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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ORTHOGNATHIC SURGERY 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 www.indiandentalacademy.com
ORTHOGNATHIC SURGERY 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” www.indiandentalacademy.com
ORTHOGNATHIC SURGERY ITS EVOLUTION Modern era Central Europe 1950’s Vienna, Graz, North Berlin, Hamburg.
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ORTHOGNATHIC SURGERY ITS EVOLUTION Trauner’s contributions (1955) Inagurator of several procedures trained Heinz Kole & Hugo Obwegeser
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ORTHOGNATHIC SURGERY ITS EVOLUTION Martin Wassmund (Berlin) • Developed anterior maxillary osteotomy • Described lefort I osteotomy (1927) • Trained Karl Schuchhardt
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ORTHOGNATHIC SURGERY ITS EVOLUTION Karl Schuchhardt (1955) Posterior maxillary osteotomy Improved by Kufner to enable total mobilisation of the segment
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ORTHOGNATHIC SURGERY ITS EVOLUTION Heinz Kole (1959) Graz Several innovations • Bimaxillary alveolar surgery • Deep bite correction • Open bite closure • Genioplasty • Extensive literature contribution www.indiandentalacademy.com
ORTHOGNATHIC SURGERY ITS EVOLUTION Hugo Obwegeser (Zurich) Sagittal split of the mandible (1955) opened new dimension in mandibular surgery Dal Pont (1958) improved the method
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ORTHOGNATHIC SURGERY ITS EVOLUTION Hugo Obwegeser (Zurich) Undoubtedly single greatest contributor to orthognathic surgery in the world
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ORTHOGNATHIC SURGERY ITS EVOLUATION Hugo Obwegeser Numerous contributions • • • •
Sagittal split osteotomy Large series of Le fort I ostetomy (1969) Le fort I osteotomy in cleft cases Total maxillary & mandibular osteotomies www.indiandentalacademy.com
ORTHOGNATHIC SURGERY ITS EVOLUTION Paul Tessier (France 1967) Developed craniofacial surgery in europe. Particularly Le fort III osteotomy www.indiandentalacademy.com
ORTHOGNATHIC SURGERY ITS EVOLUTION Application of rigid, semi rigid fixation of bony segments. B.spiessl was the first to apply rigid fixation in orthognathic surgery (1974) www.indiandentalacademy.com
ORTHOGNATHIC SURGERY ITS EVOLUTION Caldwell & Letterman (1954) Vertical sub sigmoid osteotomy
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ORTHOGNATHIC SURGERY ITS EVOLUTION
H.Luhr (1979) H. Luhr introduced mini bone plates in orthognathic surgery
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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 www.indiandentalacademy.com
ORTHOGNATHIC SURGERY ITS EVOLUTION What did plastic surgeons contribute ? • • • • •
Blepharoplasty Rhinoplasty Rhitidectomy Liposuction Lip corrections www.indiandentalacademy.com
ORTHOGNATHIC SURGERY 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
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ORTHOGNATHIC SURGERY ITS EVOLUTION Current scenario “It is a grown up speciality and an important part of oral, maxillofacial and facial plastic surgery”
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ORTHOGNATHIC 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”
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ORTHOGNATHIC SURGERY 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
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ORTHOGNATHIC SURGERY 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. www.indiandentalacademy.com
ORTHOGNATHIC SURGERY ITS EVOLUTION William H. Bell Provided biologic evidence for the success of maxillary osteotomies with his research on vascularity of maxilla.
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ORTHOGNATHIC SURGERY 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 www.indiandentalacademy.com
ORTHOGNATHIC SURGERY ITS EVOLUTION Deric Henderson St. Thomas Hospital (London) Greatest contributor in the United Kingdom
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ORTHOGNATHIC SURGERY ITS EVOLUTION Norman Rowe Queen Mary Hospital (Roehampton )
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ORTHOGNATHIC SURGERY ITS EVOLUTION Harold Hargis coined the term orthognathic previously referred to as orthodontic corrective jaw surgery
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“Every
man owes some of his time to the upbuilding of the profession to which he belongs� Theodore Roosevelt
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ORTHOGNATHIC SURGERY ITS EVOLUTION Prof. C.Bhasker Rao Director Craniofacial Surgery S.D.M.C.D.S., Dharwad
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ORTHOGNATHIC SURGERY ITS EVOLUTION Developments which contributed to the growth of orthognathic surgery
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ORTHOGNATHIC SURGERY ITS EVOLUTION • • • • •
Rigid, semirigid fixation Vascular studies Bone grafts Antibiotics Anaesthetic techniques www.indiandentalacademy.com
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