Purpose: To evaluate a method to identify condylar sag intraoperatively by clinical examination after bilateral sagittal split osteotomy (BSSO). Methods: We. Condylar sag is an immediate or late alteration in the position of the condylar process in the glenoid fossa after the fixation of the osteotomy. Peripheral condylar sag (type II) had developed in three of these patients. In 15 patients central sag was diagnosed. One-week postoperatively, three patients.

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Click on image for details. None, Conflict of Interest: Unfavourable outcomes are part and parcel of performing surgeries of any kind. Unfavourable outcomes are results of such work, which the patient and or the clinician condylae not like.

This is an attempt to review various causes for unfavorable outcomes in orthognathic surgery and discuss them in detail. All causes for unfavorable outcomes may ssg classified as belonging to one of the following periods A Pre- Treatment B Swg treatment Pre-Treatment: In orthognathic surgery- as in any other discipline of surgery- which involves changes in confylar aesthetics and function, the patient motivation for seeking treatment is a very important input which may decide, whether the outcome is going to be favorable or not.

Also, inputs conrylar diagnosis and plan for treatment and its sequencing, involving the team of the surgeon and the orthodontist, will play a very important role in determining whether the outcome will be favorable.

In other words, an unfavorable outcome may be predetermined even before the actual treatment process starts.

Good treatment planning itself does not guarantee favorable results. The execution of the correct plan could go wrong at various stages which include, Pre-Surgical orthodontics, Intra and Post-Operative periods. A large number of these unfavorable outcomes are preventable, if attention is paid to detail while carrying out the treatment plan itself.


Unfavorable outcomes in orthognathic surgery may be minimized If pitfalls are avoided both, at the time of treatment planning and execution. An open access publication of Association of Plastic Surgeons of India.

Intraoperative diagnosis of condylar sag after bilateral sagittal split ramus osteotomy.

Home Subscribe Feedback Login. How to cite this article: Bonanthaya K, Anantanarayanan P.

Unfavourable outcomes in orthognathic surgery. Indian J Plast Surg ; How to cite this URL: Class 3 patient with isolated maxillary retrognathism. Patient demonstrating skeletal class 2 relationship with anterio-posterior discrepancy. Dental relationship before orthodontic treatment Click here to saf.

Dental relationship after orthodontic decompensation. Exaggerated reverse overjet visible Click here to view. Dental relationship after surgery Click here to view. Unilateral cross-bite Click here to view. Unilateral cross-bite corrected post-orthodontics and surgery Click here to view. Models mounted in a SAM 3 condylr with the orientation lines marked Click here to view.

Use of Ericsson platform for measuring movements during the surgical simulation Courtesy: Pramod Subash, Cochin Click here to view. Occlusal wafers on the model Courtesy: Nerves predisposed to injury Click here to view. Psychological factors in orthognathic surgery. J Craniomaxillofac Surg ; What are orthognathic patients’ expectations of treatment outcome: J Oral Maxillofac Surg ; Assessment of motivation and psychological characteristics of adult orthodontic patients.

Am J Orthod Dentofacial Orthop ; Psychological aspects of orthognathic surgery: A review of the literature. Impact of dentofacial deformity and motivation for treatment: Professionals’ and laypersons’ appreciation of various options for Class III surgical correction. Eur J Orthod ; Association between ratings of facial attractivess and patients’ motivation for orthognathic surgery. Orthod Craniofac Res ;6: Diagnosis and treatment planning.

Essentials of Orthognathic Surgery. Diagnosis and treatment planning, dentofacial deformities. Esthetic objectives and surgical solutions.

Oral and Maxillofacial Surgery. Willey Blackwell, Sussex; Contemporary management of dentofacial deformities: Optimizing benefit to the patient.

Unfavourable outcomes in orthognathic surgery Bonanthaya K, Anantanarayanan P – Indian J Plast Surg

Elective orthognathic treatment decision making: A survey of patient reasons and experiences. An assessment of the quality of care provided to orthognathic surgery patients through a multidisciplinary clinic.


A new style of orthognathic clinic. Grubb J, Evans C. Orthodontic management of dentofacial skeletal deformities. Clin Plast Surg ; Kaban L, Pogrel M.

Intraoperative diagnosis of condylar sag after bilateral sagittal split ramus osteotomy.

W B Saunders, Pennsylvania Effect of presurgical incisor extrusion on stability of anterior open bite malocclusion treated with orthognathic surgery. Combining orthodontics and surgery: Who does what and when. Contemporary Management of Dentofacial Deformities.

Development of visual treatment objectives. Illinois, Quintessence Books; Evaluation of an improved orthognathic articulator system: Accuracy of cast orientation. Int J Oral Maxillofac Surg ; Wolford LM, Galiano A. A simple and accurate method for mounting models in orthognathic surgery.

How accurate is model planning for orthognathic surgery? Facial altered sensation and sensory impairment after orthognathic surgery. Pitfalls in orthognathic surgery: Avoidance and management of complications. Occurrence of bad splits during sagittal split osteotomy. Complications of the mandibular sagittal split ramus osteotomy associated with the presence or absence of third molars.

Ophthalmic complications associated with orthognathic surgery. Blindness as a complication of Le Fort osteotomies: Role of atypical fracture patterns and distortion of the optic canal. Plast Reconstr Surg ; Orbital compartment syndrome following orthognathic surgery.

Late onset of abducens palsy after Le Fort I maxillary osteotomy. Br J Oral Maxillofac Surg ; Lack of tearing after Le Fort I osteotomy. J Oral Surg ; Aseptic necrosis following maxillary osteotomies: Report of 36 cases. Intraoperative and perioperative complications in anterior maxillary osteotomy: A retrospective evaluation of patients.

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Intra-and perioperative complications of the LeFort I osteotomy: A prospective evaluation of patients. J Craniofac Surg ; Aseptic necrosis of the mandible: Report of two cases. Fibroscopic findings in patients following maxillary osteotomies in orthognathic surgery.