Orthodontics for the Oral and Maxillofacial Surgery Patient

173 Pages·2020·7.584 MB·English

by  Michael R. Markiewicz, Veerasathpurush Allareddy, Michael Miloro

Orthodontics for the Oral
and Maxillofacial Surgery
Patient
Editors
MICHAEL R. MARKIEWICZ
VEERASATHPURUSH ALLAREDDY
MICHAEL MILORO
ORAL AND MAXILLOFACIAL SURGERY
CLINICS OF NORTH AMERICA
www.oralmaxsurgery.theclinics.com
Consulting Editor
RUI P. FERNANDES
February 2020 • Volume 32 • Number 1
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ORALANDMAXILLOFACIALSURGERYCLINICSOFNORTHAMERICAVolume32,Number1
February2020ISSN1042-3699,ISBN-13:978-0-323-75426-2
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OrthodonticsfortheOralandMaxillofacialSurgeryPatient
Contributors
CONSULTING EDITOR
RUIP.FERNANDES,MD,DMD,FACS,
FRCS(Ed)
ClinicalProfessorandChief,DivisionofHead
andNeckSurgery,DepartmentsofOraland
MaxillofacialSurgery,Neurosurgery,and
OrthopaedicSurgeryandRehabilitation,
UniversityofFloridaHealthScienceCenter,
UniversityofFloridaCollegeofMedicine,
Jacksonville,Florida,USA
EDITORS
MICHAELR.MARKIEWICZ,DDS,MPH,MD, VEERASATHPURUSHALLAREDDY,BDS,
FACS PhD
ProfessorandChair,DepartmentofOraland BrodieCraniofacialEndowedChair,Professor
MaxillofacialSurgery,WilliamM.Feagans andHead,DepartmentofOrthodontics,
EndowedChair,AssociateDeanforHospital CollegeofDentistry,TheUniversityofIllinoisat
Affairs,SchoolofDentalMedicine,Clinical Chicago,Chicago,Illinois,USA
Professor,DepartmentofNeurosurgery,
MICHAELMILORO,DMD,MD,FACS
DivisionofPediatricSurgery,Departmentof
ProfessorandHead,DepartmentofOraland
Surgery,JacobsSchoolofMedicineand
MaxillofacialSurgery,CollegeofDentistry,The
BiomedicalSciences,UniversityatBuffalo,
UniversityofIllinoisatChicago,Chicago,
Co-Director,CraniofacialCenterofWestern
Illinois,USA
NewYork,JohnR.OisheiChildren’sHospital,
Buffalo,NewYork,USA
AUTHORS
SHELLYABRAMOWICZ,DMD,MPH,FACS SHARONARONOVICH,DMD,FRCD(C)
AssociateProfessor,OralandMaxillofacial DepartmentofOralandMaxillofacialSurgery,
SurgeryandPediatrics,Departmentof UniversityofMichigan,AnnArbor,Michigan,
Surgery,DivisionofOralandMaxillofacial USA
Surgery,EmoryUniversitySchoolofMedicine,
AssociateChiefofOralandMaxillofacial JENNIFERCAPLIN,DMD,MS
Surgery,Children’sHealthcareofAtlanta, AssociateDirector,Post-Graduate
EmoryUniversity,Atlanta,Georgia,USA Orthodontics,AssistantProfessor,
DepartmentofOrthodontics,Collegeof
VEERASATHPURUSHALLAREDDY,BDS, Dentistry,TheUniversityofIllinoisatChicago,
PhD Chicago,Illinois,USA
BrodieCraniofacialEndowedChair,Professor
andHead,DepartmentofOrthodontics, RICHARDSCOTTCONLEY,DMD
CollegeofDentistry,TheUniversityofIllinoisat PrivatePracticeofOrthodontics,Washington,
Chicago,Chicago,Illinois,USA Pennsylvania,USA
iv Contributors
MOHAMMEDH.ELNAGAR,DDS,MS,PhD MICHAELR.MARKIEWICZ,DDS,MPH,
DepartmentofOrthodontics,Collegeof MD,FACS
Dentistry,TheUniversityofIllinoisatChicago, ProfessorandChair,DepartmentofOral
Chicago,Illinois,USA andMaxillofacialSurgery,WilliamM.Feagans
EndowedChair,AssociateDeanfor
BRIANFARRELL,DDS,MD,FACS HospitalAffairs,SchoolofDentalMedicine,
