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Bite correction

- reconstructive surgery on the upper or lower jaw. During the surgery a fragment of jaw containing the entire dentition, or only a part. There are no scars on the skin, the intervention is carried out only from the intraoral access.

 

Restoration of the correct anatomy of the dentition, facial skeleton, elimination of functional disorders and improvement of aesthetic parameters of the face – the purpose of the orthognathic surgery.

Indications:

  1. Irregularity in the anterior-posterior direction:

Mesial bite: excessive standing of the lower jaw and lower lip in relation to the upper jaw.

 

Distal bite: excessive standing of the upper jaw and upper lip.

2. Irregularities in the vertical direction:

 

​Deep bite – excessive development of the alveolar parts of the jaws in the anterior part, in which there is an enormous vertical overlap of the incisors (invisible incisors).

 

Open bite is characterized by the presence of a gap between the dentition when closing in frontal or sided teeth. In an open bite, when the front teeth do not close, there is an increase of a height of a lower third part of the face which will be greatly elongated because of general proportions.

 

3. Violations right-left, which is named crossbite.

 

Crossbite can be unilateral and bilateral. In the case of these irregularities there are different options of the asymmetries. ​

 

4. The presence of an anomaly of the dentition.

Standard approach

Any clinical case should be firstly considered under this protocol and only after that the treatment plan is supplemented or edited as the standard approach is more preferable in most cases. It includes 3 stages:

 

1. Orthodontics preparation;

Alignment of the dentition, closing of the teeth, disconnection of occlusive contacts, decompensation of the bite. The goal of an orthodontist is to form the dentition closed to the planned final form. The volume of a jaw fragment movement and the severity of facial changes depend on the level of a bite decompensation. The patient is considered prepared for the surgical treatment after the installation of full-size «rigid» arcs, filling he groove of the locks as much as possible; steel and TMA-arcs of the rectangular profile of maximum cross-section can be used. The duration of the period of wearing such arcs before the surgery varies from a few days to 2-4 months.  

 

2. Surgical stage;

 

Reconstructive surgery to normalize the ratio of the jaws.

 

What is next?

 

The stitches are removed, swelling and bruising gradually pass. It is necessary to use interdental elastic traction 2-3 weeks after the upper jaw osteotomy and 3-4 weeks after the osteotomy of the lower one; the dentition in neutral ratio; stable occlusion contacts, the mouth opens the same way as before the surgery.

 

3. Orthodontic completion of the treatment;

 

Goal – final alignment of jaws, the creation of a normal aesthetic of the face, beautiful smile, correct dental arch.

Advantages

Good predictability of results, full rehabilitation from the orthodontic and surgical sides and strict control of the stages of treatment.

Surgery First 

Two-steps treatment involves orthodontic teeth movement after the bite correction.

 

1. The braces without arcs are installed before the surgery. The patient uses an auxiliary plate-spline 2-3 weeks after the surgery, which allows to keep the planned position of the teeth. After the abolition of splints, the arcs are prescribed, and the accelerated teeth movement starts.

 

2. The bone tissue if reconstructed after the surgery due to the mobilization of the endocrine and immune systems. The force effect of elastic arc and the thrust of the interdental elastics due to the plasticity of the bone tissue is allowing to normalize the dentition in a short term.

Operative-prosthetic scheme

It is used in case of an absence of a large number of teeth or in case of significant changes of rigid teeth tissues. So, in cases involving long-term restoration of dentition. After 4-5 weeks after the surgery the prosthetics is performed in order to create occlusion contacts.

Important

There is no one universal scheme of treatment which solves problems of all clinical cases in a optimal way. In some cases, the change of traditional protocol or the use of different rehabilitation schemes allow to get the best or the fastest result.

Глубокий прикус

Deep

Открытый прикус

Open

перекрестный прикус

Cross

Дистальный прикус

Distal

Мезиальный прикус

Mesial

Исправление прикуса
Исправить прикус
Ортогнатическая операция
Неправильный прикус
Jaw surgery

Examples of bite correction

Ортогнатическая операция до и после
Ортогнатическая операция до и после
Ортогнатическая операция до и после
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