Article: Volume 43 Number 6 Page 550 - July/August 2016

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  Dent Update 2016; 43: 550-562

Oral and Maxillofacial Surgery:  An Overview of the Surgical Correction of Dentofacial Deformity

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Abstract: The correction of severe dentofacial discrepancies involving a combination of orthodontic and surgical therapies (termed ‘orthognathic treatment’) is commonplace. There is an abundance of evidence within this field but it is often inconsistent. This article is an evidence-based overview of such treatments and is aimed at the general dental practitioner. It will cover: the timing of treatment; the indications and risks associated with different surgical osteotomies; the magnitude of surgical movements that can be achieved with these procedures; and the importance of mandibular autorotation when planning treatment. Orthognathic treatment is considered to be the gold standard for comprehensive correction of severe dentofacial discrepancies. It is undertaken by a multidisciplinary team of clinicians involving, but not exclusive to, consultants in orthodontics and oral and maxillofacial surgery in secondary and tertiary medical centres throughout the United Kingdom.

Clinical relevance: It is imperative that general dental practitioners have a good understanding of orthognathic treatment in order to recognize when such treatments are indicated, to inform the patient of possible treatment modalities and to be able to discuss associated risks in order to make appropriate referrals. Since treatment timing and magnitude of surgical movements have a profound effect on stability of the treatment result, these must be carefully considered by all clinicians involved in patient care to minimize relapse potential.

Author notes: Ovais H Malik, BDS, MSc(Orth), MFDS RCS(Ed), MOrth RCS(Eng), MOrth RCS(Ed), FDS(Orth) RCS(Eng), Consultant in Orthodontics, University of Manchester Dental Hospital and Salford Royal NHS Foundation Trust, Stott Lane, Manchester, M6 8HD (ovaismalik@yahoo.com), David T Waring, BChD, MDentSci, MFDS RCS(Eng), MOrth RCS(Ed), FDS(Orth) RCS(Ed), Consultant in Orthodontics, University of Manchester Dental Hospital, Richard Lloyd, BDS, MB ChB, FDS RCS, FRCS, Consultant in Oral and Maxillofacial Surgery, Salford Royal NHS Foundation Trust, Sangeeta Misra, BDS, MFDS RCS(Eng), MOrth RCS(Eng), FDS(Orth) RCS(Ed), Consultant in Orthodontics, Barnsley General Hospital and Elizabeth Paice, BDS(Hons), MClinDent, MJDF RCS(Eng), MOrth RCS(Eng), FTTA in Orthodontics, University of Manchester Dental Hospital and Salford Royal NHS Foundation Trust, Stott Lane, Manchester, M6 8HD, UK.

Objective: To provide an overview of the surgical correction of dentofacial deformity.

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