PrivatePractitioner,CarolinaCenterforOral ClinicalProfessor,Departmentof
andFacialSurgery,Charlotte,NorthCarolina, Neurosurgery,DivisionofPediatricSurgery,
USA;ClinicalAssistantProfessor,Department DepartmentofSurgery,JacobsSchoolof
ofOralandMaxillofacialSurgery,Louisiana MedicineandBiomedicalSciences,University
StateUniversity,SchoolofDentistry,New atBuffalo,Co-Director,CraniofacialCenterof
Orleans,Louisiana,USA WesternNewYork,JohnR.OisheiChildren’s
Hospital,Buffalo,NewYork,USA
MICHAELD.HAN,DDS
AssistantProfessor,DepartmentofOral MOHAMEDI.MASOUD,BDS,DMSc
andMaxillofacialSurgery,TheUniversity Director,AdvancedGraduateOrthodontics,
ofIllinoisatChicago,Chicago,Illinois, AssistantProfessorofDevelopmentalBiology,
USA HarvardSchoolofDentalMedicine,Boston,
Massachusetts,USA
CHESTERS.HANDELMAN,DMD
DANIELJ.MEARA,MS,MD,DMD,
ClinicalProfessor,Departmentof
MHCDS,FACS
Orthodontics,CollegeofDentistry,The
Chair,DepartmentofOralandMaxillofacial
UniversityofIllinoisatChicago,Chicago,
SurgeryandHospitalDentistry,Christiana
Illinois,USA
CareHealthSystem,Wilmington,Delaware,
USA;AffiliateFaculty,DepartmentofPhysical
JASONP.JONES,DDS,MD
Therapy,UniversityofDelaware,Newark,
DepartmentofOralandMaxillofacialSurgery,
Delaware,USA
UTHealthSanAntonio,SanAntonio,Texas,
USA
LOUISG.MERCURI,DDS,MS
VisitingProfessor,Departmentof
LEONARDB.KABAN,DMD,MD
OrthopaedicSurgery,RushUniversityMedical
WalterC.GuralnickDistinguishedProfessor
Center,Chicago,Illinois,USA;Clinical
ofOralandMaxillofacialSurgery,Chief
Consultant,TMJConcepts,Ventura,California,
Emeritus,DepartmentofOraland
USA
MaxillofacialSurgery,Massachusetts
GeneralHospital,HarvardSchoolof
MICHAELMILORO,DMD,MD,FACS
DentalMedicine,Boston,Massachusetts,
ProfessorandHead,DepartmentofOraland
USA
MaxillofacialSurgery,CollegeofDentistry,The
UniversityofIllinoisatChicago,Chicago,
KATHERINEP.KLEIN,DMD,MS
Illinois,USA
Director,OrthodonticsandDentofacial
Orthopedics,MassachusettsGeneral SVENERIKNØRHOLT,DDS,PhD
Hospital,InstructorinOraland DepartmentofOralandMaxillofacialSurgery,
MaxillofacialSurgery,HarvardSchoolof AarhusUniversityHospital,ClinicalProfessor,
DentalMedicine,Boston,Massachusetts, SectionofOralMaxillofacialSurgery,Aarhus
USA University,Aarhus,Denmark
BUDIKUSNOTO,DDS,MS PETRAOLIVIERI,MD,DMD
DepartmentofOrthodontics,Collegeof Resident,DepartmentofOralandMaxillofacial
Dentistry,TheUniversityofIllinoisatChicago, Surgery,CaseWesternReserveUniversity,
Chicago,Illinois,USA Cleveland,Ohio,USA
Contributors v
THOMASKLITPEDERSEN,DDS,PhD CapeTown,SouthAfrica;ClinicalProfessor,
ClinicalProfessor,SectionofOrthodontics, DepartmentofOralandMaxillofacialSurgery,
AarhusUniversity,DepartmentofOraland UniversityofOklahoma,OklahomaCity,
MaxillofacialSurgery,AarhusUniversity Oklahoma,USA;AssociateProfessor,
Hospital,Aarhus,Denmark DepartmentofOralandMaxillofacialSurgery,
VNAIFacultyofDentistry,Universidad
DANIELE.PEREZ,DDS
NacionalAutonomadeMexico,SanSalvador,
DepartmentofOralandMaxillofacialSurgery,
Mexico
UTHealthSanAntonio,SanAntonio,Texas,
