Orthognathic Surgery Principles and Practice 1st Edition by Jeffrey Posnick ISBN B00JBSPUTS 978-0323226899

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ISBN 10: B00JBSPUTS
ISBN 13: 978-0323226899
Author: Jeffrey Posnick

Capturing the latest thinking for the evaluation and treatment of dentofacial deformities, Orthognathic Surgery: Principles and Practice, covers the basic principles and concepts of dentofacial deformities along with planning, surgical techniques, surgical complications, classic patterns, and clinical presentations. Over 5,000 clinical photos and detailed art make this a valuable reference for clinical orthodontists, craniofacial surgeons, oral and maxillofacial surgeons, and residents in training.
“It is an excellent all round educational source for any practitioner and the owner of this text is unlikely to need any other textbook on orthognathic surgery.” Reviewed by J Murphy, British Dental Journal Jan 2015.
“..will be of interest to all orthodontic professionals who deal with the specialty of orthognathic surgery.” Reviewed by Antonio M. Miotti on behalf of European Journal of Orthodontics, July 2015

– The latest in surgical protocols for OMS and Orthodontics puts you at the forefront of the orthognathic surgery field.
– Logically organized material aids you prior to developing treatment plans or in surgery.
– Over 5,000 new photos and illustrations boost your understanding of key teaching points and surgical techniques.
– Over 40 videos from Dr. Posnick’s archive available on the companion website.

Orthognathic Surgery Principles and Practice 1st Table of contents:

Section 1: Basic Principles and Concepts

Chapter 1: The New Perspectives on the Face

What Constitutes a Face?

Facial Perspectives and Stages in the Life Cycle

Evolutionary Considerations

Craniofacial Growth and Development

Dysmorphic Faces

The Outer Limits in Facial Surgery

Making Blind People See Again

Prosopagnosia

The New Psychiatric Genetics

Artistic Perspective

Chapter 2: Pioneers and Milestones in the Field of Orthodontics and Orthognathic Surgery

Pioneers in the Field of Orthodontics

Early Pioneers in the Field of Orthognathic Surgery

Hugo L. Obwegeser: Development of the Standard Orthognathic Procedures*

William H. Bell: Experimental Studies to Confirm the Biologic Basis of the Standard Orthognathic Procedures*

Hans G. Luhr: Development of Plate and Screw Fixation for Craniomaxillofacial Surgery*

Paul Louis Tessier: Development of Craniofacial Surgery101,215,216

Conclusions

Chapter 3: Definition and Prevalence of Dentofacial Deformities

Prevalence of Jaw Deformities and Malocclusion

Orthognathic Procedures Performed on Hospitalized Patients in the United States

Conclusions

Chapter 4: Hereditary, Developmental, and Environmental Influences on the Formation of Dentofacial Deformities

Development of the Head and Neck

Syndromes and Anomalies that Include Dentofacial Deformities

Hereditary Tendencies in the Development of Dentofacial Deformities

Environmental and Neuromotor Effects on Skeletal Growth

Effects of Trauma on Skeletal Growth

Effects of Tumors and Growths on Skeletal Growth

Conclusions

Chapter 5: Orthodontic Considerations in the Evaluation and Treatment of Dentofacial Deformities

Orthodontic Treatment Philosophy

The Biologic Basis for Orthodontic Tooth Movement

Periodontal Ligament Structure and Function

Response of the Teeth and the Periodontium to Normal Occlusal Function

Orthodontic Tooth Movement

Conclusions

Chapter 6: Periodontal Considerations in the Evaluation and Treatment of Dentofacial Deformities

Teeth

The Tissues of the Periodontium

Aging and the Periodontium

Etiology of Periodontal Disease

Assessing the Individual’s Biologic and Anatomic Risk Factors

Potential Detrimental Effects of Orthodontic “Camouflage” Maneuvers on the Periodontium

