Surgical correction of prognathism

PLEASE NOTE: This work is protected by copyright. Downloading is restricted to the BU community: please click Download and log in with a valid BU account to access. If you are the author of this work and would like to make it publicly available, please contact open-help@bu.edu.Thesis (M.Sc.D.)--Boston University School of Graduate Dentistry, 1977.Includes bibliography.Class III patients sometimes have no teeth that are in a functional relationship, and therefore disuse becomes a primary cause for early deterioration and loss of teeth. Prognathism has been attributed to faulty development in the embryo, or to the “effects of trauma or disease upon growth centers in postnatal life.” [1] E.C. Hinds feels that heredity plays a role in approximately 30% of the cases reported, and finds that in each succeeding generation prognathism seems more pronounced. The management of prognathic individuals encompasses two goals. These are the development of a useful occlusion and secondly the attainment of a balanced facial outline. Ideally, the goal should be to set back the entire mandibular arch to allow for conservation of all remaining teeth as well as an improvement in the gonial angle. However, before ostectomy or osteotomy in the ramus or body of the mandible, presurgical methods are required for evaluation and diagnosis. Complete clinical records should include oriented study casts; photographs; cephalometric radiographs; panoramic, lateral oblique and intraoral periapical radiographs; and a familial case history. If a mild Class III relation or a pseudo prognathism is evident, then orthodontics is the treatment of choice. Otherwise, surgery is necessary, and as Kosteka said, “it is impossible to recommend only one method for the operation..., because the varieties of this anomaly are numerous.” [2] [TRUNCATED