USA PETERSTOUSTRUP,DDS,PhD
AssociateProfessor,SectionofOrthodontics,
FAISALA.QUERESHY,MD,DDS,FACS
AarhusUniversity,Aarhus,Denmark
Professor,DepartmentofOraland
MaxillofacialSurgery,Director,Residency FLAVIOA.URIBE,DDS,MDentSc
Program,DepartmentofOralandMaxillofacial CharlesBurstoneProfessor,ProgramDirector
Surgery,CaseWesternReserveUniversity, andInterimChair,AssociateProfessor,
UniversityHospitalsClevelandMedicalCenter, DivisionofOrthodontics,Departmentof
Cleveland,Ohio,USA CraniofacialSciences,Universityof
Connecticut,UConnHealth,Farmington,
CORYM.RESNICK,DMD,MD,FACS
Connecticut,USA
AssistantProfessor,DepartmentofPlasticand
OralSurgery,BostonChildren’sHospital,Oral LARRYM.WOLFORD,DMD
andMaxillofacialSurgery,HarvardSchoolof ClinicalProfessor,DepartmentsofOraland
DentalMedicine,HarvardMedicalSchool, MaxillofacialSurgeryandOrthodontics,Texas
Boston,Massachusetts,USA A&MUniversityCollegeofDentistry,Baylor
UniversityMedicalCenter–PrivatePractice,
JOHANP.REYNEKE,MChD,FCOMFS(SA),
Dallas,Texas,USA
PhD
PrivatePractice,DirectoroftheCenterfor SUMITYADAV,MDS,PhD
OrthognathicSurgery,Mediclinic; AssociateProfessor,Departmentof
ExtraordinaryProfessor,DepartmentofOral CraniofacialSciences,Universityof
andMaxillofacialSurgery,FacultyofHealth ConnecticutSchoolofDentalMedicine,
Sciences,UniversityoftheWesternCape, Farmington,Connecticut,USA
OrthodonticsfortheOralandMaxillofacialSurgeryPatient
Contents
Preface: Orthodontics for theOraland Maxillofacial Surgery Patient xiii
MichaelR.Markiewicz,VeerasathpurushAllareddy,andMichaelMiloro
DigitalWorkflow for CombinedOrthodontics andOrthognathicSurgery 1
MohammedH.Elnagar,SharonAronovich,andBudiKusnoto
ThisarticleprovidesanoverviewofthedigitalworkflowprocessforCombinedor-
thodontics and Orthognathic surgery treatment starting from data acquisition (3-
dimensional scanning, cone-beam computed tomography), data preparation, pro-
cessingandCreationofathree-dimensionalvirtualaugmentedmodelofthehead.
EstablishingaProperDiagnosisandQuantificationoftheDentofacialDeformityus-
ing 3D diagnostic model. Furthermore, performance of 3-dimensional Virtual or-
thognathic surgical treatment, and the construction of a surgical splint (via 3-
dimensional printing) to allow transfer of the treatment plan to the actual patient
during surgery.
Orthodontic andSurgical Considerations forTreating Impacted Teeth 15
VeerasathpurushAllareddy,JenniferCaplin,MichaelR.Markiewicz,andDanielJ.Meara
Impactedteethoccurinasignificantnumberofpatients.Theirmanagementrequires
coordinated efforts of orthodontists and oral and maxillofacial surgeons. Specif-
ically, optimal results require a prompt orthodontic diagnosis and treatment plan
with execution of either closed or open exposure of impacted teeth by the oral
and maxillofacial surgeon. Failure to consider orthodontic mechanics and proper
surgicaltechniquecanleadtosuboptimalresults.Thus,orthodontist/oralandmaxil-
lofacialsurgeoncommunicationisessentialforsuccessandpatienteducationand
shareddecision-makingismandatorybeforeinitiatingtreatment.
