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References

In: Naini FB, Gill DS (eds). Oxford: Wiley-Blackwell; 2017
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Bull R, Rumsey N.New York, Chicago: Springer-Verlag; 1988
Alanko OM, Svedström-Oristo AL, Tuomisto MT. Patients' perceptions of orthognathic treatment, well-being, and psychological or psychiatric status: a systematic review. Acta Odontol Scand. 2010; 68:249-260
Proothi M, Drew SJ, Sachs SA. Motivating factors for patients undergoing orthognathic surgery evaluation. J Oral Maxillofac Surg. 2010; 68:1555-1559
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Cunningham SJ, Hunt NP, Feinmann C. Psychological aspects of orthognathic surgery: a review of literature. Int J Adult Orthodon Orthognath Surg. 1995; 10:159-172
Edgerton MT, Knorr MJ. Motivational patterns of patients seeking cosmetic (aesthetic) surgery. Plast Reconstr Surg. 1971; 48:551-557
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Principles of orthognathic management of dentofacial discrepancies

From Volume 45, Issue 11, December 2018 | Pages 1048-1056

Authors

Kulraj S Achal

BDS, MJDF RCS(Eng), MClinDent, MOrth RCS(Eng), FDS RCS(Orth)

Consultant Orthodontist, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust

Articles by Kulraj S Achal

Farhad B Naini

Consultant Orthodontist, St George's and Kingston Hospitals, London, UK

Articles by Farhad B Naini

Daljit S Gill

BDS, BSc, MSc, FDS RCS, MOrth, FDS(Orth) RSC(Eng)

Consultant Orthodontist/Honorary Senior Lecturer, UCL Eastman Dental Institute, Honorary Consultant Orthodontist, Great Ormond Street Hospital, London

Articles by Daljit S Gill

Abstract

Abstract: Individuals with severe dentofacial discrepancies that are beyond the scope of conventional orthodontic treatment will often require a joint orthodontic-surgical approach to manage their malocclusion. This treatment approach involving orthodontics in combination with orthognathic surgery is used to manage severe underlying skeletal discrepancies in the anterior-posterior (AP), vertical and transverse dimensions. The purpose of this article is to highlight the principles of orthognathic treatment. The general dental practitioner (GDP) plays an important role in maintaining dental health, especially whilst patients are on the orthognathic care pathway. Patients may also seek the advice of the GDP about the possible benefits of such a treatment approach before deciding to embark upon treatment.

CPD/Clinical Relevance: It is important for GDPs to understand the principles of orthognathic management in order to support their patients through treatment.

Article

Individuals with severe dentofacial discrepancies, beyond the scope of conventional orthodontic treatment (ie orthodontic camouflage), will often require a joint orthodontic-surgical approach to managing their malocclusion.1 This treatment approach, involving a combination of orthodontic treatment with orthognathic surgery, is used to manage severe underlying skeletal and dental discrepancies in the anterior-posterior (AP) (such as severe Class II or Class III malocclusions), vertical (such as anterior open bites and deep overbites) and transverse dimensions (usually involving facial asymmetries and severe crossbites/scissors bites).1 Treatment of this nature is usually started when facial growth has slowed, and timed such that the pre-surgical orthodontics have been completed and patients are ready for surgery, when their growth is significantly reduced or stopped, usually at about 17−18 years in females and over 18−19 years in males.2 However, it is prudent for orthodontists to assess each patient individually, sometimes with growth charts, as growth patterns vary and these timings may not be correct for all patients.2

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