2013 Annual Session - Progressive Development of Class II in Teenagers / The Importance of Orthognathic Surgery in Orthodontics

Progressive Development of Class II in Teenagers

Progressive development of Class II skeletal and occlusal changes in teenagers is usually related to a few specific TMJ pathologies that cause condylar resorption and consequently progressive retrusion of the mandible. Jaw and occlusal mal-alignment usually accompany these TMJ pathologies as do other medical conditions such as TMJ pain, myofascial pain, headaches, earaches, tinnitus, vertigo, sleep apnea, etc. Diagnostic records, including MRI, provide information for diagnosis and treatment planning. The most common TMJ conditions causing condylar resorption and progressive Class II development include: Adolescent Internal Condylar Resorption (AICR), reactive arthritis, congenital deformities, trauma, TMJ ankylosis, and connective tissue/autoimmune diseases. Based on the diagnoses, specific treatment protocols (orthodontics, TMJ surgery, orthognathic surgery and other adjunctive procedures) can provide high-quality outcomes. Outcome studies will be presented to validate the predictability and stability of the treatment protocols presented.

Learning Objectives:

• Relate the diagnostic criteria for determining etiology and diagnoses of the common TMJ pathologies that cause progressive development of Class II in teenagers
• Develop the abilities to understand and establish appropriate treatment protocols that will provide optimal treatment outcomes
• Analyze the evidence-based outcome studies on the surgical treatment protocols recommended to treat specific TMJ pathologies as well as correct associated dentofacial deformities and malocclusions.

The Importance of Orthognathic Surgery in Orthodontics

Progress in orthodontics has been linked with the development of jaw surgery. Orthognathic surgery and distraction osteogenesis have enabled orthodontists to diagnose, plan and treat malocclusions in all three planes of space. A variety of malocclusions that were historically resistant to satisfactory correction can now be successfully treated with a surgical orthodontic approach. The ability of orthodontists to adequately improve facial esthetics, airway, jaw function, vertical, A-P and transverse skeletal deformities are dependent in many cases on collaboration with our oral surgical colleagues. With the current dwindling in the number of orthognathic surgery cases in the U.S., primarily due to third party issues as well as others, are treatment outcomes diminishing because of "compromise" treatment. What can be done?

Learning Objectives:

• Recognize the historical significance of orthognathic surgery in the development of orthodontics
• Relate the importance of utilizing orthognathic surgery for achieving optimal treatment results
• Analyze orthodontic principles in treating orthognathic surgical patients.