Modern medicine offers ample opportunities to eliminate or correct annoying natural anomalies of the maxillofacial region. Sometimes, to obtain the desired result, only a small correction is needed with the help of orthodontic devices - braces, caps, etc. But often the matter is much more serious, and we are talking not only about cosmetic problems, but also about violation of the most important functions of the body - chewing, breathing, diction. In such cases, the patient is recommended orthognathic surgery.
Definition
Surgical intervention of this kind involves correcting the shape, size, position and ratio of the upper and lower jaws. This plasty provides for a significant correction of the bite, as well as the restoration of facial proportions. For many, orthognathic surgery is the only option.make life easier and gain a good appearance.
The procedure is included in the section of maxillofacial and plastic surgery, fifteen years ago such treatment was prescribed only in the case when anomalies in the structure of the skeleton interfered with a person in everyday life: the function of chewing, speaking, etc. was impaired. Today Aesthetic surgery is becoming increasingly popular, when orthognathic surgery and rhinoplasty work together to eliminate facial defects that prevent a person from leading a full life.
Features
In general, orthodontics and orthognathic treatment are aimed at performing similar tasks, but in the latter case, there is more opportunity to eliminate serious problems when it comes to repositioning the bones.
Orthognathic surgery is a full-fledged surgical intervention, therefore it is not recommended for every patient. Only after a thorough examination and diagnosis can we speak with confidence about such treatment. Contraindications may include the age of the patient, unprepared dentition, serious diseases such as heart disease, diabetes, acute infection, etc.
Indications for surgery
Incorrect position of the upper and lower jaws, bite anomalies can be both congenital and acquired, that is, the consequences of injuries or improperly performed surgery. During the period of a person growing up, all these problems begin to adversely affect his psyche, lead to the development of a variety of complexes. Not toto bring the matter to a neglected state, people with such anomalies must be prescribed an orthognathic operation. Patient reviews, as well as numerous photos with the result, confirm the positive results of such surgery.
Treatment implies a comprehensive approach and begins with an examination by an orthodontist, if the problems of the maxillofacial system cannot be corrected with correction using braces, then the orthodontist and a specialist in orthognathic surgery are already working together. The following reasons may be indications for surgery.
Cosmetic:
- asymmetry of facial proportions;
- open bite;
- gummy smile;
- strongly protruding lower jaw;
- skew chin.
Physiological:
- problems chewing food;
- breathing disorder;
- various speech defects;
- chronic pathology of the temporomandibular joint.
Treatment involves several stages, where the longest is preparation for surgery, it can take a year or more. Surgical intervention is possible only when the patient reaches the age of 18, when the process of bone growth has already stopped, the ideal age is 20 or 30 years. The reason for the refusal of the operation may be the individual characteristics of the person - an allergy, a reaction to anesthesia or intolerance to certain drugs.
Benefits: Patient feedback
Behind the frightening word "operation" is the solution of a large list of problems that can only be eliminated by surgery. Treatmenthas the following benefits according to patients:
- A person gains confidence in his appearance, and therefore in himself.
- As a result, self-esteem rises, before and after photos speak best of all about the cardinal changes that occur to the patient.
- Incorrect bite or displacement of the jaws relative to each other causes not only aesthetic discomfort, but also affects important body functions; a person chews incorrectly and gets a constant indigestion, diction deteriorates, breathing difficulties arise; orthognathic surgery eliminates such problems.
In addition, the results of treatment, according to people, with rare exceptions, are well preserved for a long time. But, as with any procedure, it also has its drawbacks. For example, the fact that the preparatory period, the operation itself and rehabilitation is a complex process that is difficult for a person to bear. In addition, many people are stopped by the high cost of treatment and the duration of all actions.
Preparation
A patient who decides on a surgical intervention to correct anomalies of the maxillofacial skeletal system should be prepared for the duration and complexity of such treatment. Doctors always work in a complex, especially if cosmetic changes are coming, in this case it is necessary to immediately connect a plastic surgeon in order to correct the nose, lips and other soft tissues after the main operation. Preparatory stageincludes the following actions:
- Monitoring of oral problems and their elimination, at this stage the dentist can remove plaque, carry out complex dental treatment, remove excess roots, etc.
- The second preparatory period involves orthodontic treatment. Specialists jointly develop a model of action and draw up a plan of work to be carried out with the help of braces. This stage can last from several months to one and a half years, it all depends on the complexity of the anomaly and the extent of the correction.
- Only after orthodontic treatment, the patient goes to the surgeon's group, where he will have to undergo various kinds of diagnostics.
- The casts of the jaws are being made; with the help of a computer program, 3D modeling of the initial and final results takes place; profilometry; x-ray examination; anthropometry of the face.
As needed, the surgeon may prescribe additional examinations, as well as involve specialists from other areas.
Immediately before the operation, doctors recommend not eating or drinking anything for twelve hours, if the patient is taking any medications or if he feels a slight malaise, it is imperative to notify the surgeon.