TemporarySkeletal AnchorageTechniques 27
JasonP.Jones,MohammedH.Elnagar,andDanielE.Perez
Asorthodontictreatmenthasadvancedincomplexityandinfrequency,morerecent
techniques, using temporary skeletal anchorage, were developed to help correct
moresevereocclusalanddentofacialdiscrepanciesthatweretreatedwithorthog-
nathicsurgeryalonepreviously.Thesetechniqueshaveallowedtheorthodontistto
move teeth against a rigid fixation, allowing for more focused movementsof teeth
andfororthopedicgrowthmodification.Thesetypesoftreatmentsusingrigidfixa-
tionhaveallowedforgreaterinteractionbetweentheorthodontistandtheoraland
maxillofacial surgeon, and have vastly enhanced the treatment planning for the
orthodontistintoday’ssociety.
Interceptive Dentofacial Orthopedics (Growth Modification) 39
JenniferCaplin,MichaelD.Han,MichaelMiloro,VeerasathpurushAllareddy,
andMichaelR.Markiewicz
Althoughalldentofacialdeformitiesinvolvedeviationofskeletalanddentalunitsthat
require correction, the timing and method of treatment can vary considerably.
Contents
viii
Growth is a key consideration when managing dentofacial deformities, because it
has a direct impact on the timing and method of management. Some deformities
maybeinterceptedandmanagedduringgrowth,whereasotherscanonlybedefin-
itivelymanagedaftercessationofgrowth.Thisarticlefocusesonclinicalconsider-
ations of growth in managing dentofacial deformities, and discusses methods of
growth evaluation and interceptive orthodontic management strategiesindifferent
typesofdentofacialdeformities.
Surgical/Orthodontic Correction of TransverseMaxillary Discrepancies 53
JohanP.ReynekeandRichardScottConley
Thetransversedimensionisacriticalcomponentofcomprehensivetreatmentinor-
thognathicsurgery.Severaltreatmentapproachesexistandtheteammustconsider
thepatient’sneeds,desires,andlimitationswhenworkingtocorrectthemalocclu-
sion.Treatmentapproachesmayincludeonlyorthodonticexpansionorrapidpalatal
orthodontic expansion; however, in adults, the orthodontist may require surgical
assistancetoexpandthebonymaxilla.Segmentalmaxillaryexpansionmaybeindi-
catedinseveretransversedeficienciesofthemaxillaryarchordentofacialdeformity
patients also requiring vertical and sagittal corrections. The various treatment op-
tions, advantages, and disadvantages, and indications foreach surgical approach
arediscussed.
OrthognathicSurgeryandOrthodontics:InadequatePlanningLeadingtoComplications
orUnfavorable Results 71
KatherineP.Klein,LeonardB.Kaban,andMohamedI.Masoud
Complicationsinorthognathicsurgeryarecommonlyaresultofinadequatepreop-
erativeplanningandcommunicationbetweenthesurgeonandorthodontist.Unfa-
vorableoutcomescanoftenbeavoidedwhenoveralltreatmentgoalsalongwitha
surgicalandorthodonticplanaredevelopedandagreeduponbytheorthodontist,
surgeon,andpatientbeforethestartofactivetoothmovementoranysurgicalpro-
cedures.Continuousevaluationofthepatient’sprogressthroughouttreatmentand
subsequentcommunicationbetweenthesurgeonandorthodontistarerecommen-
ded to prevent frequent errors, such as inadequate dental decompensation, poor
appliance selection or management, and occasional contraindicated orthodontic
elastictractionortoothmovements.
DentoalveolarDistraction Osteogenesis for Rapid MaxillaryCanineRetraction: An
Overview ofTechnique, Treatment, andOutcomes 83
SumitYadav,MichaelR.Markiewicz,andVeerasathpurushAllareddy
Patients and orthodontists seek to reduce treatment time in braces. Rapid canine
retraction through dentoalveolar distraction osteogenesis is one of several treat-
mentapproachestoreduce treatmentinbraces.Thisarticle providesanoverview
oftechnique ofdentoalveolar distraction osteogenesis toaccomplish rapidcanine
retractionandassociatedoutcomes.Whenthistreatmentprotocolisimplemented
well, rapid canine retraction is achieved predictably with minimal side effects.
