ORTHOGNATHIC SURGERY TONIA

Orthognathic Surgery

The poor occlusion of the teeth can only be corrected by the orthodontist with braces or other methods when the problem is due to crooked teeth and dealt with at an early age. It is however estimated that 5% of the general population show poor occlusion of the teeth, due to abnormal growth of the jaws and facial bones in general.

These problems are classified according to the onset time as:

“Relative”, if they occur during skeletal growth
“Developmental”, if manifestations appear during adolescence and
“Postnatal”, if  they are related to trauma or tumors resulting facial defects and malformations.

The skeletal disorder of the jaw and facial bones results in disruption of the functions of the stomatognathic system affecting chewing ability,  swallowing, speaking, and breathing as well as facial aesthetic disharmonies.

 

The Orthognathic surgery refers to surgery to correct abnormalities of the jaws and facial bones with the primary purpose of improving the functionality of the stomatognathic system and facial aesthetics. Τhis is achieved by osteotomies during which the bones of the jaws are separated and placed in the correct position to maintain their blood supply. The immobilization of the jaws in the new position is done by use of screws and small titanium plates.

In the case of distraction osteogenesis, the new position of the bones and soft   tissues is obtained gradually (1mm / day) using intraoral or extraoral equipment.

To deal with these cases the Oral and Maxillofacial Surgeon cooperates closely with the orthodontist and other medical specialist. (Physician, Anaesthesiologist, Otorhinolaryngologist (ENT), Plastic Surgeon, General Dentist, Periodontist, Endodontists, Prosthodontist etc.)


What you should know about the Treatment Plan Process

The surgery is usually done after the age of 16 to 17 years when the growth of the maxilla is completed. The only exception is birth defects such as clefts and syndromes.

Once the problem is identified, diagnosed and found that it requires surgery, the patient begins the orthodontic treatment for preparation prior to surgery for about 9 to 18 months depending on the case. The aim of the orthodontic preparation is:

  1. a) to arrange dental occlusion of the jaws, so that after surgery there is a good dental occlusion
  2. b) to maintain the stability of the result.

Once the orthodontic treatment is at the proper stage, the Maxillofacial Surgeon plans surgery. Nowadays we have the ability to analyse deformity problems in the three levels of space by using different study methods and computer technology in order to identify the exact problem and compile a treatment plan.

With the help of the three-dimensional imaging methods (3D CBCT) the movements of the maxilla can be done accurately in a three-dimensional level and surgical stents can be designed and constructed to accurately represent the necessary movement of the bones.

The three-dimensional design method (3D virtual planning) is the new development in Orthognathic Surgery.

The operation is performed under general anesthesia.

The development of surgical techniques has reduced the duration of the surgery in 1-4 hours. This means avoiding the intensive care unit, short hospital stay, less swelling, inapplicability mandibular immobilizer and of course regular meals from the next day after surgery.

Patients after surgery are monitored at specified intervals as defined by the protocol followed by the Oral and Maxillo Facial Surgeon.

After surgery the orthodontic treatment continues for a few more months to refine the result.

Finally, it should be noted that due to the overall development in the field of surgery to the visceral skull, relapse of the effect is very small as lacking even after many years.

Upper and lower jaws’ osteotomies and the wider craniofacial area may be combined with placing the fat tissue using special methods for best cosmetic results. Adipose tissue can be procured from other parts of the body and fitted on the lip to the nose in the cheeks and in any area of the face.

ORTHOGNATHIC CASE 1

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