Veidlapa Nr. M-3 (8)

Study Course Description

Orthognathic and Craniofacial Surgery

Main Study Course Information

Course Code

RMS_045

Branch of Science

Clinical medicine

ECTS

15.00

Target Audience

Dentistry; Medicine

LQF

Level 8

Study Course Implementer

Course Supervisor

Ģirts Šalms

Residency Speciality

Speciality

Maxillofacial Surgeon

Supervisor of Medical Speciality

Ģirts Šalms

Contacts

About Study Course

Objective

To introduce students to the theoretical and practical foundations of orthognathic surgery. To learn the theoretical foundations of orthognathic surgery, as well as to practically learn the operative techniques by performing specific operative manipulations.

Learning Outcomes

Knowledge

1.Will be able to analyze specific clinical cases and plan the treatment. Know the theoretical and practical foundations of maxillary osteotomies, mandibular osteotomies, principles of osteosynthesis, model surgery. Understand distraction osteogenesis, usage options, post-operative care, analysis of results and patient monitoring principles, complications and treatments.

Skills

1.Be able to do: - analysis of specific clinical situation, - model surgery, - Le-Fort osteotomy, vertical and sagittal mandibular osteotomy, - fragments osteosynthesis after osteotomies, - application of the distractor, - Any steps 3 D planning, - post-operative treatment, - detect complications and to treat them. Perform the following manipulations: - Le-Fort osteotomies (5x); - BSSO (5x); - VRO (5x); - model surgery (5x); - take osteosynthesis after osteotomies (5x) in every situation.

Competences

1.Is able to decide on the appropriate treatment approach for the orthognathic patient. Is be able to interpret the objectives prior to orthognathic operations. Is be responsible for planning of orthognathic operations. Is able to carry out a full investigation, diagnosis, treatment planning, conservative surgery and organize surgical treatment of patients with congenital and acquired soft tissue and skeletal malformations in oral and maxillo-facial area.

Assessment

Individual work

Title	% from total grade	Grade
1. Individual work	-	-
Following the teacher's instructions investigate patients to prepare reports about possible treatment options. Participate in orthognathic council, participate in virtual operations planning, participate in operations. Read and analyze the practical and scientific literature on orthognathic surgery. To prepare an analysis of clinical situations of patients in whose treatment the resident participated.

Examination

Title	% from total grade	Grade
1. Examination	-	-
When summarizing, knowledge, preparation for seminars and ongoing work are evaluated together: presentation on the topic assigned by the instructor, as well as practical performed specific surgical manipulations.

Study Course Theme Plan

FULL-TIME

Part 1

Seminar

Modality	Location
On site	Auditorium

Topics

Development and growth of craniofacial structures. Historical development of orthognathic surgery. Diagnosis of craniofacial diseases. Radiological diagnosis of craniofacial diseases. Systematic accumulation of patient data (photo, 3D photo, models, radiological examinations). Aspects of patient data protection. The psychosocial impact of craniofacial deformities on the patient, and on the integration into society.

Seminar

Modality	Location
On site	Auditorium

Topics

Planning surgical operations for craniofacial patients. Principles of 2D and 3D operation planning. Current available computer programs for orthognathic surgery planning, their analysis, advantages and disadvantages. Errors in the orthognathic planning process. How to avoid them. Model surgery in the classic articulator and in the digital environment. Making intraoperative guides (guides for intermediate and final stage).

Seminar

Modality	Location
On site	Auditorium

Topics

Basic principles of orthodontic preparation for orthognathic surgery. Orthodontic treatment after orthognathic surgery. Orthodontic preparation of Angle class II patients for orthognathic surgery. Orthodontic preparation of Angle class III patients for orthognathic surgery. Preparation of patients with facial asymmetry for orthognathic surgery. Orthodontic preparation of patients for segmental maxillary surgery. Distraction osteogenesis for the treatment of facial and jaw deformities, operating.

Seminar

Modality	Location
On site	Auditorium

Topics

Mandibular orthognathic surgery. Bilateral sagittal split osteotomy (BSSO). Subsigmoid intra and extraoral mandibular osteotomy. Inverted L osteotomy. Segmental osteotomy of the mandible. Subapical osteotomy of the mandible. Chin osteotomy (genioplasty). Chin implants. Mandibular body and angle osteotomy to achieve symmetry. Variants of orthognathic mandibular osteosyntheses.

Seminar

Modality	Location
On site	Auditorium

Topics

Maxillar orthognathic operations. Le Fort I osteotomy. Le Fort I osteotomy with segments. Le Fort II osteotomy. Le Fort III osteotomy. Maxillary segmental osteotomies. Corrective operations for anterior open bite. Variants of orthognathic maxillary osteosyntheses.

Seminar

Modality	Location
On site	Auditorium

Topics

Surgically assisted maxillary expansion. Minimally invasive surgically assisted maxillary expansion. Insertion of orthodontic plates for growth modification. Ultrasound-assisted bone thinning for orthodontic adjustment. Soft tissue surgery for lip lengthening and shortening. Nose bridge reduction surgery.

Seminar

Modality	Location
On site	Auditorium

Topics

Additional surgical operations in patients with craniofacial deformities. Liposuction and lipofilling in the facial area. Rhinoplasty and orthognathic surgery. Face and neck tissue lifting surgery. Complications and orthognathic surgery. Revision orthognathic surgery.

Seminar

Modality	Location
On site	Auditorium

Topics

Orthognathic surgery in patients with congenital cleft lip and palate. Effects of orthognathic surgery on patients' speech. Etiology and pathogenesis of craniofacial deformities, genetics. Classification of craniofacial pathologies, nomenclature in Europe. Multidisciplinary approach to the treatment of patients with craniofacial deformities. Non-syndromal craniosynostoses (unilateral and bilateral, plagiocephaly). Incidence, diagnosis and treatment. Syndromal complex craniosynostoses. Classifica

Seminar

Modality	Location
On site	Auditorium

Topics

Types of craniofacial distraction in syndromic patients. External and internal distractors. The choice of their application. Craniofacial clefts. Encephalocele. Craniofrontonasal dysplasia. Hypertelorism. Craniofacial microsomia. Etiology, classification, principles of treatment, difficulties. Trecher Collins syndrome. Romberg's disease. Skull base surgery: meningioma, chordoma, congenital anomalies. Neurofibromatosis. Vascular malformations in the craniofacial region.

Total ECTS (Creditpoints):

15.00

Number of Residency Seminars:

Length (weeks):

Final Examination:

Residency exam (Theory and practice)

Bibliography

Required Reading

Jeffrey C. Posnick. Orthognathic Surgery. 2 Volume Set, 2nd Edition. Principles and Practice. Date of Publication: 06/2022

Surgical approaches to the facial skeleton. by Edward Ellis III. M.F. Zide. 3rd Edition. March 1, 2018

D. Henderson, D. Poswillo. Orthognathic surgery. Wolfe Medical Publications Ltd, London, 1985.

James Hupp, Myron Tucker, Edward Ellis. Contemporary Oral and Maxillofacial Surgery. 7th Edition. September 27, 2018.

Split Osteotomy of the Mandible in Detail Hardcover – 1 Jan. 2014. English edition by Simonas Grybauskas (Autor), George Deryabin (Autor). ISBN-10: 6099567607; ISBN-13: 978-6099567600

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