Although current evidence suggests that adverse sequelae, such as root resorp-
tions and pulp devitalization, are rare, prospective clinical studies that are
adequately powered and documenting long-term follow-up of these outcomes
are lacking.
Contents ix
Surgery-First Approachinthe OrthognathicPatient 89
FlavioA.UribeandBrianFarrell
The surgery-first approach (SFA) has become a recent alternative to the conven-
tional3-stageapproachtoorthognathicsurgery.Skeletalanchorageinorthodontics
hasfacilitatedtheresurgenceofthistreatmentsequence.Byeliminatingthepresur-
gical phase of orthodontic treatment, patients have immediate resolution to their
facialdeformity.Treatmentdurationhasbeenshowntobereduced;thedifference
withtheconventionalapproachbeingapproximately5months.Patientsatisfaction
with this approach is very high as measured by quality-of-life surveys. This article
describestheindicationsandstep-by-stepapproachofthistechniqueinconjunc-
tionwithvirtualsurgicalplanning.
Idiopathic CondylarResorption: WhatShouldWeDo? 105
LouisG.MercuriandChesterS.Handelman
Idiopathic condylar resorption (ICR), alternatively called progressive condylar
resorption,isanuncommonaggressiveformofdegenerativediseaseofthetempo-
romandibular joint seen mostly in adolescent and young women. ICR occurring
beforethecompletionofgrowthresultsinashortermandibularcondyloidprocess,
ramusandbody,compensatorygrowthatthegonialangleandcoronoidprocess,as
well as an increase in anterior facial vertical dimension. Management options dis-
cussed include oral appliances, orthodontics, medical management, orthognathic
surgerywithandwithoutdiscrepositioning,andalloplastictemporomandibularjoint
replacement.
Interdisciplinary Management ofDentofacial Deformityin JuvenileIdiopathic Arthritis 117
PeterStoustrup,ThomasKlitPedersen,SvenErikNørholt,CoryM.Resnick,
andShellyAbramowicz
Temporomandibular joint (TMJ) arthritis impacts mandibular growth and develop-
ment.Thiscanresultinskeletaldeformity,suchasfacialasymmetryand/ormaloc-
clusionasymmetry.ThisarticlereviewstheuniquepropertiesofTMJanddentofacial
growthanddevelopmentinthesettingofjuvenileidiopathicarthritis(JIA).Specific
orthopedic/orthodontic and surgical management of children with JIA and TMJ
arthritisisdiscussed.Theimportanceofinterdisciplinarycollaborationishighlighted.
ComprehensivePost Orthognathic Surgery Orthodontics: Complications,
Misconceptions, and Management 135
LarryM.Wolford
Post orthognathic surgery patient management is critical for high-quality and pre-
dictableoutcomes.Surgeonsandorthodontistsmusthavetheknowledgeandabil-
itytoimplementpostsurgicalmanagementprotocolsandstrategiestoprovidethe
best care and outcomes possible. This article presents basic concepts, philoso-
phies,treatmentprotocols,risks,andpotentialcomplicationsassociatedwithpost-
surgical patient management. Postsurgical orthodontic goals are to maximize the
occlusalfitandprovidepredictablemeanstoretaintheocclusion.Aggressiveortho-
dontic mechanics may be required to provide the best occlusal fit. Complications
canoccur,butearlyrecognitionofcomplicationsandimplementationofcorrective
tacticsshouldminimizeadverseoutcomes.
Contents
x
Aesthetic FacialSurgery andOrthodontics: CommonGoals 153
PetraOlivieri,FlavioA.Uribe,andFaisalA.Quereshy
Manyoftheaestheticfacialprocedurescanbeperformedsimultaneouslyatthetime
of initial orthognathic surgery. Correction of any residual deformities after surgery,
suchasmandibularnotching,malarasymmetry,labiomentalcrease,andanycam-
ouflagetreatment,shouldbeperformedasadelayedprocedure,whentheoutcome
is more predictable. Additionally, these procedures could be used to enhance the
orthodonticresult,withouttheneedofosteotomiestorepositionthebones.