Concepts, protocol, variations and current trends in surgery first orthognathic approach: a literature review

Mahmood, Hafiz Taha; Ahmed, Maheen; Fida, Mubassar; Kamal, Adeel Tahir; Fatima, Farheen

doi:10.1590/2177-6709.23.3.36.e1-6.onl

Cited by 25 publications

(26 citation statements)

References 31 publications

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“…15-17 The 3D virtual planning and communication within the team were instrumental in re-directing our plan to a “surgery-early” approach. 18-20 In addition, the virtual planning allowed us to confidently proceed with an alternative approach for the management of the missing central and lateral incisors by space closure and dental substitutions. Limited gingivoplasties were performed for the substituted teeth in efforts to improve gingival symmetry and esthetics.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Rehabilitation of an Adult with a Cleft Lip and Palate: An Illustration of a Dental Substitution Approach for the Management of Unilateral Agenesis of Central and Lateral Incisors

Bous

Kumar

Valiathan

2021

FACE

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Cleft lip and Palate (CLP) is the most common craniofacial condition. Management of patients with clefts often requires multi-disciplinary rehabilitation of the orofacial structures. This case report demonstrates the multi-disciplinary management of an adult with a cleft lip and palate, highlighting the benefits of 3-Dimensional (3D) diagnosis, treatment planning and clinical execution of the plan. The patient presented with a severe maxillary deficiency, mandibular asymmetry, and congenitally missing maxillary right central and lateral incisors. This case report demonstrates an alternative approach for the management of cases with ipsilateral missing central and lateral incisors. The maxillary right canine substituted the congenitally missing maxillary right central incisor, while the maxillary right first premolar substituted the congenitally missing right lateral incisor, eliminating the need for prosthetic replacements. Total treatment time was 19 months, and the burden of care for the patient was minimized. An acceptable occlusion was achieved, and the patient’s esthetics improved significantly at the end of treatment. More importantly, the patient reported a marked improvement in his quality of life.

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Section: Discussionmentioning

confidence: 99%

Multidisciplinary Rehabilitation of an Adult with a Cleft Lip and Palate: An Illustration of a Dental Substitution Approach for the Management of Unilateral Agenesis of Central and Lateral Incisors

Bous

Kumar

Valiathan

2021

FACE

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“…CES University, in conjunction with the mentioned consortium [100], and with the Universidad del Valle [101] have applied SFEA schemes in Latin-American patients. SFEA rely on performing orthognathic surgery at the beginning of treatment with minimal preoperative orthodontics [102]. This treatment protocol allows the reduction in time of pre-surgical treatment (obtaining one-year reduction in average), with the patient's benefit of an early improvement in facial esthetics.…”

Section: Surgical Management Of Maxillo-mandibular Asymmetry: Alternative Strategies In the Correction Of Uclp And Application Of Surgerymentioning

confidence: 99%

Alternative Craniofacial Orthodontics Treatment Approaches for Differential Severity in Patients with Unilateral Cleft Lip with/without Palate

Gómez-Gil¹

2021

Recent Advances in the Treatment of Orofacial Clefts [Working Title]

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The treatment of patients with cleft lip with/without cleft palate is still a challenge for its correct team management. The fact that not all clefts are alike, based on anatomical findings and ortho/surgical alternatives used in their correction, requires that clinicians -working in interdisciplinary or multidisciplinary teams- direct efforts not only to repair the facial and oral characteristics of the cleft, but also to work in the context of the patient’s craniofacial growth and development, tri-dimensionally affected by this type of craniofacial difference. The first part of this chapter is focused on the diagnostic approach for patients with unilateral cleft lip and palate (UCLP), using a modified version of the GOSLON yardstick (GOSLON+) that considers not only dental components but also 3D facial aspects of a complex malocclusion originated from this congenital malformation. Second, current treatment alternatives based on patient’s stages of dental development and cleft width, using either straight-wire or passive self-ligation appliances are presented, directed to avoid dental prosthetic replacements if possible. Finally, our treatment algorithms summarized in a step-by-step fashion the treatment of such differences with approaches that will focus on these two key aspects, essential for a successful, patient-based, interdisciplinary treatment protocol.

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“…The differences detected by patients between the conventional orthognathic approach and the surgery-first one, in terms of satisfaction and quality of life was also investigated, using two questionnaires -Oral Health Impact Profile and Orthognathic Quality of Life Questionnaire. The presurgical orthodontic stage has been highly criticized for the long duration and other connected issues such dental diseases, deterioration in masticatory and speech functions, worsening of the facial aspect, as well as the negative psychological impact, arising from the delay in solving the patient's chief complaint (36,37).…”

Section: Orthognathic Patients' Quality Of Lifementioning

confidence: 99%

"Psychological status and quality of life of orthognathic patients – highlights in “surgery first” approach "

Costan¹,

Simionescu²,

Dragomir³

et al. 2020

BPI

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The aesthetic aspect, irrespective of the era and the dominant trend represent a defining element of the individuals' quality of life. Patients with dento -facial anomalies carry a more or less conscious stigma that gives them a psychological and social disadvantage. Along with oral health, speech and masticatory impairment, these persons experience different degrees of mental well-being alteration, affecting the entire spectrum that represents quality of life. Dento-skeletal anomalies, especially those involving the anterior region of the jaw can lead to a distorted perception of the entire body image and consequently to a lifelong negative influence. Individuals with negative facial body image view themselves as less outgoing and less socially skilled than those with positive facial image, independent of objective judgements of the individual's facial attractiveness. 78/Bulletin of Integrative Psychiatry New Series  March 2020  Year XXVI  No. 1 (84)Orthognathic surgery is typically planned in order to correct malocclusion and other functional impairment, but also to improve facial appearance and consequently the quality of life, often the main motivation of patients who choose this treatment and request a multidisciplinary approach, involving orthodontists, maxillofacial surgeons, psychologists, physiotherapists.

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Concepts, protocol, variations and current trends in surgery first orthognathic approach: a literature review

Cited by 25 publications

References 31 publications

Multidisciplinary Rehabilitation of an Adult with a Cleft Lip and Palate: An Illustration of a Dental Substitution Approach for the Management of Unilateral Agenesis of Central and Lateral Incisors

Multidisciplinary Rehabilitation of an Adult with a Cleft Lip and Palate: An Illustration of a Dental Substitution Approach for the Management of Unilateral Agenesis of Central and Lateral Incisors

Alternative Craniofacial Orthodontics Treatment Approaches for Differential Severity in Patients with Unilateral Cleft Lip with/without Palate

"Psychological status and quality of life of orthognathic patients – highlights in “surgery first” approach "

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