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Surgical Correction of Facial Deformities Varghese Mani

CHAPTER 1:Evolution of Face and Beauty Through Time
- Introduction
- Ancestry of Humans
  - Important Hominid Evolution
- Changes Through Time
- Evolution of Facial Beauty
  - Skull Face Proportion
- Do We Ever Reach Perfection?
CHAPTER 2:Etiology of Facial Deformities
- Introduction
- Etiological Factors
- Indication for Orthognathic Surgery
CHAPTER 3:Growth and Development of Face
- Introduction
- Remodelling and Displacement Combinations
- Facial Growth and Tooth Movement
- Growth of Dentofacial Complex in Adolescence
- Summary of Changing Features of Growing Face
- Summary of Developmental Sequence
CHAPTER 4:Surgical Anatomy of the Maxillofacial Region
- The Maxillae
- Mandible (Figures 4-1 and 4-2)
- Arterial Supply
  - Facial Artery
  - Internal Maxillary Artery
- Veins of the Head and Neck Region (Figure 4-3)
- Muscles of the Head and Neck
- Trigeminal Nerve (V Cranial Nerve) (Figure 4-4)
  - Upper Face
    - Clinical Notes
  - Lower Face
    - Clinical Notes
- Motor Innervation
  - Course and Branches
- Surface Anatomy and Surface Markings of the Head
CHAPTER 5:Surgical Cephalometric Analysis
- Introduction
- Cranium
  - Saddle Angle (Ba-S-N)
  - Length of the Cranial Base
- Maxilla
  - Measurement by Size
  - Measurement by Position
    - SNA
    - Point-A to N-Perpendicular
- Maxillary Dentoalveolar Measurements
- Mandible
  - Measure by Size
  - Orientation of the Mandible
    - Angle of the Mandible
    - Mandibular Plane Angle
- Mandibular Dentoalveolar Measurements
- The Chin
- Dental
- Maxilla-Dental
  - Intermaxillary Orientation
  - Intermaxillary Orientation
CHAPTER 6:Evaluation of the Patient
- Introduction
- Medical Evaluation
- Evaluation of Oral Cavity
- Psychological Evaluation
- Esthetic Evaluation of the Patient
- Cephalometric Analysis
CHAPTER 7:Identification of the Deformity
- Introduction
  - Classification
- Maxillary Deformity
  - Maxillary Excess (Figures 7-2A to C)
    - Clinical Findings
    - Cephalometric Findings
  - Maxillary Deficiency (Figures 7-3A to C)
    - Cephalometric Findings
    - Maxillary Transverse Deformities
- Mandibular Deformity
- Deformities of Chin
- Bite Deformities
- Facial Asymmetry (Figures 7-8 and 7-9)
CHAPTER 8:Treatment Planning
- Introduction
- Possibilities and Limitations of Orthognathic Surgery
- Analysis
- Clinical Criteria for Identification of the Problem and Treatment Planning
- Treatment Planning
- Model Analysis
- Cephalometric Prediction Tracing
CHAPTER 9:Presurgical Orthodontics
- Introduction
- Class II Skeletal Malocclusion
  - Presurgical Orthodontic Approach
- Class III Skeletal Malocclusion
  - Presurgical Orthodontic Approach
- Cleft Lip and Palate
  - Presurgical Treatment Approach
- Postsurgical Orthodontics
CHAPTER 10:Model Surgery
- Introduction
- Presurgical Database
- Clinical Examination
- Impressions, Models, Face-Bow Transfer
- Mounting and Measuring Models
- Measuring Mounted Casts
  - Measuring the Maxilla
  - Measuring the Mandible
- Co-Relating the Database, Cephalometric Tracing and Model Surgery
- Treatment Schemes
- Summary
CHAPTER 11:Anesthesia for Orthognathic Surgery
- Introduction
- Anesthetic Considerations
- Preoperative Assessment and Planning
- Preparation of the Patient and Premedication
- Induction of Anesthesia
- Positioning
- Maintenance of Anesthesia
- Autologous Transfusion
- Acute Normovolemic Hemodilution
CHAPTER 12:Surgical Treatment
- Introduction
- Principles of Surgical Treatment
- Maxillary Surgery
- Mandibular Surgery
- Case Reports
CHAPTER 13:Unilateral Cleft Lip
- Introduction
- Classification
- Treatment Protocol
- Complications
  - Other Problems
- Acknowledgement
CHAPTER 14:Primary Cleft Palate Repair
- History
- General Consideration
- Anatomy
  - Nerve Supply of the Muscles of the Palate
- Classification of Cleft Palates
- Timing for Surgery
  - Feeding
- Anesthesia
  - Anesthesia and Positioning
  - Infiltration
- Procedure
  - The Use of the Vomerine Flap
  - Suturing
- Early Postoperative Complications
