Changes in the face and smile of patients with dentofacial deformities

Abstract

Patients with dentofacial deformities commonly suffer from malocclusion, chewing deficit and aesthetic problems. Some of these patients are associated with obstructive sleep apnoea syndrome with potential threat to their life. What commonly overlooked is the psychology of these patients. It is increasingly accepted that the best management is by a multidisciplinary team of specialists, including an oral and maxillofacial surgeon, orthodontist, and other medical/dental professions. The patients should be assessed in a joint consultation clinic for establishing the diagnosis and treatment plan. The integrated treatment plan is commonly composed of a sequence of orthodontic dental decompensation, surgery and post-surgical orthodontic alignment and retention. Orthognathic surgery remains the mainstream treatment and is accomplished by a combination of maxillary and mandibular osteotomies with mini-plate fixation. There is an increasing trend of applying distraction osteogenesis for treatment of cleft maxillary deformities and severe mandibular hypoplasia. The treatment concept and cases of different dentofacial deformities corrected by orthognathic osteotomies and distraction osteogenesis will be illustrated resulting in transforming of not only the face but also the smile of these patients.