Abstract

Aesthetics in the Contemporary Ortho-Surgical Treatment. A Few Numbers and a Lot of Sensibility

by Melhem Elias Fernando

Throughout the years, orthodontists and surgeons have focused on cephalometric and facial analyzes for planning ortho-surgical treatment, as they allow objective calculations of the required dentoskeletal movements and the impact on the soft tissue profile. However, contemporary concepts of ortho-surgical planning may comprise some subjectivity to match the standards of facial harmony and the patient’s wishes. Therefore, sensibility is crucial for a well conducted planning. This presentation is about the art and science of ortho-surgical treatment, expressed by the connection between facial aesthetics and the head posture, cranial base and jaw relationships, dental occlusion, shape and dimension of the dental arches. Inputs of a rationale ortho-surgical planning will be presented, comprising some of the 12 steps of an innovative universal protocol for orthognathic surgery 3D virtual simulation: 1, bite registration; 2, facial imaging; 3, recording of neutral head position (NHP); 4, dental arch impressions; 5, CT scanning; 6, image segmentation; 7, creation of the composite skull; 8, orientation of the composite skull to the NHP; 9, landmark placement and cephalometric analyses; 10, surgical simulation; 11, sequencing of the actual surgery; 12, fabrication of the surgical guides.

Learning Objectives

After this lecture, you will be able to recognize the impact on facial aesthetics produced by the head posture, cranial base and jaw relationships, dental occlusion, shape and dimension of the dental arches.
After this lecture, you will be able to define a strategy for a rationale ortho-surgical treatment, guided by the balance between numbers and sensibility.
After this lecture, you will be able to incorporate into clinical practice some innovative concepts of a universal protocol for orthognathic surgery 3D virtual simulation.