26. d srinu facial asymmetry dr. rahul vc tiwari, sibar institute of dental sciences, guntur, andhra...
TRANSCRIPT
CASE PRESENTATIONORTHOGNATHIC SURGERY
PRESENTED BY
Dr. RAHUL TIWARI
3RD YEAR MDS - PG Student
DEPT. OF ORAL & MAXILLOFACIAL SURGERY
SIBAR INSTITUTE OF DENTAL SCIENCES
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PRELIMNARY DATA
Patient name – D SRINU Date – 23/07/2016
Age / sex – 22/M O.P.No. – 730541
Occupation – STUDENT Religion – HINDU
Marital status – UNMARRIED Blood group – O +VE
Date of birth – 20/6/1992 Socioeconomic status – GOOD
Address – CHIRALA GUNTUR Contact no. – 0961887515
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PATIENT CHIEF COMPLAINT
UNAESTHETIC APPEARENCE
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HISTORY OF PRESENT ILLNESS
2002- CONDYLECTOMY – 10 YRS AGE- CHENNAI
07/12/2015- SIDS- LE FORT 1, UNI. SAG RT. , IVRO LT. SIDE
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HISTORY
Past Medical History – NRH
Past Dental History – ORTHOGNATHIC SURGERY
Family History – NRH
Personal History – NRH
Drug History - NRH
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GENERAL PHYSICAL EXAMINATION
Height – 5’9” Weight – 68KG
Gait – NAD Built – AVERAGE
Nourishment – FAIR Signs of Clubbing – NO
Pulse – 78 Resp. Rate – 22
Blood Pressure- 130/84 Temperature – AFEBRILE
P.I.C.K.L.E. - NO
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EXTRA ORAL EXAMINATION 7
EXTRA ORAL EXAMINATION 8
OCCLUSION9
R.S- 26
OTHER FINDINGS 10
OVERJET & OVERBITE
INTRA ORAL EXAMINATION 11
ANALYSIS 12
ASYMMETRIC FACE
INNER INTER CANTHAL- 32MM
INTER PUPILARY – 67MM
ALAR BASE WIDTH- 31MM
NOSE DORSUM LENGTH- 43MM
COLLUMELLA HEIGHT0- 10 MM
MOUTH WIDTH- 48MM
MOUTH OPENING – 52MM
UPPER FACE- 55MM
MIDDLE FACE- 49MM
LOWER FACE – 73MM
FACAIL FIFTHS – DISSIMMILAR
C CURVE – ONE BREAK
NASAL CONTOUR – CONVEX
NASOLABIAL ANGLE- ACUTE
UPPER LIP – 17MM
LOWER LIP – 46MM
LIP POSTURE- INCOMPITENT
LIP CONTOUR- EVERTED
LIP TEXTURE – FISSURED
ANALYSIS13
INCISAL SHOW AT SMILE – 4MM
INCISAL SHOW AT REST- 2MM
GINGIVAL EXPOSURE – 0MM
CHIN FORM – RECESSIVE
MENTOLABIAL SULCUS- SHALLOW
MENTALIS ACTIVITY – ABSENT
CHI THROAT ANGLE- OBTUSE
DENTAL MIDLINE – 2MM DEVIATED RT. SIDE
OVERJET – 11MM
OVERBITE- 10 MM
MOLAR RELATION- ABSENT
CANNINE REALTION- CLASS I
BRACHYCEPHALIC HEAD
LEPTOPROSCOPIC FACE
INVESTIGATIONS- RADIOLOGICAL 14
INVESTIGATIONS- RADIOLOGICAL 15
INVESTIGATIONS- RADIOLOGICAL16
INVESTIGATIONS- RADIOLOGICAL 17
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PRE OPERATIVE POST OPERATIVE
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PRE-OPERATIVE
ANALYSIS20
POST -OPERATIVE
RO
CK
Y M
OU
NTA
IN A
NA
LYSIS
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11.5 mm
10.8 mm
0 mm
0.7 mm
85.8 mm 72.1 mm66.2 mm 65.2 mm
85.8-66.2 =19.6
72.1-65.2 = 6.719.6-6.9 = 12.7
(1.27 cm.)
VTO22
INVESTIGATIONS-HEAMATOLOGICAL
CBP
GRBS
VIRAL MARKERS
OTHERS - PAC
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PROBLEM LIST
ASYMMETRIC FACE
ASYMMETRIC CHIN
TEETH SHOWN DURING REST
ANTERIOR PROCLAINED TEETH
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DIAGNOSIS
FACIAL ASYMMETRY
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PREVIOUS SURGERIES
CONDYLECTOMY ON LEFT SIDE
LE FORT 1 OSTEOTOMY
UNILATERAL SSRO ON RIGHT SIDE
IVRO ON LEFT SIDE OF MANDIBLE
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TREATEMENT PLAN
ILEAC CREST GRAFTING FROM ANGLE TO BODY ON RIGHT SIDE
PROPELLAR GENIOPLASTY ON THE ANTERIOR MANDIBLE
ANTERIOR MAXILLARY OSTEOTOMY OF SETBACK OF 4MM
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ILEAC GRAFT HARVESTING28
PROPELLER GENIOPLASTY29
ANTERIOR MAXILLARY OSTEOTOMY30
THANK YOU
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