Orthodontics for the Oral and Maxillofacial Surgery Patient Editors MICHAEL R. MARKIEWICZ VEERASATHPURUSH ALLAREDDY MICHAEL MILORO ORAL AND MAXILLOFACIAL SURGERY CLINICS OF NORTH AMERICA www.oralmaxsurgery.theclinics.com Consulting Editor RUI P. FERNANDES February 2020 • Volume 32 • Number 1 ELSEVIER 1600JohnF.KennedyBoulevard(cid:1)Suite1800(cid:1)Philadelphia,Pennsylvania,19103-2899 http://www.oralmaxsurgery.theclinics.com ORALANDMAXILLOFACIALSURGERYCLINICSOFNORTHAMERICAVolume32,Number1 February2020ISSN1042-3699,ISBN-13:978-0-323-75426-2 Editor:JohnVassallo;[email protected] DevelopmentalEditor:LauraFisher ª2020ElsevierInc.Allrightsreserved. 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OrthodonticsfortheOralandMaxillofacialSurgeryPatient Contributors CONSULTING EDITOR RUIP.FERNANDES,MD,DMD,FACS, FRCS(Ed) ClinicalProfessorandChief,DivisionofHead andNeckSurgery,DepartmentsofOraland MaxillofacialSurgery,Neurosurgery,and OrthopaedicSurgeryandRehabilitation, UniversityofFloridaHealthScienceCenter, UniversityofFloridaCollegeofMedicine, Jacksonville,Florida,USA EDITORS MICHAELR.MARKIEWICZ,DDS,MPH,MD, VEERASATHPURUSHALLAREDDY,BDS, FACS PhD ProfessorandChair,DepartmentofOraland BrodieCraniofacialEndowedChair,Professor MaxillofacialSurgery,WilliamM.Feagans andHead,DepartmentofOrthodontics, EndowedChair,AssociateDeanforHospital CollegeofDentistry,TheUniversityofIllinoisat Affairs,SchoolofDentalMedicine,Clinical Chicago,Chicago,Illinois,USA Professor,DepartmentofNeurosurgery, MICHAELMILORO,DMD,MD,FACS DivisionofPediatricSurgery,Departmentof ProfessorandHead,DepartmentofOraland Surgery,JacobsSchoolofMedicineand MaxillofacialSurgery,CollegeofDentistry,The BiomedicalSciences,UniversityatBuffalo, UniversityofIllinoisatChicago,Chicago, Co-Director,CraniofacialCenterofWestern Illinois,USA NewYork,JohnR.OisheiChildren’sHospital, Buffalo,NewYork,USA AUTHORS SHELLYABRAMOWICZ,DMD,MPH,FACS SHARONARONOVICH,DMD,FRCD(C) AssociateProfessor,OralandMaxillofacial DepartmentofOralandMaxillofacialSurgery, SurgeryandPediatrics,Departmentof UniversityofMichigan,AnnArbor,Michigan, Surgery,DivisionofOralandMaxillofacial USA Surgery,EmoryUniversitySchoolofMedicine, AssociateChiefofOralandMaxillofacial JENNIFERCAPLIN,DMD,MS Surgery,Children’sHealthcareofAtlanta, AssociateDirector,Post-Graduate EmoryUniversity,Atlanta,Georgia,USA Orthodontics,AssistantProfessor, DepartmentofOrthodontics,Collegeof VEERASATHPURUSHALLAREDDY,BDS, Dentistry,TheUniversityofIllinoisatChicago, PhD Chicago,Illinois,USA BrodieCraniofacialEndowedChair,Professor andHead,DepartmentofOrthodontics, RICHARDSCOTTCONLEY,DMD CollegeofDentistry,TheUniversityofIllinoisat PrivatePracticeofOrthodontics,Washington, Chicago,Chicago,Illinois,USA Pennsylvania,USA iv Contributors MOHAMMEDH.ELNAGAR,DDS,MS,PhD MICHAELR.MARKIEWICZ,DDS,MPH, DepartmentofOrthodontics,Collegeof MD,FACS Dentistry,TheUniversityofIllinoisatChicago, ProfessorandChair,DepartmentofOral Chicago,Illinois,USA andMaxillofacialSurgery,WilliamM.Feagans EndowedChair,AssociateDeanfor BRIANFARRELL,DDS,MD,FACS HospitalAffairs,SchoolofDentalMedicine, PrivatePractitioner,CarolinaCenterforOral ClinicalProfessor,Departmentof andFacialSurgery,Charlotte,NorthCarolina, Neurosurgery,DivisionofPediatricSurgery, USA;ClinicalAssistantProfessor,Department DepartmentofSurgery,JacobsSchoolof