Malcolm Harris - Fundamentals Of Orthognathic Surgery
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Contents: General Assessment (M Harris & N Hunt); Radiographic Analysis and Imaging (N Hunt); Computerised Cephalometrics for Orthodontic and Orthognathic Planning (P Thomas); Orthodontic Preparation (N Hunt); The Definitive Treatment Plan (M Harris & N Hunt); The Psychopathology of Facial Deformity and Orthognathic Surgery (S Cunningham); The Recording and Transfer of Orthognathic Planning Data (M A Bamber & E Payne); Fixation Techniques (M A Bamber); Surgical and Osteodistraction Procedures (M Harris & K M Coglan); The Surgical Correction of Common Deformities (M Harris); Secondary Cleft Lip and Palate Deformities (P Ayliffe); Rhinoplasty Surgery (S H Paun); Ankylosis of the Temporomandibular Joint (M Harris); Emergencies and Complications (D Harris); Feeding and Postoperative Nutrition Support (O Griffin).
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ORTHOGNATHIC SURGERY
Second Edition
editors
Malcolm Harris
Warwick University Medical School, UK
Nigel Hunt
University College London, UK
Imperial College Press
Published by
Imperial College Press
57 Shelton Street
Covent Garden
London WC2H 9HE
Distributed by
World Scientific Publishing Co. Pte. Ltd.
5 Toh Tuck Link, Singapore 596224
USA office: 27 Warren Street, Suite 401-402, Hackensack, NJ 07601
UK office: 57 Shelton Street, Covent Garden, London WC2H 9HE
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library.
FUNDAMENTALS OF ORTHOGNATHIC SURGERY (2nd Edition)
Copyright 2008 by Imperial College Press
All rights reserved. This book, or parts thereof, may not be reproduced in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage and retrieval system now known or to be invented, without written permission from the Publisher.
For photocopying of material in this volume, please pay a copying fee through the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, USA. In this case permission to photocopy is not required from the publisher.
ISBN-13 978-1-86094-993-7
ISBN-10 1-86094-993-2
ISBN-13 978-1-86094-994-4 (pbk)
ISBN-10 1-86094-994-0 (pbk)
Typeset by Stallion Press
Printed in Singapore.
Peter Ayliffe
FDSRCS, FRCS (OMFS)
Consultant Oral and Maxillofacial Surgeon
Great Ormond Street Hospital for Children
and University College London Hospital NHS Trust
Honorary Senior Lecturer
Institute of Child Health, University College London, London
Mohammad Anwar Bamber
PhD, BA, MSSCh, FIMPT, MBRCP, LFHom, ILTM
Senior Maxillofacial Instructor
Department of Oral and Maxillofacial Surgery Eastman Dental Institute, London
Kieran M. Coglan
MB FRCS (Ed.), FFDRCSI
Consultant Oral and Maxillofacial Surgeon
Barts and the London NHS Trust/
Princess Alexandra Hospitals NHS Trust
NHS Trust, London
Susan Cunningham
PhD, MSc, BChD, FDS RCS (Eng), MOrth RCS, FDS (Orth) RCS
Senior Lecturer and Honorary Consultant
Unit of Orthodontics
University College London Eastman Dental Institute, London
Oonagh Griffin
BSc (Hons) SRD
Senior Specialist Dietician
Barts and the London NHS Trust
Dan Harris
MBBS, BSc, MRCS, FCEM
Consultant Accident and Emergency Physician
Kingston Hospital, Kingston upon Thames
Malcolm Harris
DSc, MD, FRCS (Edin), FDSRCS
Emeritus Professor
University College London
Postgraduate Dental Education Unit
Warwick University Medical School, Coventry
Nigel Hunt
PhD, MSc, BDS, FDS RCS (Eng), FDS RCS (Ed), FDS RCPS,
DOrth, MOrth RCS
Chairman of Division of Craniofacial and Developmental Sciences
Head of Unit of Orthodontics
University College London Eastman Dental Institute, London
Santdeep H. Paun
FRCS (ORL-HNS)
Consultant Rhinologist and Facial Plastic Surgeon
Barts and the London Hospital Trust, London
Edwin Payne
Chief Technical Instructor
Division of Craniofacial Developmental Sciences
University College London Eastman Dental Institute, London
Paul Thomas
DMD, MS
Senior Research Fellow
Units of Orthodontics and Maxillofacial Surgery
University College London Eastman Dental Institute, London
This is the second edition of this broad-based craft book which was originally published in 1991 by Malcolm Harris and Ian Reynolds shortly after Ian's untimely death. It is intended to be a basic manual for undergraduate and postgraduate students as well as trainees in surgery and orthodontics. It is also hoped to be of value to the professions complimentary to medicine and dentistry and especially technical and nursing staff.
