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Orthognathic Surgery. Techniques, tips & tricks.

Orthognathic Surgery. Techniques, tips & tricks.

Name: Orthognathic Surgery. Techniques, tips & tricks.
Brand: Lisermed
SKU: 979-13-990060-8-7
Price: 145 EUR
Availability: InStock

Autor: Johan P. Reyneke

145,00 €

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Master the art of mandibular sagittal ramus osteotomy with this essential manual by world-renowned expert Prof. Johan Reyneke. Drawing from thousands of successful cases, this guide transforms complex 3D data into a safe, clinical, step-by-step surgical maneuver.

Perfectly illustrated and thoroughly detailed, the manual goes beyond basic technique to provide "tricks of the trade" for avoiding and managing complications. Whether you are a trainee building a foundation or an experienced surgeon seeking to improve predictability and safety in dysgnathia corrections, this book offers a rare opportunity to learn directly from a global "guru" of orthognathic surgery.

Detalles del producto

Disciplina/s:: Cirugía oral y maxilofacial
Idioma:: Inglés
Encuadernación:: Tapa Dura
Edición:: 1ª Edición
Año de publicación:: 2025
Número de páginas:: 225

Marca Lisermed

Referencia 979-13-990060-8-7

isbn 979-13-990060-8-7

Índice de contenidos

PART 1: THE BILATERAL SAGITTAL SPLIT MANDIBULAR RAMUS OSTEOTOMY

SURGICAL APPROACH

Step 1. Infiltrate the area of the intendid soft tissue dissection with a vasoconstrictor

Step 2. Soft tissue incision

Step 3. Buccal subperiosteal dissection

Step 4. Superior subperiosteal dissection

Step 5. Medial subperiosteal dissection

Step 6. Identifi cation of the lingula 34

PERFORMING THE OSTEOTOMY

Step 7. Medial ramus osteotomy

Step 8. Vertical vertical ramus osteotomy

Step 9. Prepare for the vertical buccal osteotomy

Step 10. Buccal osteotomy of the mandibular body

Step 11. Drill the holes for the placement of a holding wire

Step 12. Drill a purchase hole for the condylar positioner* and place reference marks perpendicular to the vertical osteotomy line

SPLITTING THE RAMUS OF THE MANDIBLE

Step 13. Define the osteotomy cut with an osteotome

Splitting the mandible

Step 14. Starting the split

Step 15. Completion of the split

The bad split

1. Fracture of the buccal cortex of the body of the mandible

2. Fracture of the buccal cortex involving the body and ramus of the mandible, and continues to the coronoid process

3. The vertical osteotomy on the medial aspect of the mandibular ramus fractures anterior to the inferior alveolar foramen

4. Fracturing the segment of bone distal to the second molar

Step 16. Stripping the pterygo-masseteric sling

Step 17. Stripping the medial pterygoid muscle and stylomandibular ligament for setback procedures

Step 18. Removal of impacted third molars

PREPARATION FOR REPOSITIONING THE DISTAL SEGMENT

Step 19. Contour contact areas of the bone segments

Step 20. Placement of a holding wire (018”)

Step 21. Note the position of the inferior alveolar neurovascular bundle

Step 22. Note the position of the third molar tooth (socket)

Step 23. Lavage

Step 24. Splitting the opposite side

Step 25. Mobilize the distal segment

Step 26. Selective odontoplasty and placement of a intermaxillary fixation

Step 27. Removal of bone for mandibular setback procedures

PROXIMAL SEGMENT REPOSITIONING

Step 28. Condylar positioning

PLACEMENT OF RIGID FIXATION

Step 29. Tightening the holding wire

Step 30. Placement of the trocar

Step 31. Placement of rigid fixation. Bicortical screws

Step 31. Plate fixation

Step 32. Remove the intermaxillary fi xation and check the occlusion

EVALUATION OF POST FIXATION OCCLUSION

Step 33. Intra operative diagnosis of an incorrect occlusion

A. Incorrect condylar positioning (condilar sag)

1. Central condilar sag

1.1. Bilateral central condylar sag

1.2. Unilateral central condylar sag left side

1.3. Unilateral condylar sag right side

2. Peripheral condylar sag type I

3. Peripheral condylar sag type II

3.1. Bilateral peripheral condylar sag

3.2. Unilateral peripheral condylar sag right

3.3. Unilateral peripheral condylar sag left

B. Mobility at the osteotomy site

C. Movement of the occlusion during placement of rigid fixation

D. Maloclusion as a result of a poorly fitted final surgical splint

COMPLETE THE PROCEDURE

Step 5. Place intra- and extra-oral sutures

Step 6. Place elastics – 4Oz, 1/4”