Establishing a Healthy Periodontium and Periodontal Therapeutics

Adult Orthodontic Treatment

Conclusions

Chapter 7: Psychosocial Considerations in the Evaluation and Treatment of Dentofacial Deformities

Psychosocial Aspects to Consider Before Surgery

Body Dysmorphic Disorder

Psychological Functioning in the Individual With a Facial Deformity

Patient and Family Decision for or Against the Correction of a Dentofacial Deformity

Patient and Family Education Regarding Convalescence After Orthognathic Surgery

Patient-Centered Assessment of Surgical and Orthodontic Outcomes

Controversies Surrounding “Successful” Orthognathic Outcomes

Conclusions

Chapter 8: Speech, Mastication, and Swallowing Considerations in the Evaluation and Treatment of Dentofacial Deformities

The Neuromuscular Masticatory System

Mastication Mechanism

Swallowing Mechanism

Speech: Mechanism, Formation, and Assessment

Effects of Jaw Deformities with Malocclusion on Speech

Effects of Successful Orthodontics and Orthognathic Surgery on Speech

Conclusions

Chapter 9: Temporomandibular Disorders: Effects of Occlusion, Orthodontic Treatment, and Orthognathic Surgery

Incidence of Temporomandibular Disorders in the General Population and the Basic Treatment Approach

Mandibular Range of Motion

Review of Occlusal Factors and Association with Temporomandibular Disorders

Occlusal Conditions More Frequently Associated with Temporomandibular Disorders

Orthodontic Treatment and Its Effects on Temporomandibular Disorders

Association of Jaw Deformities, Orthognathic Surgery, and Temporomandibular Disorders

Brief Overview of Okeson’s Thinking About Temporomandibular Disorders and the Effects of Occlusion

Personal Thoughts About the Role of Open Joint Procedures for Temporomandibular Disorders

Conclusions

Chapter 10: Nasal Airway Considerations in the Evaluation and Treatment of Dentofacial Deformities

Frequent Causes of Chronic Obstructive Nasal Breathing

The Effects of Respiratory Pattern and Jaw Posture on Maxillofacial Growth

Simultaneous Management of Chronic Obstructed Nasal Breathing and the Presenting Dentofacial Deformity

Approaching the Nasal Airway Through Le Fort I Down-Fracture ( Video 1 and 2)

Management of Residual Postoperative Nasal Obstruction

Effects of Maxillary Arch Expansion and Nasal Floor Recontouring on the Airway

Comprehensive Approach to Chronic Nasal Airway Obstruction

Conclusions

Chapter 11: Anesthesia Techniques, Blood Loss/Fluid Replacement, Airway Management & Convalescence in the Treatment of Dentofacial Deformities

Use of Deliberate Hypotensive Anesthesia to Limit Blood Loss

Use of Hemorrhage Depressors to Limit Blood Loss

Deliberate Hypotensive Anesthesia Used in Orthognathic Surgery: Review of the Literature

The Need for Blood Replacement in Orthognathic Surgery

Perioperative Airway Management in the Patient with a Dentofacial Deformity

In-Hospital Convalescence After Orthognathic Surgery

At-Home Convalescence and Outpatient Care After Orthognathic Surgery

Patient Education Materials

Section 2: Planning, Surgical Technique, and Complications

Chapter 12: Orthognathic Surgery Treatment Planning

Part I: The Importance of Proportions and Symmetry to Establish Ideal Facial Aesthetics

Part II: Clinical Evaluation of the Patient with a Dentofacial Deformity

Chapter 13: Standard Analytic Model Planning for Orthognathic Surgery

Controversies Surrounding Model Planning for Orthognathic Surgery

Standard Facial Records for Orthognathic Surgery

Key Measurements Obtained via Direct Visual Examination to Define Planned Maxillary Surgical Change

Face-Bow Registration and Transfer to the Semi-Adjustable Articulator

Use of the Erickson Model Table to Define the Spatial Orientation of the Articulator-Mounted Maxillary Unit* (see Fig. 13-6)

