Evolution of orthognathic surgery /certified fixed orthodontic courses by Indian dental academy

ORTHOGNATHIC SURGERY
ITS EVOLUTION
VILARY BLAIR & EDWARD ANGLE
1898 - 1906

• Osteoctomy of horizontal ramus
• Horizontal osteotomy of the ramus
• V.shaped osteotomy for open bite

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INDIAN DENTAL ACADEMY
Leader in continuing dental education


ITS EVOLUTION
“Blair’s contributions to orthognathic
surgery”
• Pioneer in orthognathic surgery
• Racial differences in planning
• Classification of jaw deformities
• Co-operation between surgeon & orthodontist

ITS EVOLUTION
Blair’s single significant contribution
(1907)
• “Treating of skeletal deformities is really
surgical work, but the earlier a competent,
congenial orthodontist is associated with the
case, the better it will be for both the surgeon
and the patient”

ITS EVOLUTION
Modern era
Central Europe 1950’s
Vienna, Graz, North Berlin, Hamburg.


ITS EVOLUTION
Trauner’s contributions (1955)
Inagurator of several procedures
trained Heinz Kole & Hugo
Obwegeser


ITS EVOLUTION
Martin Wassmund (Berlin)
• Developed anterior maxillary osteotomy
• Described lefort I osteotomy (1927)
• Trained Karl Schuchhardt


ITS EVOLUTION
Karl Schuchhardt (1955)
Posterior maxillary osteotomy
Improved by Kufner to enable total
mobilisation of the segment


ITS EVOLUTION
Heinz Kole (1959) Graz
Several innovations
• Bimaxillary alveolar surgery
• Deep bite correction
• Open bite closure
• Genioplasty
• Extensive literature contribution

ITS EVOLUTION
Hugo Obwegeser (Zurich)
Sagittal split of the mandible (1955) opened
new dimension in mandibular surgery
Dal Pont (1958) improved the method


ITS EVOLUTION
Hugo Obwegeser (Zurich)
Undoubtedly single greatest contributor to
orthognathic surgery in the world


ITS EVOLUATION
Hugo Obwegeser
Numerous contributions
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•
•
•

Sagittal split osteotomy
Large series of Le fort I ostetomy (1969)
Le fort I osteotomy in cleft cases
Total maxillary & mandibular osteotomies

ITS EVOLUTION
Paul Tessier (France 1967)
Developed craniofacial surgery in europe.
Particularly Le fort III osteotomy

ITS EVOLUTION
Application of rigid, semi rigid fixation of
bony segments.
B.spiessl was the first to apply rigid
fixation in orthognathic surgery (1974)

ITS EVOLUTION
Caldwell & Letterman (1954)
Vertical sub sigmoid osteotomy


ITS EVOLUTION

H.Luhr (1979)
H. Luhr introduced mini bone plates in
orthognathic surgery


ITS EVOLUTION
What are the advantages of rigid
fixation ?
• More rapid & easier
• Stabilization of segments better
• Patient convenience is greater
because no intermaxillary fixation
• Less danger for the patient

ITS EVOLUTION
What did plastic surgeons contribute ?
•
•
•
•
•

Blepharoplasty
Rhinoplasty
Rhitidectomy
Liposuction
Lip corrections

ITS EVOLUTION
Which way is the pendulum of progress ?
swung back to the United States of America
where orthognalthic surgery started about 100
years ago


ITS EVOLUTION
Current scenario
“It is a grown up speciality and an
important part of oral, maxillofacial and
facial plastic surgery”


ITS EVOLUTION
Indian situation
“Prof. M.S.N.Ginwalla started orthognathic
surgery in india in early sixities and credited
as father of orthognathic surgery in India”


ITS EVOLUTION
Maxillary procedure
Langenbeck (1859) did first maxillary osteotomy
for removal of nasopharyngeal polyp, the next
70 years it was used only for pathological
conditions


ITS EVOLUTION
K.H.Thoma (1883-1972)
Oblique osteotomy of the ramus
Father of oral pathology, defender of oral
surgery, and great teacher of oral medicine,
raised the standards, originated several surgical
techniques.

ITS EVOLUTION
William H. Bell
Provided biologic evidence for the success
of maxillary osteotomies with his research
on vascularity of maxilla.


ITS EVOLUTION
Bruce N. Epkar (Texas, U.S.A.)

Interested in the dynamics of bone metabolism and
facial skeletal surgery
- more than 200 scientific contributions
Created Fort worth cleft palate program
John Peer Smith hospital centre for correction of
facial deformities

ITS EVOLUTION
Deric Henderson
St. Thomas Hospital (London)
Greatest contributor in the United Kingdom


ITS EVOLUTION
Norman Rowe
Queen Mary Hospital (Roehampton )


ITS EVOLUTION
Harold Hargis coined the term orthognathic
previously referred to as orthodontic
corrective jaw surgery


“Every

man owes some of his
time to the upbuilding of the
profession to which he belongs”
Theodore Roosevelt


ITS EVOLUTION
Prof. C.Bhasker Rao
Director
Craniofacial Surgery
S.D.M.C.D.S., Dharwad


ITS EVOLUTION
Developments which contributed to the
growth of orthognathic surgery


ITS EVOLUTION
•
•
•
•
•

Rigid, semirigid fixation
Vascular studies
Bone grafts
Antibiotics
Anaesthetic techniques

Thank you
Leader in continuing dental education


Evolution of orthognathic surgery /certified fixed orthodontic courses by Indian dental academy

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Evolution of orthognathic surgery /certified fixed orthodontic courses by Indian dental academy