ofOralandMaxillofacialSurgery,Louisiana MedicineandBiomedicalSciences,University StateUniversity,SchoolofDentistry,New atBuffalo,Co-Director,CraniofacialCenterof Orleans,Louisiana,USA WesternNewYork,JohnR.OisheiChildren’s Hospital,Buffalo,NewYork,USA MICHAELD.HAN,DDS AssistantProfessor,DepartmentofOral MOHAMEDI.MASOUD,BDS,DMSc andMaxillofacialSurgery,TheUniversity Director,AdvancedGraduateOrthodontics, ofIllinoisatChicago,Chicago,Illinois, AssistantProfessorofDevelopmentalBiology, USA HarvardSchoolofDentalMedicine,Boston, Massachusetts,USA CHESTERS.HANDELMAN,DMD DANIELJ.MEARA,MS,MD,DMD, ClinicalProfessor,Departmentof MHCDS,FACS Orthodontics,CollegeofDentistry,The Chair,DepartmentofOralandMaxillofacial UniversityofIllinoisatChicago,Chicago, SurgeryandHospitalDentistry,Christiana Illinois,USA CareHealthSystem,Wilmington,Delaware, USA;AffiliateFaculty,DepartmentofPhysical JASONP.JONES,DDS,MD Therapy,UniversityofDelaware,Newark, DepartmentofOralandMaxillofacialSurgery, Delaware,USA UTHealthSanAntonio,SanAntonio,Texas, USA LOUISG.MERCURI,DDS,MS VisitingProfessor,Departmentof LEONARDB.KABAN,DMD,MD OrthopaedicSurgery,RushUniversityMedical WalterC.GuralnickDistinguishedProfessor Center,Chicago,Illinois,USA;Clinical ofOralandMaxillofacialSurgery,Chief Consultant,TMJConcepts,Ventura,California, Emeritus,DepartmentofOraland USA MaxillofacialSurgery,Massachusetts GeneralHospital,HarvardSchoolof MICHAELMILORO,DMD,MD,FACS DentalMedicine,Boston,Massachusetts, ProfessorandHead,DepartmentofOraland USA MaxillofacialSurgery,CollegeofDentistry,The UniversityofIllinoisatChicago,Chicago, KATHERINEP.KLEIN,DMD,MS Illinois,USA Director,OrthodonticsandDentofacial Orthopedics,MassachusettsGeneral SVENERIKNØRHOLT,DDS,PhD Hospital,InstructorinOraland DepartmentofOralandMaxillofacialSurgery, MaxillofacialSurgery,HarvardSchoolof AarhusUniversityHospital,ClinicalProfessor, DentalMedicine,Boston,Massachusetts, SectionofOralMaxillofacialSurgery,Aarhus USA University,Aarhus,Denmark BUDIKUSNOTO,DDS,MS PETRAOLIVIERI,MD,DMD DepartmentofOrthodontics,Collegeof Resident,DepartmentofOralandMaxillofacial Dentistry,TheUniversityofIllinoisatChicago, Surgery,CaseWesternReserveUniversity, Chicago,Illinois,USA Cleveland,Ohio,USA Contributors v THOMASKLITPEDERSEN,DDS,PhD CapeTown,SouthAfrica;ClinicalProfessor, ClinicalProfessor,SectionofOrthodontics, DepartmentofOralandMaxillofacialSurgery, AarhusUniversity,DepartmentofOraland UniversityofOklahoma,OklahomaCity, MaxillofacialSurgery,AarhusUniversity Oklahoma,USA;AssociateProfessor, Hospital,Aarhus,Denmark DepartmentofOralandMaxillofacialSurgery, VNAIFacultyofDentistry,Universidad DANIELE.PEREZ,DDS NacionalAutonomadeMexico,SanSalvador, DepartmentofOralandMaxillofacialSurgery, Mexico UTHealthSanAntonio,SanAntonio,Texas, USA PETERSTOUSTRUP,DDS,PhD AssociateProfessor,SectionofOrthodontics, FAISALA.QUERESHY,MD,DDS,FACS AarhusUniversity,Aarhus,Denmark Professor,DepartmentofOraland MaxillofacialSurgery,Director,Residency FLAVIOA.URIBE,DDS,MDentSc Program,DepartmentofOralandMaxillofacial CharlesBurstoneProfessor,ProgramDirector Surgery,CaseWesternReserveUniversity, andInterimChair,AssociateProfessor, UniversityHospitalsClevelandMedicalCenter, DivisionofOrthodontics,Departmentof Cleveland,Ohio,USA CraniofacialSciences,Universityof Connecticut,UConnHealth,Farmington, CORYM.RESNICK,DMD,MD,FACS