Directly provided by the American Society of Plastic Surgeons® (ASPS®)
Authors: Sanjay Naran MD, Derek M. Steinbacher MD, Jesse A. Taylor MD
Plastic and Reconstruction Surgery® Editors:
Editor-in-Chief: Rod J. Rohrich, MD
Co-Editor: James M. Stuzin, MD
Section Editor: Donald H. Lalonde, MD
The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The ASPS designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Patient Safety Credit: 0.5
Media: Journal Article, Video
Publish Date: 6/1/2018
Estimated time to complete this course: 1.0 hour
Minimum Post-test Score to Claim Credit: 80%
This educational activity is intended for plastic surgery practitioners, residents, and other healthcare professionals interested in translating expanded knowledge into practice for the improvement of patient outcomes in plastic and reconstructive surgery.
This CME article outlines the goals of orthognathic surgery, highlighting advances in the field and current controversies. The principles of the sequencing of osteotomies are discussed and literature is reviewed that may assist in decision-making as to maxilla-first versus mandible-first surgery. The emergence of “surgery first,” in which surgery precedes orthodontics, is discussed and important parameters for patient candidacy for such a procedure are provided. The emerging standard of virtual surgical planning is described, and a video is provided that walks the reader through a planning session. Softtissue considerations are highlighted, especially in the context of osseous genioplasty and fat grafting to the face. The utility of orthognathic surgery in the treatment of obstructive sleep apnea is discussed. The reader is provided with the most current data on complications following orthognathic surgery and advice on avoiding such pitfalls. Finally, outcome assessment focusing on the most current trend of patient-reported satisfaction and the psychological impact of orthognathic surgery are discussed.
After studying this article, the participant should be able to:
- Identify skeletal differences that are treated with orthognathic surgery; describe the goals of orthognathic surgery; and understand modern virtual surgical planning of orthognathic movement of the mandible, maxilla, and chin.
- Appreciate the surgical principles of maxilla- versus mandible-first surgery, and orthognathic surgery before orthodontic correction; and understand when an osseous genioplasty may be beneficial, and the potency of this bony movement.
- Appreciate the utility of fat grafting as an adjunct to orthognathic bony movements, and demonstrate understanding of the utility of orthognathic surgery in the treatment of obstructive sleep apnea.
- Be aware of associated complications and be able to critically assess outcomes following orthognathic surgery.
Dr. Rohrich, MD is the Principal/Co-Principal Investigator of research grants awarded to the University of Texas Southwestern Medical Center, Dallas, from Medicis, Mentor, and Contura Pharmaceutical. All research funds are provided directly to UT Southwestern. Dr. Stuzin has no relevant financial relationships or affiliations to disclose. Dr. Lalonde is a consultant for ASSI Instruments. None of the authors have any relevant financial relationships or affiliations to disclose. All ASPS staff members managing this activity have no relevant financial relationships or affiliations to disclose. All identified conflicts of interest have been resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity, and appropriateness of patient care recommendations. The ASPS also requires faculty/authors to disclose when off-label/unapproved uses of a product are discussed in a CME activity or included in related materials.
Participants must have internet access, browser software (either Chrome, Firefox, or InternetExplorer), Adobe Flash, and Adobe Reader. Supported Operating & Browser Systems: Microsoft Windows - IE7 or later, Firefox 3.x or later, Chrome 8.x or later. Macintosh Mac OS - Firefox 3.x or later, Safari 4.x or later. Linux - Firefox 3.x or later. Minimum Hardware Configurations: Windows - Intel Pentium II 450MHz or faster processor and 128MB of RAM. Macintosh - Power PC G3 500 MHz or faster processor OR Intel Core Duo 1.33GHz or faster processor and 128MB of RAM. Linux - Modern processor 800MHz or faster and 512MB of RAM with 128MB of graphics memory.
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