Jaw disorders and their treatment

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Orthognathic Surgery; It is surgery to correct jaw closing disorders.
It is a series of operations to reconstruct the upper and lower jaw relationship that has been disrupted for any reason. The reasons that disrupt this relationship; genetic factors, trauma to the upper, lower or both, as a baby, thumb sucking, faulty tooth extraction, difficult birth, surgery as an infant (for example, cleft palate operations). The reasons listed above cause jaw closing disorders by affecting the growth points in the bones, causing the lower and upper jaws, which should grow together, to develop independently from each other.
Jaw disorders:
– Side or front open bite
– Extremely anterior positioning of the upper jaw (Maxillary protrusion)
– Developmental retardation of the upper jaw ( Maxillary retrusion)
– Lower jaw in front of upper jaw (prognaty)
– Low development of the lower jaw (retrognaty)
– It is possible to count the stenosis of the upper palate
These disorders not only impair the chewing function of the mouth, but also cause both functional and visual disturbances in the nose, which is the closest neighbor of the face and the mouth most of the time (the base of the nose is the upper jaw).
Treatment planning:
In order to correct this pathology, the body tries to correct it with its own efforts by activating the compensation mechanisms. Changing the direction and angle of the teeth is the most important effort to fulfill the biting process as much as possible. As a result, both the bone position of the face and the position of the teeth are placed incorrectly.
Surgery planning; How much and in which direction the jaw bones will be moved, the anteroposterior and lateral X-rays of the face (cephalometry) are examined and the angle and distances of certain points described in this X-ray are made with each other. In the examination, the angle of the teeth to the jawbone and some points on the teeth constitute important reference points. In order for the evaluation and planning to be healthy, it is desired that the teeth of the patients return to their normal place with orthodontic treatment. While applying orthodontic treatment, the relationship between the teeth will increase gradually. Because the order that the body adjusts according to itself is disrupted, it is ensured that the teeth come to the place where they should normally be. This reverse situation will be corrected with the normalization of the bones in the operation. Towards the end of orthodontic treatment, facial x-rays are taken and surgery is planned in the cephalometric examination.
At the end of orthodontic treatment, a plaster mold of the patient’s lower and upper jaw teeth is taken and model surgery is applied. Thus, both the cephalometry calculation verification and the apparatus to be used during the surgery are prepared.
After all the preparations are completed, the bone structures of the upper or lower jaws or both jaws are moved to the places where they should be normal in the surgery, which lasts approximately 2.5-3 hours. The moved jawbones are firmly fixed in their new places with titanium plates and screws. Since all procedures are done through the mouth, there is no problem of surgical scarring.
POSTOPERATIVE
After the operation, the patient stays in the hospital for one day, and the next day, drug treatment is arranged and he is discharged. If the lower jaw has been interfered with during the surgery, elastics are attached to the brackets on the upper and lower teeth on the third or fourth day, and they are splinted. Duration of stay with the tire ranges from one week to ten days (10). During this period, they are fed with liquid foods, and maximum attention should be paid to oral hygiene by regularly brushing teeth and mouthwash. After the time is up, the tires are removed. For 1.5 months, it is started to be fed with all kinds of food that does not require biting and chewing (mashed potatoes, soup, food and fruits passed through a blender, …). Two months after surgery, normal chewing and biting is allowed.
UNDESIRED CONDITIONS
– The general risks in all surgeries are also valid for these operations.
– There may be complaints of nausea, headache, throat burning due to anesthesia. (prevented by drugs)
– There may be swelling and bruising in the face and neck area. (It goes away on its own within 1-2 weeks. However, medication and application of ice at intervals shorten this process.)
– Slight blood leaks into the nose and mouth for 2-3 days. (Blood clots in the mouth and nose are cleaned with oxygenated water and mouthwash.)
– There may be numbness in the lips ranging from one week to 1.5 years. This numbness is caused by the solution given during the surgery, as well as the nerve resentment (Neurapraxia).
– Weight loss due to diet can be seen.
SUGGESTIONS
You can take a shower or bath the next day after you are discharged from the hospital. As long as your doctor recommends at home, you should lie in a semi-sitting position. Sports should not be done for two months, but light sports and individual sports can be allowed after two months. Short-term orthodontic treatment may be required for fine adjustment of the teeth after the convalescence period. It should be known from the beginning that the face will fully fit and take its final shape after one year.
This is an informative post. For more detailed information, you should definitely talk to your doctor.

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