Use of the Erickson Model Table to Define the Spatial Orientation of the Articulator-Mounted Mandibular Unit

Separation of the Maxillary Cast from the Articulator Base (see Fig. 13-7, A)

Segmentation of the Maxilla (see Fig. 13-7, A, B, and C)

Use of the Erickson Model Table Measurements to Reorient the Maxillary Cast (see Fig. 13-8, A through F)

Intermediate Splint Construction for the Positioning of the Maxilla During Operation (see Fig. 13-9, A through E)

Reorientation of the Mandibular Cast to Register the Final Occlusion (see Fig. 13-10, A and B)

Final Splint Construction for the Positioning of the Mandible During Operation (see Fig. 13-10, C through F)

Finishing of the Prefabricated Acrylic Splints (see Fig. 13-10, G and H, and Fig. 13-11, A and B)

Accuracy of the Described Analytic Model Planning Technique: Review of Study

Conclusions

Chapter 14: Mandible-First Analytic Model Planning for Orthognathic Surgery

Controversies Surrounding Centric Relation

Mandible-First Analytic Model Planning Technique

Technical Aspects of Executing the Mandible-First Approach During Orthognathic Surgery

Mandible-First Analytic Model Planning: Step-by-Step Approach

Case Presentations

Conclusions

Chapter 15: Sequencing of Orthognathic Procedures: Step-by-Step Approach

Description and Sequencing of Orthognathic and Other Frequent Simultaneous Procedures: Step-by-Step Approach

Conclusions

Chapter 16: Complications Associated with Orthognathic Surgery

General Considerations

Risks and Complications Specific to Sagittal Split Ramus Osteotomies of the Mandible

Risks and Complications Specific to Le Fort I Osteotomy

Risks and Complications Specific to the Oblique Osteotomy of the Chin (see Chapter 38)

Conclusions

Patient Education Materials

Chapter 17: Malocclusion after Orthodontics and Orthognathic Surgery: Prevention and Treatment Pitfalls

Sagittal Split Ramus Osteotomies of the Mandible: Skeletal Stability and Relapse

Le Fort I Osteotomy: Skeletal Stability and Relapse

Orthodontic Treatment: Dental Stability and Relapse

Management of Transverse Maxillary Deficiency: Techniques and Relapse Patterns

Conclusions

Chapter 18: Grafts Frequently Used During Orthognathic Surgery and for Adjunctive Procedures

Bone Grafting: Definitions and Options

Grafting Interpositional Defects and Gaps of the Mandible and the Maxilla

Grafting Condyle and Ascending Ramus Defects

Cartilage Grafting for Nasal Reconstruction

Alloplastic Grafts and Implants for the Augmentation of the Facial Skeleton

Conclusions

Section 3: Classic Patterns and Presentations of Dentofacial Deformity

Chapter 19: Primary Mandibular Deficiency Growth Patterns with or without Maxillary Arch Constriction

Functional Aspects

Clinical Characteristics

Dental Findings

Radiographic Findings

Treatment Indications and Objectives

The Role of Growth Modification in the Preadolescent Child

Orthodontic Camouflage Approach

Definitive Reconstruction

Postsurgical Orthodontic Maintenance and Detailing

Complications, Informed Consent, and Patient Education

Temporomandibular Disorders: The Effects of Orthodontics and Orthognathic Surgery

Conclusions

Chapter 20: Maxillary Deficiency with Relative Mandibular Excess Growth Patterns

Functional Aspects

Clinical Characteristics

Dental Characteristics

Radiographic Findings

The Role of Growth Modification in the Preadolescent Patient

Orthodontic Camouflage Approach

Surgical Camouflage Approach

Definitive Reconstruction

Postsurgical Orthodontic Maintenance and Detailing

Complications, Informed Consent, and Patient Education

Malocclusion after Orthodontics and Orthognathic Surgery

Temporomandibular Disorders: The Effects of Orthodontics and Orthognathic Surgery