Types of operation
Such a surgical intervention involves a combination of several techniques and is a rather complex and responsible operation. Depending on the specifics of a particular case, it can last from one to six hours. The doctor makes all incisions inside the oral cavity, sothat there are no external scars.
After all the diagnostics and analyzes, the compilation of a computer model of the patient's jaw, an orthognathic operation is performed. How it is done depends on the type of violation and how to eliminate it:
- Orthognathic surgery on the upper jaw involves the following manipulations: through the holes behind the eye sockets, the surgeon shifts the skeletal system, palate and teeth, including in the right direction and fixes them with a special splint.
- Mandibular osteotomy - here the incision is made behind the molars, the jaw is set in the desired position, which is fixed with titanium plates. After the growth of bone tissue, the plates are removed.
- Aesthetic orthognathic surgery - this is about the cosmetic correction of the shortcomings of the maxillofacial system. Here, the symmetry of the face is corrected due to the correct installation of the chin part.
- Segmental osteotomies, when the bite is normalized by moving one or more teeth.
In some cases, archwires for orthognathic surgery may be needed to fix the jaw in the required position, in difficult cases they are also used at the preparatory stage. Usually, patients spend 2-3 days in the hospital, and if there are no complications, an equally significant stage of treatment begins - rehabilitation.
Post-operative period
As with anysurgery, a person may experience pain, discomfort, swelling of the face, slight weight loss, nausea, nasal congestion and numbness, the occurrence of all these effects depends on the individual, usually they disappear within 15-20 days.
After an orthognathic operation, a person still has a whole range of measures to prevent complications and to consolidate the result. The next day, the patient is prescribed a course of antibiotics, and an elastic bandage is applied to the problem area, which is removed after a day.
The most unpleasant moment for the patient is the forced need to wear special rubber bands that are located between the teeth. With them you can not open your mouth wide, chew and blow your nose. Postoperative sutures are usually removed after 10-14 days, and after another three months, the internal screws are removed from the gums.
Rehab
The rest of the healing process, after the orthognathic operation has been performed, is on the conscience of the person himself. The doctor is obliged to instruct the patient on how to eat, brush their teeth, as well as other nuances of rehabilitation. For a while, you will have to give up physical activity, do not take vitamins and some medications.
Don't hope for a quick result, it takes several days or months after orthognathic surgery to detect a noticeable difference. Before and after photos will show the desired appearanceview only when all the swelling is gone, and the bones finally get into their new position.
Possible Complications
As with any branch of surgery, there are several unpleasant consequences that orthognathic surgery can lead to. Complications are extremely rare, but patients should still be aware of them:
- possible nerve rupture in lower jaw;
- damage to the facial nerve, which can cause numbness of the lips;
- scarring occurs in some cases but is usually easily removed with special creams;
- the lack of professionalism of a doctor can lead to damage to the teeth, in which case there is only one way out - restoration;
- damage to the infraorbital nerve;
- blood loss during surgery;
- temporarily deformity and asymmetry may occur;
- Insufficient oral disinfection results in inflammation;
- fractured jaw.
All these cases are the rare exception rather than the rule. Typically, surgeons performing such operations are highly qualified specialists who do not allow negligence or accidents. Thousands of people in Russia have already learned what orthognathic surgery is. Patient reviews are almost always positive and grateful, because the doctor, in fact, gave a person a new life.
Best clinics
Several years ago, Russians were frightened by the mere thought of the possibility of surgical correction of the maxillofacial system. In our country, a culture has recently begun to take shape.maintaining beauty and he alth, it became necessary to look good and presentable. Today, there are already hundreds of clinics offering similar services, and you can do the procedure in public hospitals.
Thus, the Federal Scientific Center of Otorhinolaryngology of the FMBA of Russia has been operating in Moscow on Volokolamskoye Highway for many years, where the best specialists in this field work. A team of highly qualified doctors not only performs operations and related treatment, but actively implements world technologies and develops its own.
Besides this, there are dozens of private clinics in the capital and in every region of the country, whose services include orthognathic surgery. Feedback from former and current patients can greatly help in the final choice. The decision should be made after a personal visit, the treatment is long, and a change of specialist is undesirable.
Orthognathic surgery before and after it raises many questions, the answers to which cannot be fully answered. Each case is unique, all the nuances of treatment can be voiced only by direct contact.
Cost
It is almost impossible to make accurate calculations of orthognathic treatment. The whole process involves several important, sometimes lengthy stages, as well as the participation of specialists from different fields, so the patient must be prepared for very large costs. Even in public clinics, you will have to purchase braces, arcs, special bolts and more.equipment.
The cost of the operation itself varies from 100 thousand to 200 thousand, depending on the complexity of the operation. Orthodontic treatment that precedes surgical correction will also depend on the degree of tooth correction needed. Despite the complexity and cost of the process, such operations are quite in demand in Russia, because the result is worth both this expectation and the money spent.
