tailieunhanh - Oxford Challenging Concepts in Oral and Maxillofacial Surgery Cases with Expert Commentary: Part 2

(BQ) Continued part 1, part 2 of the document Emergency medicine in critical care has contents: Management after cardiac surgery, pericardial diseases, gastrointestinal bleeding, electrolyte disorders, alterations in mental status, management of acute intracranial hypertension, and other contents. Invite you to refer. | Oxford Challenging Concepts in Oral and Maxillofacial Surgery Cases with Expert Commentary Part 2 SECTION 5 Orthognathic surgery Case 14 The anterior open bite Case 15 Severe Class II skeletal deformity Case 16 The segmental maxillary osteotomy The anterior open bite Barbara Gerber Expert commentary Andrew Currie Case history A 14-year-old boy was referred by his orthodontist due to an increased overjet crowding in the upper maxilla with mandibular retrognathia and retrogenia. The patient requested treatment as he wanted his teeth to be straighter and for his chin to be brought forward . He mentioned some adverse comments at school in the preceding years and desired a more favourable appearance of his teeth. He had no previous orthodontic or dental treatment and only suffered with occasional asthma for which he used a salbutamol inhaler. His family history was unremarkable. On examination it was immediately apparent that he had an anterior open bite AOB with incompetent lip seal at rest. It was also noted that he had retrognathia and retrogenia. Notably he had antegonial notching and features of an unfavourable clockwise growth pattern of the mandible. Learning point Mandibular growth The mandible has the most postnatal growth of all the facial bones. The right and left bodies of the mandible unite at the midline of the mental symphysis during the first year of life. The primary sites of growth are at the condylar cartilages posterior rami and alveolar ridges 1 . Mandibular growth is highly dependent on the functional demands placed on it and has a capacity to adapt. Numerous functional matrices including the muscles of mastication facial soft tissues and the tongue ultimately all influence the size and shape of the mandible 1 . Deep antegonial notching has been associated with a smaller increase in total mandibular length corpus length and less displacement of the chin in a horizontal direction than those with shallow notches 2 3 . The clinical presence of a .