Step 7. Place a pressure dressing 95

PART 2: THE LEFORT I MAXILLARY OSTEOTOMY

SURGICAL APPROACH

Step 1. Infi ltrate the soft tissue with a vasoconstrictor

Step 2. Mucosal incision

Step 3. Complete the soft tissue incision through the muscle and periosteum onto bone

Step 4. Subperiosteal dissection

Step 5. Intraoral reference marks & extraoral measurements

PERFORMING THE OSTEOTOMY

Step 6. Anterior buccal osteotomy

Step 7. Posterior buccal osteotomy

Step 8. Connect the anterior and posterior osteotomies

Step 9. Prepare for buttress wires

Step 10. Separate the tuberosity from the pterygoid plates

Step 11. Complete and refi ne the posterior maxillary osteotomy

Step 12. Lateral nasal wall osteotomy

Step 13. Complete the soft tissue incision on the contralateral side and perform the osteotomies on the opposite side

Step 14. Place a maxillary positioning wire

Step 15. Complete the subperiosteal nasal spine dissection

Step 16. Septal cartilage and vomer osteotomy

MAXILLARY DOWN FRACTURE

Step 17. Maxillary down fracture

FAILURE TO EFFECT MAXILLARY DOWN FRACTURE

Step 18. Redefine the osteotomies

Step 19. Mobilize the maxilla

Step 20. Exposure of the posterior maxilla

Step 21. Check the level of the fracture

Step 22. Trim the lateral nasal wall

Step 23. Refine the osteotomy at the posterior maxilla

REFINE THE OSTEOTOMY

Step 24. Reduce the palatal aspect (nasal floor) of the septum

Step 25. Contour the piriform rim

Step 26. Feed positioning wires through the drilled holes

INTERMAXILLARY FIXATION

Step 27. Place the splint and apply intermaxillary fixation

Step 28. Check the nasal septum position

MAXILLARY REPOSITIONING

Step 29. Reposition the maxilla

Step 30. Turbinectomy (if necessary)

Step 31. Nasal mucosa suturing

Step 32. Tighten the buttress wires

Step 33. Rigid fixation placement

SEGMENTAL MAXILLARY SURGERY

1. Interdental osteotomies

2. Nasal floor (palatal) osteotomy

3. Closing interdental spaces

4. Fixation and stabilization after segmental osteotomies

EVALUATE THE OCCLUSION

Step 34. Remove the intermaxillary fi xation and carefully check the occlusion

POST-PROCEDURAL SUTURING

Step 35. Place a cinch and nasal septum suture

Step 36. Submucosal suturing

Step 37. Mucosal suturing

PROCEDURE COMPLETION

Step 38. Placing elastics or intermaxillary fixation

Step 39. Apply a pressure dressing

Step 40. Extubation

PART 3: THE SLIDING GENIOPLASTY

SURGICAL APPROACH

Step 1. Infiltration of the soft tissue with a vasoconstrictor

Step 2. Mucosal incision

Step 3. Submucosal incision

Step 4. Mucoperiosteal dissection

Step 5. Mark reference points

Step 6. Mark the design of the osteotomy

PERFORMING THE OSTEOTOMY

Step 7. Osteotomy of the chin

MOBILIZING THE CHIN SEGMENT

Step 8. Mobilisation of the chin

Step 9. Engage the positioning wire

Step 10. Reduction of soft tissue tension

Step 11. Refinement of the osteotomy

ANTEROPOSTERIOR AUGMENTATION OF THE CHIN

Step 12. Repositioning the chin segment

INTERNAL RIGID FIXATION OF THE CHIN SEGMENT

Step 13. Tri-cortical fixation

Step 14. Placement of the tricortical screwss

BONE PLATE FIXATION

Step 15. Bone plate fixation as an alternative to screw fixation

ANTEROPOSTERIOR REDUCTION OF THE CHIN

Step 16. Antero-posterior reduction of chin prominence

VERTICAL AUGMENTATION OF THE CHIN

Step 17. Down graft of the chin segment

VERTICAL REDUCTION OF THE CHIN

Step 18. Vertical reduction of the chin

CORRECTION OF CHIN ASYMMETRY

Step 19. Correction of asymmetry of the chin

CORRECTION OF TRANSVERS CHIN DEFORMITIES

Step 20. Changing the width of the chin

1. Altering the posterior dimension of the chin: Widening (increasing the posterior width / Narrowing (decreasing the posterior width

2. Altering the anterior dimension of the chin: Widening (increasing the anterior dimension and squareness of the chin) / Narrowing (decreasing the anterior width and squareness of the chin)

COMPLETION OF THE PROCEDURE

Step 21. Suture the submucosal tissue

Step 22. Suture the mucosa

Step 23. Place a pressure dressing

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