JDentalCare

07/08/2022

Many dentofacial deformities require surgery for both the maxilla and mandible to optimize occlusal function, facial esthetics, and long term stability of the results. Conventional treatment planning in double-jaw surgery either maintains the existing occlusal plane angulation or alters it by rotation of the mandible after vertical repositioning of the maxilla (superiorly or inferiorly). Although treatment according to these designs may achieve an acceptable relationship of the teeth in centric relation, it may on occasion not provide for optimum esthetics. When I treatment plan Orthognathic cases the most important factor is the patient’s “chief complaint” in determining what type of surgery I proceed with.
This is a case from last month. His chief complaint was, “I like having a strong jawline yet dying to bite into a burger.”

This case has to be a double jaw surgery, both the patient and I liked a strong chin and cheek bones. I felt that I could only get a great functional and esthetic result with a high LeFort 1 four-piece osteotomy advancement with a 9mm expansion, posterior maxillary impaction and clockwise rotation of the maxilla decreasing the steep mandibular plane angle and the bringing the anterior nasal spine slightly forward to give a beautiful rotation of the tip of the nose and prominent cheekbones.

Fortunately I trusted my intuition and the patient didn’t take my advice the wrong way, “Beauty is skin deep, Ugly goes to bone.”

Through orthognathic surgery, clockwise rotation of the maxillomandibular complex has been proposed for a better improvement on mandibular prognathism, inadequate smile arc, and upper incisor show. I adopted this from an innovative orthodontic concept and strategy of “orthodontic clockwise rotation of MMc” or “orthognathic camouflage” for patients with Class III malocclusion, therefore, developed my own version of “orthognathic camouflage”.

It’s important to remember when planning an Orthognathic case the most important factor in determining what type of surgery to proceed with is the patients “chief complaint” not what we perceive the problem to be. He can now enjoy biting into a burger rather than having to use his back teeth to enjoy it which was his “chief complaint”, the nicely rotated nose, lengthened lip and high cheek bones are an added bonus that he enjoys as an added bonus !

https://www.instagram.com/broumand_oralsurgery/

06/24/2022

06/20/2022

The ultimate dental implant challenge for any implant surgeon is reconstruction of the severely resorbed MAXILLA!
There is always an option, even without any bone, using Zygomatic and Pterygoid implants.
Here, we changed these patients' lives in just a day. These patients were each previously told that they weren’t candidates for dental implants due to severe bone loss. Thanks to the All-On X and the Quad-Zygoma with Pterygoids, we can now perform full arch implant rehabilitation immediately and deliver teeth for every patient on the day of surgery.
One-on-One Mentorships are available once a month. A licensed dentist in any state may obtain a temporary license to place Zygomatic and Pterygoid implants on a live patient under my mentorship and supervision.

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06/17/2022

With severe Dentaofacial and skeletal deformities, orthodontics combined with orthognathic surgery gives the best and stable result. Nowadays, we do all the treatment planning virtually and digitally giving more accurate and precise results than traditional model surgery and manual methods.
Recently many surgeons advocate surgery first and Orthodontics later while most of us continue to be proponents of Orthodontics first and Surgery later. What’s your preference? Surgery first or Orthodontics first ?

Surgery shown is a which will include Lefort 1 4-piece Osteotomy with mid-face shortening, Sagittal split mandibular osteotomy with setback. I am so excited and proud to show the before and after of my star patient who is finally able to chew and looks amazing. It was an honor being your surgeon and I am continuously thankful to be able to perform these life changing surgeries. Swipe to see the amazing transformation of her occlusion too.