- Prevention of Complications
- Speech
- Acknowledgement
CHAPTER 15:Alveolar Bone Grafting
- Introduction
- Incidence and Etiology
  - Incidence of Cleft Lip and Palate
- Clinical Features of an Alveolar Cleft
- Rationale for Grafting
- Philosophies in Alveolar Bone Grafting
- Surgical Procedures
  - Primary Bone Grafting
  - Secondary Bone Grafting
- Grafting Material And Donor Sites
- Presurgical Orthodontic Care
- Surgical Technique (Figures 15-1 to 15-5)
- Complications in Alveolar Bone Grafting
- Outcomes in Secondary Grafting and Assessment
CHAPTER 16:Orthognathic Surgery for Deformities Secondary to Cleft Lip and Palate Repair
- Introduction
- Orthognathic Surgery
- Conclusion
- Case Report
CHAPTER 17:Facial Asymmetry
- Introduction
- Congenital Deformities
  - Hemifacial Microsomia
  - Plagiocephaly
- Developmental Deformities
- Injury to the Mandible
- Degeneration of Joint
- Clinical Assessment of Facial Asymmetry (figure 17-7)
  - Radiographic Findings
- Treatment Modalities
- Cast Prediction
- Principles of Treatment in Facial Asymmetry
- Camouflage
  - Maxillary Asymmetry
- Extended Lateral Sliding Genioplasty
CHAPTER 18:Orthognathic Surgery for TMJ Disorders: Condylar Hyperplasia and Condylar Resorption
- Introduction
- Condylar Hyperplasia
  - Etiology and Pathogenesis
  - History and Clinical Presentation
- Condylar Resorption
- Summary
CHAPTER 19:Surgical Management of Apertognathia
- Introduction
- Etiologic Factors
  - Skeletal Influences Resulting in Vertical Skeletal Imbalance
- Diagnostic Aids
- Model Studies
- Treatment Modalities
- Case Reports
CHAPTER 20:Midface Deformity
- Introduction
- Evaluation of the Patient
- Treatment Planning
- Le Fort II Osteotomy
  - Surgical Planning
  - Surgical Procedure
- Le Fort III Osteotomy
- Modified Le Fort III Osteotomy
  - Surgical Technique
    - Osteotomy (Figures 20-3A and B and 20-4)
  - Wound Closure
- Transcranial Le Fort III
CHAPTER 21:Distraction Osteogenesis
- Distraction Osteogenesis: The Biologic Process
- The Scientific Foundation of Distraction
- Factors Determining the Process of Distraction
  - Bone Factors
  - Distraction Factors
- Indication for Distraction Osteogenesis
- Contraindications
- The General Protocol
  - Preoperative Work Up
- The Distraction Device
  - External Distractors
    - Advantages
    - Disadvantages
  - Internal Fixators
    - Advantages
    - Disadvantages
- Operative Procedure
- POSTOPERATIVE PROTOCOL
- Complications
CHAPTER 22:Temporomandibular Joint in Orthognathic Surgery
- Introduction
- Causes of Incorrect Occlusion in the Intraoperative and Immediate Postoperative Phase
- Author's Note
- CONCLUSION
CHAPTER 23:Rhinoplasty
- Introduction
- Rhinoplasty: Various Types
- Assessment and Patient Counselling
- Surgical Approaches
  - Open Approach
  - Closed Approaches
- Common Surgical Steps
- Specific Clinical Situations and the Procedures
- COMPLICATIONS
CHAPTER 24:Troubleshooting in Orthognathic Surgery
- Introduction
- Vascular Complications
- Infections
  - Oronasal/Oroantral Fistula and Sinus Infections
- Nerve Injuries
  - Facial Nerve
- Soft Tissue/Morphologic Changes
- Occlusal Disturbances and Relapse
- Wrong Splits
- Temporomandibular Joint Problems
- Ocular Complications
CHAPTER 25:Ankylosis of the Temporomandibular Joint
- Introduction
- Anatomy of TMJ
  - True Ankylosis
  - False Ankylosis
- ETIOLOGY
- Clinical Features
- Radiological Investigations
- Management of TMJ Ankylosis
- Functional Correction
- Esthetic Correction
  - Surgical Correction Techniques
    - Ramus Osteotomies
    - Extended Lateral Sliding Genioplasty
- CONCLUSION
CHAPTER 26:Informed Consent for Orthognathic Surgery
- Introduction
- Definition and Principles of Informed Consent
- History and Theory of Informed Consent2
- Types of Informed Consent4
- Informed Consent in Orthognathic Surgery
- Informed Consent and Negligence in Orthognathic Surgery
- Defense for Noninformation
- Exceptions for the Use of Informed Consent
  - Informed Consent for Clinical Trials and New Techniques
- Conclusion

INDEX

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Chapter Notes