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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2003 December;14(3):141-52
Diagnostic evaluation and presurgical orthodontic treatment. A case report
Silvestri A., Vernucci R. A., Paparo F.
Units of Orthodontics University La Sapienza of Rome, Rome, Italy
The treatment of a dental-maxillo-faccial skeletal malformation requsts the resource to combined orthodontic-surgical therapies for the resolution of skeletal malformation and dental malocclusion associated. Patient must be subjected to an accurate clinical and instrumental analysis to set more correctly as possible the pathology in the 3 plans of the space and to be able to reach to a correct diagnosis and to an appropriate treatment plane, with the relative prgnostic index. Uusual clinical procedure is made up of: anamnesis; extraoral, intraoral and functional clinical examination; a series of instrumental analyses: photographic, radiographic, cephalometric, functional examinations. On dental casts will be carried out the study of the occlusion and presurgical orthodontic programming. With orthodontic treatment will be eliminated all the dental component of the malformation, carrying out the occlusal reconstruction necessary to guarantee the stability of the result at the end of treatment. A clinical case is reported: patient shows a dento-skeletal III class, facial asimmetry with left mandibular deviation, alterated morphology of left condyle and temporomandibular joint hypomobility.
In conclusion complete diagnosis and close correlation between orthodontic and surgical treatment constitute the necessary condition in order to obtain valid aesthetic and functional results and to guarantee stability in time. Combined treatment must put like primary aim the complete rehabilitation of all the functions of stomatognathic apparatus. Aesthetics, being a part of such functions, will be one of the pont of view to consider: will be the re-balance of the total functionality of the stomatognathic apparatus to allow aesthetic reharmonization.