Dentofacial and Maxillofacial Deformities-part1

Dentofacial and maxillofacial deformities are common in the general population, ranging from mild abnormalities of the teeth to extensive and widespread deformities involving the entire face and skull. Perhaps no other area in plastic surgery yields as gratifying and as outstanding aesthetic and functional results than the treatment of dentofacial and maxillofacial deformities. The plastic surgical treatment of deformities of the teeth and jaws requires a multidisciplinary team approach, often involving an orthodontist and other dental specialists. Although many deformities of the teeth can be corrected by orthodontic treatment alone, more extensive deformities require a surgical approach to treating dentofacial and maxillofacial deformities requires special expertise in the care of jaw problems, as well as in the treatment of soft tissue deformities of the face. Typically, both the soft and hard tissues of the face, along with the teeth and bite, need to be considered in formulating a definitive treatment plan, which will lead to the best outcome.

Conditions Treated

	Upper Jaw	Lower Jaw
	Long face with gummy smile Upper jaw deficiency Short face deformity Open bite Upper and lower jaw asymmetry Cleft lip and palate Craniofacial deformities and trauma Maxillofacial deformities and traum	Lower jaw protrusion Lower jaw recession Chin deformities Sleep apnea Lower jaw fractur

Systematic Evaluation of the Patient
with Dentofacial and Maxillofacial Deformities

Seeing a patient with extensive deformities of the teeth and jaws requires a systematic evaluation.The normal proportions of the face, the orbital region, as

well as the nose, lips, and mouth, must all be evaluated (Fig. 1).In addition, functional problems with the bite (Fig. 2), problems with dental hygiene such as recession of gums, abnormalities of the teeth, and functional compromise of the airway, such as sleep apnea, must be accounted for during the initial patient consultation. Computerized facial imaging may be recommended to assess the potential treatment modalities and their relative benefits. Together with the orthodontist and dental specialist, if necessary, a formal treatment plan is established.

Fig. 2: Definitions of the normal and abnormal bite (occulusion).

Class I: normal
Class II: lower teeth too far behind upper teeth;usually associated with a recessed lower jaw.
class III: lower teeth in front of upper teeth; usually associated with a recessed upper or protrusive lower jaw.

Associated Aesthetic Facial Concerns

	Frequently patients with abnormalities of the teeth and jaws present with associated aesthetic facial problems. One of the most common complaints is related to the appearance of the nose. Older patients also present with a variety of aesthetic concerns. In patients with small recessed lower jaws and chins, the appearance of the neck is often the presenting complaint. Extra tissue and skin gathers earlier in such patients and may be dramatically improved by simply advancing the lower jaw or chin. Often, however, additional soft tissue surgery such as suction-assisted lipectomy, endoscopic face and neck lift, and conventional facelift procedures may be necessary.

Computer Imaging

	Computer imaging is available to "picture" anticipated postoperative changes in facial appearance. At Pediatric Plastic Surgery & Craniofacial Associates, a state-of-art computer imaging system is available to give patients a better idea of the results that might be achieved by surgical intervention.

For consultations send us an E-mail at appointments@ppsca.com
or
call us at 1-800-615-1323

Pediatric Plastic Surgery and Craniofacial Associates (PPSCA),
a division of Atlanta Plastic Surgery P.C.


	Chin Deformities		Trauma to the Jaws
	Upper Jaw Deformities		Pre-Prosthetic Surgery
	Lower Jaw Deformities		Distraction Ostogenesis
	Combined Upper and Lower Jaw Deformities