Connecticut,USA AssistantProfessor,DepartmentofPlasticand OralSurgery,BostonChildren’sHospital,Oral LARRYM.WOLFORD,DMD andMaxillofacialSurgery,HarvardSchoolof ClinicalProfessor,DepartmentsofOraland DentalMedicine,HarvardMedicalSchool, MaxillofacialSurgeryandOrthodontics,Texas Boston,Massachusetts,USA A&MUniversityCollegeofDentistry,Baylor UniversityMedicalCenter–PrivatePractice, JOHANP.REYNEKE,MChD,FCOMFS(SA), Dallas,Texas,USA PhD PrivatePractice,DirectoroftheCenterfor SUMITYADAV,MDS,PhD OrthognathicSurgery,Mediclinic; AssociateProfessor,Departmentof ExtraordinaryProfessor,DepartmentofOral CraniofacialSciences,Universityof andMaxillofacialSurgery,FacultyofHealth ConnecticutSchoolofDentalMedicine, Sciences,UniversityoftheWesternCape, Farmington,Connecticut,USA OrthodonticsfortheOralandMaxillofacialSurgeryPatient Contents Preface: Orthodontics for theOraland Maxillofacial Surgery Patient xiii MichaelR.Markiewicz,VeerasathpurushAllareddy,andMichaelMiloro DigitalWorkflow for CombinedOrthodontics andOrthognathicSurgery 1 MohammedH.Elnagar,SharonAronovich,andBudiKusnoto ThisarticleprovidesanoverviewofthedigitalworkflowprocessforCombinedor- thodontics and Orthognathic surgery treatment starting from data acquisition (3- dimensional scanning, cone-beam computed tomography), data preparation, pro- cessingandCreationofathree-dimensionalvirtualaugmentedmodelofthehead. EstablishingaProperDiagnosisandQuantificationoftheDentofacialDeformityus- ing 3D diagnostic model. Furthermore, performance of 3-dimensional Virtual or- thognathic surgical treatment, and the construction of a surgical splint (via 3- dimensional printing) to allow transfer of the treatment plan to the actual patient during surgery. Orthodontic andSurgical Considerations forTreating Impacted Teeth 15 VeerasathpurushAllareddy,JenniferCaplin,MichaelR.Markiewicz,andDanielJ.Meara Impactedteethoccurinasignificantnumberofpatients.Theirmanagementrequires coordinated efforts of orthodontists and oral and maxillofacial surgeons. Specif- ically, optimal results require a prompt orthodontic diagnosis and treatment plan with execution of either closed or open exposure of impacted teeth by the oral and maxillofacial surgeon. Failure to consider orthodontic mechanics and proper surgicaltechniquecanleadtosuboptimalresults.Thus,orthodontist/oralandmaxil- lofacialsurgeoncommunicationisessentialforsuccessandpatienteducationand shareddecision-makingismandatorybeforeinitiatingtreatment. TemporarySkeletal AnchorageTechniques 27 JasonP.Jones,MohammedH.Elnagar,andDanielE.Perez Asorthodontictreatmenthasadvancedincomplexityandinfrequency,morerecent techniques, using temporary skeletal anchorage, were developed to help correct moresevereocclusalanddentofacialdiscrepanciesthatweretreatedwithorthog- nathicsurgeryalonepreviously.Thesetechniqueshaveallowedtheorthodontistto move teeth against a rigid fixation, allowing for more focused movementsof teeth andfororthopedicgrowthmodification.Thesetypesoftreatmentsusingrigidfixa- tionhaveallowedforgreaterinteractionbetweentheorthodontistandtheoraland maxillofacial surgeon, and have vastly enhanced the treatment planning for the orthodontistintoday’ssociety. Interceptive Dentofacial Orthopedics (Growth Modification) 39 JenniferCaplin,MichaelD.Han,MichaelMiloro,VeerasathpurushAllareddy, andMichaelR.Markiewicz