty. Micro-implant anchorage is a precious help to find lower incisors good position and optimum lower occlusal plane frontal shift in asymmetric facial pattern. Orthodontics criteria are essential factors to access an aesthetic success in genioplasties procedures.