Abstract
Orthognathic surgery for the correction of facial deformity arising from discrepancy in spatial relationship or dimensional differences is well established. However, when the cause of the deformity includes an alteration of the shape of the jaws, orthognathic surgery is unable to correct the resulting contour deformity. The purpose of this paper is to describe the essential mechanisms involved in development of mandibular dysmorphology and establish basic objectives for morphometry as a basis for surgical correction. The characteristics of severe mandibular dysmorphology seen in unilateral temporomandibular ankylosis are analyzed using a simple morphometric technique, which can be used for surgical planning. The gross changes seen in disturbances of facial growth, as in the case of unilateral ankylosis become “geometric compensations” when significant alteration of shape is characteristic of the deformity. The application of morphometric analysis in establishing a specific osteotomy technique for its correction is described with several case studies. The surgical correction consisting of an osteotomy aimed at restoring the morphology is denoted the term “orthomorphic” to distinguish it from conventional orthognathic surgery. The changing perceptions of facial beauty and the emergence of utilitarian concepts of attractiveness endow a particular urgency for the orthognathic surgeons' repertoire to include orthomorphic corrections.
Published Version
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