Suboptimal Facial Aesthetics after Orthognathic Surgery

Conclusions

Chapter 21: Long Face Growth Patterns: Maxillary Vertical Excess with Mandibular Deformity

Functional Aspects

Clinical Characteristics

Dental Findings

Radiographic Findings

Etiologic Considerations

The Role of Growth Modification in the Preadolescent Patient

The Orthodontic Camouflage Approach

An Orthodontic Molar Intrusion Approach

Definitive Reconstruction

Surgical Planning Pitfalls

Postsurgical Orthodontic Maintenance and Maintenance

Complications, Informed Consent, and Patient Education

Malocclusion after Orthodontics and Orthognathic Surgery

Temporomandibular Disorders: Effects of Orthodontics and Orthognathic Surgery

Conclusions

Chapter 22: Asymmetric Mandibular Excess Growth Patterns

Hemimandibular Hyperplasia: Type I Condylar Hyperactivity

Hemimandibular Elongation: Type II Condylar Hyperactivity

Assessing Jaw Growth Maturity

High Partial Condylectomy Procedure for Active Condylar Hyperactivity

Presurgical Orthodontic Treatment

Surgical Approach

Complications, Informed Consent, and Patient Education

Malocclusion after Orthodontics and Orthognathic Surgery

Temporomandibular Disorders: The Effects of Orthodontics and Orthognathic Surgery

Conclusions

Chapter 23: Short Face Growth Patterns: Maxillomandibular Deficiency

Functional Aspects

Clinical Characteristics

Dental Findings

Radiographic Findings

Treatment Indications and Objectives

The Role of Growth Modification in the Preadolescent Patient

Definitive Reconstruction

Postsurgical Orthodontic Maintenance and Detailing

Complications, Informed Consent, and Patient Education

Malocclusion after Orthodontics and Orthognathic Surgery

Temporomandibular Disorders: The Effects of Orthodontics and Orthognathic Surgery

Conclusions

Chapter 24: Bimaxillary Dental Protrusive Growth Patterns with Dentofacial Disharmony

Functional Aspects

Clinical Characteristics

Dental Findings

Radiographic Findings

Treatment Pitfalls

Orthodontic Approach

Orthognathic and Dentoalveolar Surgical Approaches

Postsurgical Orthodontic Maintenance and Detailing

Complications, Informed Consent, and Patient Education

Malocclusion after Orthodontics and Orthognathic Surgery

Temporomandibular Disorders: The Effects of Orthodontics and Orthognathic Surgery

Conclusions

Chapter 25: Dentofacial Disharmonies in Adults: Reconstruction and Rejuvenation

Special Medical Considerations

Functional Assessment of Head and Neck Structures

Temporomandibular Disorders: Effects of Orthodontics and Orthognathic Surgery

Special Wound Healing Risk Factors

Comprehensive Dental Rehabilitation

Unique Orthodontic Treatment Considerations

Previous Suboptimal Facial Surgery

Facial Aging and Rejuvenation

Recovery in the Adult after Orthognathic Surgery

Conclusions

Chapter 26: Obstructive Sleep Apnea: Evaluation and Treatment

Rationale for Treatment

Diagnosis, Characterization, and Assessment of Obstructive Sleep Apnea Severity

Obstructive Sleep Apnea during Childhood: Diagnosis and Management

Managing the Airway during a Surgical Procedure in the Individual with Obstructive Sleep Apnea