The last 15 years have seen numerous advances in diagnostic technology and computer planning software as well as technical developments in both orthodontics and maxillofacial surgery. As a consequence, there are new sections dealing with computerised cephalometrics and digital image morphing software written by Paul Thomas, the psychological aspects of facial deformity and orthognathic surgery by Susan Cunningham, distraction osteogen-esis by Kieran Coghlan, rhinoplasty by Santdeep Paun, and anky-losis of the temporomandibular joint. Many sections of the book have been completely rewritten or revised, including on orthodontic mechanics. Peter Ayliffe has revised the section on cleft lip and palate management. Anwar Bamber has updated his chapters on laboratory technical aspects with a contribution by Edwin Payne. Oonagh Griffin has rewritten the nutrition chapter and Dan Harris has modernised the complications section.
Many of the drawings from the original text have been retained and were by Mohamed Nour Awang and David Banks. Helen McParland has provided new illustrations for the rhinoplasty chapter and Daljit S. Gill and Cristina Nacher for . The authors also wish to acknowledge the clinical contributions, illustrated cases and useful comments by Nayeem Ali, Daljit Gill, Stephen Jones, Samantha Hodges, Tim Lloyd, Mike Mars, and Allan Thom. Finally, we wish to thank Karen Burke for her secretarial assistance and Gemma Harris for her invaluable editing. The illustration for the cover was provided by Alfred Tsang and Jason Cheng and created by Dr. Kai-Hung Fung.
We both must express our gratitude for the patience and support of our wives Naomi and Susan.
1. General Assessment
Malcolm Harris and Nigel Hunt
2. Radiographic Analysis and Imaging
Nigel Hunt
3. Computerised Cephalometrics for Orthodontic and Orthognathic Planning
Paul Thomas
4. Orthodontic Preparation
Nigel Hunt
5. The Definitive Treatment Plan
Malcolm Harris and Nigel Hunt
6. The Psychopathology of Facial Deformity and Orthognathic Surgery
Susan Cunningham
7. The Recording and Transfer of Orthognathic Planning Data
Mohammad Anwar Bamber and Edwin Payne
8. Fixation Techniques
Mohammad Anwar Bamber
9. Surgical and Osteodistraction Procedures
Malcolm Harris and Kieran M. Coglan
10. The Surgical Correction of Common Deformities
Malcolm Harris
11. Secondary Cleft Lip and Palate Deformities
Peter Ayliffe
12. Rhinoplasty Surgery
Santdeep H. Paun
13. Ankylosis of the Temporomandibular Joint
Malcolm Harris
14. Emergencies and Complications
Dan Harris
15. Feeding and Postoperative Nutritional Support
Oonagh Griffin
Introduction
The overall management of a patient with facial deformity requiring orthognathic surgery is both an art and a science. The management must be based on a team approach. Whilst the team may vary according to local circumstances, the optimum would consist of an orthodontist, an oral and maxillofacial surgeon, a liaison psychiatrist or clinical psychologist, a specialist in restorative dentistry, supported by a maxillofacial technician. A speech therapist is essential for cleft cases and plastic surgery expertise should also be available on an individual patient basis. Whilst a patient may be referred to any of the above specialists, it is important that all patients follow an agreed care pathway to ensure patient satisfaction with the outcome. Unfortunately the patient's personal concerns may be overlooked and it is imperative that as part of the initial consultation, patients are encouraged to state precisely what specific aspects of their facial features and or dentition they would like corrected, for what reason and the length of time that they have sought treatment. Research has shown that clinicians and the general public differ in their perception of an ideal face. Whilst the patient can be guided to what constitutes an ideal facial appearance, it is vital that the clinician does not lose sight of the patient's underlying concerns. The motivation behind the request for treatment is also very important and special consideration is required when marked psychological factors appear to influence both the diagnosis and the treatment.
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