JOURNEY TO FACIAL HARMONY: COLLABORATION BETWEEN ORTHODONTIST AND SURGEON

DAY 1: 29.11.2024

1 - INITIAL EXAMINATION:

• Listening patients’ complaints

• Aesthetic and functional criteria for indication of orthognathic surgery

• Communication with the orthognathic surgery patient

2 - ARNETT’s FAB CONCEPT

• Considerations in the isolated occlusion planning

• Traditional Cephalometrics vs. Facially Driven Protocol

• Soft Tissue Cephalometric Analysis (STCA)

• Decision making process based in airway and face.

3 - ORTHODONTIC PREPARATION PRIOR TO ORTHOGNATHIC SURGERY

• Principles of a good orthodontic setup

  - Transversal: Arch width and curve of Wilson
  - Sagittal: Inclination and position of incisors
  - Vertical: Curve of Spee and canting

• Midlines

• Evaluation of arch length discrepancy - Bolton

• Decision of teeth extraction

• Selection of brackets and other attachments

• Evaluation of preoperative orthodontic preparation

• Application of surgical archwires

• Preoperative orthodontics with using clear aligners

4 - ANALYSIS OF THE CASE BEFORE THE SURGERY Importance and determination of natural head position

• Radiological examinations

• Clinical analysis

• Mirror Test

• Facial Markers

• Bite Registration

• CBCT Quality Control

• Understanding Patient’s expectations

5 - APPROACH TO SURGICAL PATIENTS WITH TMJ PROBLEMS

• TMJ considerations

• Preoperative splint therapy: When-How-Why?

• Construction and application stages of stabilization splints

6 - SURGICAL PLANNING

• How to be precise in the Head Volume Orientation

• Planning the surgical sequence: Mandible First vs. Maxilla First Sequence

• Multi-piece Le Fort I: When-How-Why?

• Three-dimensional virtual planning – Digital workflow

• Features of surgical splints

DAY 2 : 30.11.2024

7 - SPECIAL CONSIDERATIONS: FACIAL ASYMMETRIES

• Biological Symmetry vs. Geometric Symmetry

• Hard Tissues Analysis vs. Soft Tissues Response

• Facial Flow Concept: is it reasonable in surgical patients?

• Clinical Analysis and facial midline in asymmetries

• 3D Software requirements for precision in facial asymmetries

• Forced Symmetry Protocol

• Concomitant pathologies of the condyle - how to proceed?

8 - CONSIDERATIONS IN THE OPERATING ROOM (Tips and tricks)

• What should we take to the operating room?

• Sagittal Split of the mandible: design and how to be safe

• Passive checking of the mandibular position

• Multi Segmented Le Fort I: design and how to be safe

• Simultaneous transverse expansion - how to be stable?

• Soft tissue management

9 - ORTHODONTIC and SURGICAL FOLLOW UP

• Postoperative patient regimen

• Decision for intermaxillary fixation

• Protocol of post-op elastics: When-How-Why?

• Orthodontic finishing protocol

• Ensuring functional occlusion

10 - STABILIZATION AND RETENTION

• Fixed and removable retention devices: Which and Why?

• Causes of relapse

11 - CASE PRESENTATIONS and PANEL: Q/A