Simonas Grybauskas, D.D.S., M.D., PhD, MOS RCSEd Simonas Grybauskas graduated from Kaunas University of Medicine and acquired his Dental degree in 2000. In Vilnius University he completed his training in oral surgery (2003) and maxillofacial surgery (2006). In 2008 he acquired his Medical degree and became a double qualified oral and maxillofacial surgeon. Simonas Grybauskas passed the exams and became a Member of the Royal College of Surgeons of Edinburgh as of 2005. In 2009, he acquired PhD degree awarded by Riga Stradins University (Latvia). Present positions of Simonas Grybauskas are Consultant in Oral and Maxillofacial Surgery at Vilnius University and his private practice S’OS Simonas Grybauskas’ Orthognathic Surgery. Simonas is an author of scientific publications and has delivered more than 100 lectures on orthognathic and reconstructive surgery in international conferences and courses. Dr. Grybauskas is a member of the Lithuanian Association of Maxillofacial Surgery as of 2002, a member of the Baltic Association of Maxillofacial and Plastic Surgery since 2003 and a member of the European Association for Cranio–Maxillofacial Surgery starting from 2005. Simonas hosted and directed a major international event – the 1st and the 2nd Baltic Sea Conferences on Orthognathic Surgery and Orthodontics in Vilnius in 2009 and in Riga in 2015. Dr. Grybauskas devotes most of his time to orthognathic and reconstructive surgery, maxillofacial traumatology and implantology. Differences in facial morphology among populations and their influence on planning of facial surgery is the scope of his scientific work.
“Most common mistakes made in orthodontic preparation for surgery. The protocol.”
Simonas Grybauskas, Dalia Latkauskiene (Lithuania)
Correction of skeletal malocclusion by means of orthodontics and orthognathic surgery is a multidisciplinary treatment. That is why it has to be properly coordinated between the surgeon and the orthodontist. The best results are achieved when both players are active in team and communicate throughout the treatment.
It is important to understand that the orthodontist works at the dentoalveolar level whereas the surgeon works at the skeletal level and does not interfere into the teeth setup during the surgery. That is why the teeth should be setup properly within the jaw bones and allow the anticipated repositioning of jaw bones in the necessary vectors and distance. If not, the surgeon may be cornered during planning process and will have to alter it both incurring hesitations whether the surgical outcome is going to be the same as planned.
We are going to discuss the most usual mistakes in orthodontic setup for surgery: dental midlines non-coincident with skeletal midlines, inadequate angulation of front teeth, overzealous expansion or constriction, flaws created by improper closure of extraction spaces, unstable orthodontic mechanics resulting in postoperative orthodontic relapse. Intrinsic coordination of upper and lower dental arch shapes and extrinsic coordination of dental arches to the skeletal bases of the jaws set the protocol of our work: stable orthodontic alignment, minding the midlines and angulation of teeth while aiming to achieve maximal decompensation within physiological limits. Facial aesthetics largely depends on the surgical plan of jaw repositioning, however, the plan may largely depend on the accuracy and quality of preoperative orthodontic setup.