Althoughalldentofacialdeformitiesinvolvedeviationofskeletalanddentalunitsthat require correction, the timing and method of treatment can vary considerably. Contents viii Growth is a key consideration when managing dentofacial deformities, because it has a direct impact on the timing and method of management. Some deformities maybeinterceptedandmanagedduringgrowth,whereasotherscanonlybedefin- itivelymanagedaftercessationofgrowth.Thisarticlefocusesonclinicalconsider- ations of growth in managing dentofacial deformities, and discusses methods of growth evaluation and interceptive orthodontic management strategiesindifferent typesofdentofacialdeformities. Surgical/Orthodontic Correction of TransverseMaxillary Discrepancies 53 JohanP.ReynekeandRichardScottConley Thetransversedimensionisacriticalcomponentofcomprehensivetreatmentinor- thognathicsurgery.Severaltreatmentapproachesexistandtheteammustconsider thepatient’sneeds,desires,andlimitationswhenworkingtocorrectthemalocclu- sion.Treatmentapproachesmayincludeonlyorthodonticexpansionorrapidpalatal orthodontic expansion; however, in adults, the orthodontist may require surgical assistancetoexpandthebonymaxilla.Segmentalmaxillaryexpansionmaybeindi- catedinseveretransversedeficienciesofthemaxillaryarchordentofacialdeformity patients also requiring vertical and sagittal corrections. The various treatment op- tions, advantages, and disadvantages, and indications foreach surgical approach arediscussed. OrthognathicSurgeryandOrthodontics:InadequatePlanningLeadingtoComplications orUnfavorable Results 71 KatherineP.Klein,LeonardB.Kaban,andMohamedI.Masoud Complicationsinorthognathicsurgeryarecommonlyaresultofinadequatepreop- erativeplanningandcommunicationbetweenthesurgeonandorthodontist.Unfa- vorableoutcomescanoftenbeavoidedwhenoveralltreatmentgoalsalongwitha surgicalandorthodonticplanaredevelopedandagreeduponbytheorthodontist, surgeon,andpatientbeforethestartofactivetoothmovementoranysurgicalpro- cedures.Continuousevaluationofthepatient’sprogressthroughouttreatmentand subsequentcommunicationbetweenthesurgeonandorthodontistarerecommen- ded to prevent frequent errors, such as inadequate dental decompensation, poor appliance selection or management, and occasional contraindicated orthodontic elastictractionortoothmovements. DentoalveolarDistraction Osteogenesis for Rapid MaxillaryCanineRetraction: An Overview ofTechnique, Treatment, andOutcomes 83 SumitYadav,MichaelR.Markiewicz,andVeerasathpurushAllareddy Patients and orthodontists seek to reduce treatment time in braces. Rapid canine retraction through dentoalveolar distraction osteogenesis is one of several treat- mentapproachestoreduce treatmentinbraces.Thisarticle providesanoverview oftechnique ofdentoalveolar distraction osteogenesis toaccomplish rapidcanine retractionandassociatedoutcomes.Whenthistreatmentprotocolisimplemented well, rapid canine retraction is achieved predictably with minimal side effects. Although current evidence suggests that adverse sequelae, such as root resorp- tions and pulp devitalization, are rare, prospective clinical studies that are adequately powered and documenting long-term follow-up of these outcomes are lacking. Contents ix Surgery-First Approachinthe OrthognathicPatient 89 FlavioA.UribeandBrianFarrell The surgery-first approach (SFA) has become a recent