Prosthetic Reconstruction, Rehabilitation & Surgical Planning —
Training activity: 21

Details

Lead the planning of a complex segmental (analogue) orthognathic bimaxillary surgical case

Provide the multidisciplinary team with a comprehensive plan, design and manufacture the surgical occlusal splints

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• What are the key steps in planning a bimaxillary osteotomy?
• What are the design considerations for surgical occlusal splints?
• What will you learn about coordinating the planning process for a complex orthognathic case with the multidisciplinary team?
• How will you integrate the cephalometric analysis, model surgery, and clinical findings into the surgical plan?
• What are the critical design features for surgical occlusal splints to ensure accurate jaw positioning during surgery?
• Have you reviewed the surgical techniques for bimaxillary osteotomies?
• Have you practiced analogue model surgery and the design of surgical occlusal splints?
• Have you discussed the case and the planning process with the surgical and orthodontic team?

In action

• While leading the planning, designing, and manufacturing the surgical occlusal splints, are you consciously integrating all relevant clinical information and considering the complexities of a bimaxillary case?
• What immediate decisions are you making regarding the surgical movements, splint design features, and manufacturing techniques?
• Are you ensuring effective communication and collaboration within the multidisciplinary team?
• Is your planning process effectively addressing the patient’s malocclusion and facial aesthetics?
• Are you encountering any challenges in translating the surgical plan into accurate splint designs and manufacturing?
• What immediate learning is occurring as you navigate the complexities of a bimaxillary case and coordinate with the team?
• If unexpected challenges arise during the planning or splint design process, what alternative surgical movements or splint configurations are you considering in real-time?
• Do you need to seek input from the surgeons or orthodontists on specific aspects of the plan?
• Are you ensuring that your planning and splint fabrication are accurate, safe, and aligned with the overall treatment goals?

On action

• Describe the process of leading the planning for the complex segmental orthognathic bimaxillary surgical case. What were the key aspects and challenges of this complex case? How did you develop the comprehensive plan for the multidisciplinary team? Describe the design and manufacturing process of the surgical occlusal splints. How did the splint design relate to the overall surgical plan?
• What specific skills or knowledge did you develop or improve in leading the planning of complex orthognathic cases and designing/manufacturing surgical occlusal splints? What did you learn about the intricacies of segmental bimaxillary surgery? Were there any unexpected challenges or successes during the planning, design, or manufacturing stages? What did you learn from these? How did you ensure effective communication of the plan to the multidisciplinary team?
• What areas for continued development have you identified in complex orthognathic planning and surgical splint fabrication? How can you apply the knowledge and skills gained to future complex orthognathic cases? What resources or support might you need to further develop in this area, such as advanced planning software or surgical understanding?

Beyond action

• Have you revisited experiences of leading the planning for complex orthognathic cases? How has your understanding of multidisciplinary team dynamics and communication in surgical planning evolved?
• How have these experiences impacted upon your current practice in coordinating complex cases and providing clear input to surgical teams? Are you more confident in presenting treatment plans?
• How might these experiences contribute towards your future practice in managing highly complex craniofacial cases or developing advanced surgical planning protocols? What did you learn about surgical splint design and the sequence of surgical procedures?

Relevant learning outcomes

#	Outcome
# 1	Outcome Deliver quality patient centred care with the best interests of patients in all elements of practice.
# 2	Outcome Practice in accordance with local and national health and safety policies, regulatory requirements and overall service governance.
# 3	Outcome Communicate effectively with patients, relatives, healthcare professionals and other stakeholders.
# 4	Outcome Identify patients who need further specialist support and refer to the appropriate healthcare specialist.
# 5	Outcome Analyse and interpret patient investigations, multimodal imaging and information.
# 6	Outcome Perform clinical investigations, formulate treatment plans and manufacture medical devices to a safe clinical standard.
# 7	Outcome Prepare surgical treatment plans for complex head and neck surgery.
# 8	Outcome Select appropriate biomedical materials and components/instrumentation used in the treatment of patients and the manufacture of custom-made medical devices.
# 9	Outcome Practice in partnership with other clinical specialisms as part of a multidisciplinary team and understand their roles and their impact on patient care and pathway.
# 10	Outcome Apply the principals of a quality management system to their professional practice.
# 12	Outcome Assess and interpret patients’ needs to provide customised treatment dependent on medical, physical, social and psychological requirements.