How to move the upper jaw forward
Jaw misalignment (dysgnathia)
What is dysgnathia?
Dysgnathia is a misalignment of the jaw. This can be caused by a misalignment of the teeth or by a misalignment of the upper jaw in relation to the lower jaw. Bone misalignment can also be the cause of the misaligned teeth and thus lead to unphysiological tooth positions.
Due to the misalignment of the jaw, those affected are in varying degrees of suffering, as it can lead to impairments in speaking and chewing. Abnormally arranged teeth lead to incorrect loading over a longer period of time. In addition, those affected suffer from a certain aesthetic disfigurement, as odd teeth are perceived as unattractive and the misaligned jaw eats up the proportions of the face.
What are the jaw misalignments?
A distinction is made between the following forms of dysgnathia:
- Open bite
In a cross bite (transverse dysgnathia), the lower jaw teeth bite in front of the upper jaw teeth. This can be caused by an upper jaw that is too narrow or a lower jaw that is too wide.
In the case of an overbite (sagittal dysgnathia), the lower jaw protrudes over the upper jaw. This usually occurs when the lower jaw grows faster than the upper jaw, or when the upper jaw does not keep up with the growth in size. In the case of an overbite (also counting as sagittal dysgnathia), exactly the opposite is the case, the faster growing upper jaw or too slow growing lower jaw leads to a protrusion of the upper front teeth. As a result, the face appears disproportionate and is also popularly referred to as the "bird's face".
The open bite (vertical dysgnathia) describes a gap between the upper and lower rows of teeth when clenching. This gap can either be between the frontal teeth and / or on the sides. This problem can arise from a malfunction of the tongue, such as a lot of thumb sucking in the first few years of life. This is why this misalignment is also called an open bite. However, a deformation of the jaw caused by rickets after prolonged vitamin D deficiency can also lead to this appearance.
How can a jaw misalignment be treated?
A pure misalignment of the teeth can be treated with conservative orthodontic treatment, e.g. with braces.
If the bony apparatus is also affected by a misalignment, conservative measures are no longer sufficient. Here an orthodontic treatment is carried out with subsequent orthodontic treatment. Treatment should be given before growth is complete.
Dysgnathia surgery: how does a dysgnathia operation work?
The dysgnathia operation is usually carried out under general anesthesia and takes about three to six hours, depending on the effort. The patients are then cared for as an inpatient for up to three days. Three to four weeks after the operation, the jaw must be spared and only soft food may be consumed.
In the case of transverse jaw misalignment, the upper or lower jaw is widened by stretching. This is done largely painlessly with the help of an appliance that is firmly seated in the mouth. This is inserted by the orthodontist under general anesthesia in under an hour. This creates more space in the, so that the nested teeth can then be brought into shape with braces. The appliance remains in the oral cavity for about four months.
In sagittal dysgnathia, the operation is different depending on whether the bite is overshot or overshot. With an overbite, the lower jaw is set back; with an overbite, the upper jaw is moved forward.
In vertical dysgnathia, the base of the maxillary bone, including the nasal septum, is loosened. The rear part of the upper jaw is then moved upwards in order to create sufficient space in the oral cavity and at the same time to create a close fit of the frontal teeth.
What are the risks of dysgnathia surgery?
Every operation also carries certain risks. Relative to all risks, swelling is common. Through manipulation by the surgeon and a remaining wound, the body releases inflammatory factors that lead to increased blood flow in the jaw and in the oral cavity. As a result, the jaw area is reddened and thick after the operation.
A negative consequence of the dysgnathia operation is also the risk of inflammation. Bacteria and viruses that are part of the normal oral flora can penetrate the body through the fresh wounds and thus trigger a local infection or, in the worst case, even blood poisoning (sepsis).
Secondary bleeding is also not uncommon. This means that sewn wounds at the interfaces will reopen and bleed. In order to minimize the risk of this problem, problems with blood coagulation are discussed in advance and possible anticoagulants are discontinued.
The worst complication of dysgnathia surgery is nerve damage. Injuring or cutting small nerves in the surgical area can cause sensory disturbances in the affected areas.
Which doctors and clinics are specialists in dysgnathic surgery?
Dysgnathia operations are performed in clinics for oral and maxillofacial surgery (maxillofacial surgery) and plastic surgery. MKG specialists have studied both medicine and dentistry and often have the double title "Dr.med.Dr.dent." Specialists in aesthetic plastic surgery have a medical degree and specialist training in surgery with additional qualifications. The referral to the clinic is usually done by the resident dentist or orthodontist. The therapy concept is created in cooperation with the orthodontist.
We help you to find an expert for your illness. All listed doctors and clinics have been checked by us for their outstanding specialization in the area of jaw misalignment and await your inquiry or your treatment request.
Aumüller et al .: Dual row anatomy . Thieme 2006, ISBN 978-3-131-36041-0.
Siewert: surgery . 8th edition. Springer 2006, ISBN 978-3-540-30450-0.
Müller: Surgery (2012/13) . 11th edition. Medical Publishing and Information Services 2011, ISBN 3-929-85110-5.
Bommas-Ebert et al .: Short textbook anatomy and embryology . 2nd Edition. Thieme 2006, ISBN 978-3-131-35532-4.
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