alternative to the conven- tional3-stageapproachtoorthognathicsurgery.Skeletalanchorageinorthodontics hasfacilitatedtheresurgenceofthistreatmentsequence.Byeliminatingthepresur- gical phase of orthodontic treatment, patients have immediate resolution to their facialdeformity.Treatmentdurationhasbeenshowntobereduced;thedifference withtheconventionalapproachbeingapproximately5months.Patientsatisfaction with this approach is very high as measured by quality-of-life surveys. This article describestheindicationsandstep-by-stepapproachofthistechniqueinconjunc- tionwithvirtualsurgicalplanning. Idiopathic CondylarResorption: WhatShouldWeDo? 105 LouisG.MercuriandChesterS.Handelman Idiopathic condylar resorption (ICR), alternatively called progressive condylar resorption,isanuncommonaggressiveformofdegenerativediseaseofthetempo- romandibular joint seen mostly in adolescent and young women. ICR occurring beforethecompletionofgrowthresultsinashortermandibularcondyloidprocess, ramusandbody,compensatorygrowthatthegonialangleandcoronoidprocess,as well as an increase in anterior facial vertical dimension. Management options dis- cussed include oral appliances, orthodontics, medical management, orthognathic surgerywithandwithoutdiscrepositioning,andalloplastictemporomandibularjoint replacement. Interdisciplinary Management ofDentofacial Deformityin JuvenileIdiopathic Arthritis 117 PeterStoustrup,ThomasKlitPedersen,SvenErikNørholt,CoryM.Resnick, andShellyAbramowicz Temporomandibular joint (TMJ) arthritis impacts mandibular growth and develop- ment.Thiscanresultinskeletaldeformity,suchasfacialasymmetryand/ormaloc- clusionasymmetry.ThisarticlereviewstheuniquepropertiesofTMJanddentofacial growthanddevelopmentinthesettingofjuvenileidiopathicarthritis(JIA).Specific orthopedic/orthodontic and surgical management of children with JIA and TMJ arthritisisdiscussed.Theimportanceofinterdisciplinarycollaborationishighlighted. ComprehensivePost Orthognathic Surgery Orthodontics: Complications, Misconceptions, and Management 135 LarryM.Wolford Post orthognathic surgery patient management is critical for high-quality and pre- dictableoutcomes.Surgeonsandorthodontistsmusthavetheknowledgeandabil- itytoimplementpostsurgicalmanagementprotocolsandstrategiestoprovidethe best care and outcomes possible. This article presents basic concepts, philoso- phies,treatmentprotocols,risks,andpotentialcomplicationsassociatedwithpost- surgical patient management. Postsurgical orthodontic goals are to maximize the occlusalfitandprovidepredictablemeanstoretaintheocclusion.Aggressiveortho- dontic mechanics may be required to provide the best occlusal fit. Complications canoccur,butearlyrecognitionofcomplicationsandimplementationofcorrective tacticsshouldminimizeadverseoutcomes. Contents x Aesthetic FacialSurgery andOrthodontics: CommonGoals 153 PetraOlivieri,FlavioA.Uribe,andFaisalA.Quereshy Manyoftheaestheticfacialprocedurescanbeperformedsimultaneouslyatthetime of initial orthognathic surgery. Correction of any residual deformities after surgery, suchasmandibularnotching,malarasymmetry,labiomentalcrease,andanycam- ouflagetreatment,shouldbeperformedasadelayedprocedure,whentheoutcome is more predictable. Additionally, these procedures could be used to enhance the orthodonticresult,withouttheneedofosteotomiestorepositionthebones.