Treatment Options for Obstructive Sleep Apnea

Conclusions

Section 4: Frequently Seen Malformations with Dentofacial Deformity

Chapter 27: Treacher Collins Syndrome: Evaluation and Treatment

Inheritance, Genetic Markers, and Testing

Considerations during Infancy and into Early Childhood

Dysmorphology with Treacher Collins Syndrome

Facial Growth Potential with Treacher Collins Syndrome

Classification of Temporomandibular Joint and Mandibular Malformation

Staging of Skeletal Reconstruction: Timing and Techniques

Indications for First-Stage Mandibular Reconstruction in the Newborn

Indications for First-Stage Mandibular Reconstruction during the Mixed Dentition

Nasal Reconstruction

Facial Soft-Tissue Reconstruction

External Ear Reconstruction

External Auditory Canal and Middle-Ear Reconstruction

Conclusions

Chapter 28: Hemifacial Microsomia: Evaluation and Treatment

Inheritance Pattern

Considerations during Infancy and into Early Childhood

Dysmorphology Associated with Hemifacial Microsomia

Facial Growth Potential with Hemifacial Microsomia

Classification of Temporomandibular Joint–Mandibular Malformation

Staging of Skeletal Reconstruction: Timing and Techniques

Consideration of First-Stage Mandibular Reconstruction during the Mixed Dentition

Facial Soft-Tissue Reconstruction

External Ear Reconstruction

External Auditory Canal and Middle-Ear Reconstruction

Conclusions

Chapter 29: Binder Syndrome: Evaluation and Treatment

Current Approach to Reconstruction

Skeletal Stability after Orthognathic Reconstruction

Controversies and Unresolved Issues

Conclusions

Chapter 30: Syndromes with Craniosynostosis: Evaluation and Treatment

General Considerations

Mutations in Craniosynostosis and Craniosynostosis Syndromes

Complex Craniosynostosis

Neurologic Aspects of Craniosynostosis

Effects of Midface Deficiency on the Upper Airway

Morphologic Considerations

Surgical Approach to Craniosynostosis Syndromes

Staging of Reconstruction for Crouzon Syndrome

Staging of Reconstruction for Apert Syndrome

Conclusions

Chapter 31: Selected Complex Malformations that Frequently Require Maxillofacial Reconstruction: Evaluation & Treatment

Klippel–Feil Anomaly

Down Syndrome (Trisomy 21 Syndrome)

Neurofibromatosis

Hemihyperplasia of the Face

Vascular Malformations

Velocardiofacial Syndrome

Conclusions

Section 5: Cleft Jaw Deformities

Chapter 32: Cleft–Orthognathic Surgery: The Unilateral Cleft Lip and Palate Deformity

Facial Growth Implications of Cleft Palate Repair in the Infant with Unilateral Cleft Lip and Palate

Coordinated Team Approach

Treatment Protocol

Timing of Orthognathic Surgery

Residual Deformities in the Adolescent with Unilateral Cleft Lip and Palate

Orthodontic Considerations in the Patient with Unilateral Cleft Lip and Palate with a Jaw Deformity

Immediate Presurgical Assessment

Orthognathic Approach for Unilateral Cleft Lip and Palate Deformities

Avoiding Pitfalls

Clinical Management after Initial Surgical Healing

Orthognathic Surgery for Unilateral Cleft Lip and Palate: Review of Study

Skeletal Stability after Modified Le Fort I for Unilateral Cleft Lip and Palate Deformity: Review of Study

Controversies and Unresolved Issues

Conclusions

Chapter 33: Cleft–Orthognathic Surgery: The Bilateral Cleft Lip and Palate Deformity

Facial Growth Implications of Cleft Palate Repair in the Infant with Bilateral Cleft Lip and Palate Deformity

Coordinated Team Approach

Treatment Protocol

Timing of Orthognathic Surgery

Residual Deformities in the Adolescent with Bilateral Cleft Lip and Palate

Orthodontic Considerations in the Bilateral Cleft Lip and Palate Patient with a Jaw Deformity

