ORTHOGNATHIC SURGERY

 

Orthognathic surgery combines orthodontic treatment with surgery of the jaw to correct or establish a stable functional balance between the teeth, jaws and facial structures.  The goal of maxillofacial surgery is to treat any jaw imbalance and the resulting incorrect bite, which could adversely affect the cosmetic (esthetic) appearance as well as the proper functioning of the teeth.  This involves diagnosis, treatment planning and execution of treatment, by combining orthodontics and oral/maxillofacial surgery to correct musculoskeletal, dento-osseous and soft tissue deformities of the jaws and associated structures.

The word “orthognathic” was coined by an oral/maxillofacial surgeon and means “straight jaws”, just as orthodontics mean “straight teeth”.  Prior to that time, the term surgical orthodontics or “facial orthopedics” was used to describe the field.

 


 

 

Orthognathic surgery is needed when jaws don’t meet correctly and/or teeth don’t seem to fit with jaws.  The teeth are straightened with orthodontics, and corrective jaw surgery repositions the mal-aligned jaws.  This not only improves the facial appearance (esthetics), but also ensures that teeth meet correctly and function properly.

Successful orthognathic surgery requires the cooperation of the oral/maxillofacial surgeon, orthodontist and general dentist. Other specialists may include periodontists, prosthodontists, endodontists, neurosurgeons, ophthalmologist, otolaryngologists, plastic surgeons and speech pathologist. These professionals will work as a team to provide the diagnosis, treatment plan and actual execution of the treatment, treatment plan and actual execution of the treatment.

          

TEMPOROMANDIBULAR JOINT (TMJ)

 

Temporomandibular joint and muscle disorders, commonly called "TMJ," are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement. We don’t know for certain how many people have TMJ disorders, but some estimates suggest that over 10 million Americans are affected. The condition appears to be more common in women than men.

For most people, pain in the area of the jaw joint or muscles does not signal a serious problem. Generally, discomfort from these conditions is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Some people, however, develop significant, long-term symptoms.

 

 

 

 

 

 

 

 

 

 

The temporomandibular joint connects the lower jaw, called the mandible, to the bone at the side of the head—the temporal bone. If you place your fingers just in front of your ears and open your mouth, you can feel the joints. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint control its position and movement.

When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone. The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the condyle and the temporal bone. This disc absorbs shocks to the jaw joint from chewing and other movements.


Fractures

Mandibular fractures (broken jaw)
The lower jaw is a frequent site for fractures because of

· accidents
· assaults
· sometimes underlying disease

There are 2 types of fractures:
          · open: The bone is exposed to air inside the mouth or outside the facial skin
          · closed: The bone is completely covered by soft tissue.

Here are the three steps in the repair of most fractures.

1.Reduction of the fracture: Realigning the bony parts in their original anatomic relationship.
2.Fixation of the fracture : Methods and materials are used to hold the bony parts in their correct relationship while healing occurs.

:: Maxillomandibular fixation is the wiring of the jaw shut. Many fractures lend themselves to this treatment. When the upper dentition is good and the upper jaw is stable this allows the upper jaw to act as a cast for the lower jaw while it heals.
:: Internal fixation is the use of wires and or screws and plates to hold the bony segments in their correct relationship. This hardware may be applied inside the mouth or outside the mouth depending upon the ituation.
:: External fixation is the use surgical pins that are placed in the bony fragments and a external frame is placed between the pins to fix the bony fragments in their proper orientation.

3.Healing and Rehabilitation: This is the time that is allowed for healing and for
physical therapy. Adequate nutrition and rest, avoiding alcohol and, tobacco is very important.

 

Monkey bite

 

 

 

 

 

 

 

Tiger Mauling

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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