Immediate Presurgical Assessment

Orthognathic Approach for Bilateral Cleft Lip and Palate Deformities

Avoiding Pitfalls

Clinical Management after Initial Surgical Healing

Orthognathic Surgery for Bilateral Cleft Lip and Palate: Review of Study

Controversies and Unresolved Issues

Conclusions

Chapter 34: Cleft–Orthognathic Surgery: The Isolated Cleft Palate Deformity

Facial Growth Implications of Cleft Palate Repair in the Infant with Isolated Cleft Palate

Coordinated Team Approach

Treatment Protocol

Timing of Orthognathic Surgery

Residual Deformities in the Adolescent with Isolated Cleft Palate

Orthodontic Considerations in the Patient with Isolated Cleft Palate with a Jaw Deformity

Immediate Presurgical Assessment

Orthognathic Surgical Approach for Isolated Cleft Palate

Clinical Management after Initial Surgical Healing

Orthognathic Surgery for Isolated Cleft Palate: Review of Study

Controversies and Unresolved Issues

Conclusions

Section 6: Post-Traumatic Dentofacial Deformities

Chapter 35: Management of Secondary Jaw Deformities after Maxillofacial Trauma

Posttraumatic Temporomandibular Joint Ankylosis in the Pediatric Population

Posttraumatic Saddle-Nose Deformity

Posttraumatic Orthognathic Deformities

Posttraumatic Segmental Dentoalveolar Defects

Conclusions

Chapter 36: Idiopathic Condylar Resorption: Evaluation and Treatment

Theories of Etiology

Clinical Perspectives

Current Clinical Approach to Correction of the Secondary Jaw Deformities

Brief Overview of Author’s Current Thinking

Case Presentations

Conclusions

Section 7: Frequent Aesthetic Considerations in the Dentofacial Deformity Patient

Chapter 37: Aesthetic Alteration of the Chin: Evaluation and Surgery

Anatomy of the Chin

Aesthetics of the Chin

Biologic Foundation of Osseous Genioplasty

Frequent Patterns of Chin Deformities

Osseous Genioplasty: Surgical Technique

Achieving Favorable Chin Aesthetics

Avoiding Pitfalls during Chin Surgery

Complications and Unfavorable Results

Alloplastic Chin Augmentation

Conclusions

Patient Education Materials

Chapter 38: Aesthetic Alteration of the Nose: Evaluation and Surgery

Nasal Surface Anatomy

Classic Rhinoplasty Maneuvers

Facial versus Nasal Proportions and Effects on the Aesthetic Perspective

The Nasal Airway: Anatomy and Physiology

Anatomic Locations and Causes of Nasal Obstruction

Evaluation of the Nasal Airway

Surgical Approach to Open the Nasal Airway

Outcome Assessment of Surgery to Improve Nasal Breathing

Initial Rhinoplasty Consultation

Definitive Rhinoplasty Planning

Open versus Closed Approach to the Nose

Complications Associated with Rhinoplasty

Primary Septorhinoplasty: Step-by-Step Approach (Figs. 38-5 through 38-9)

Cleft Nasal Deformities

Congenital and Posttraumatic Saddle-Nose Deformities

Cocaine-Related and Autoimmune and Iatrogenic Saddle-Nose Deformities

Conclusions

Patient Education Materials

Chapter 39: Aesthetic Alteration of Prominent Ears: Evaluation and Surgery

Historic Perspective

Embryology and Anatomy

Timing of Surgery

Aesthetic Objectives

Surgical Principles

Surgical Technique (Figs. 39-3 through 39-9)

Otoplasty for Prominent Ears: Step-by-Step Approach

Assessment of Results

Complications and Suboptimal Aesthetic Results

Non-Surgical Correction of Prominent Ears in the Newborn

Conclusions

Patient Education Materials

Chapter 40: Aesthetic Alteration of the Soft Tissues of the Neck and Lower Face: Evaluation and Surgery

Aging of the Facial Soft-Tissue Envelope

Approach to Rejuvenation Surgery of the Neck and Lower Face

Facial Aging and Rejuvenation: Treatment Pitfalls

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