Das prä- und postoperative Management von Patienten mit Angle-Klasse-II-Verzahnung, ausgeprägter Spee-Kurve und Tiefbiss in der Dysgnathiechirurgie

Zusammenfassung

Die Dysgnathiechirurgie umfasst Korrekturen des Gesichtsskeletts mit dem Ziel, normale anatomische und funktionelle Verhältnisse wiederherzustellen. Eine besondere Herausforderung sind dabei Patienten mit Angle-Klasse-II-Verzahnung, Tiefbiss und ausgeprägter Spee-Kurve. Eine präoperative Nivellierung der Spee-Kurve gelingt nur über Bisssperrung durch okklusale Aufbauten. Alternativ und bewährt ist die Nivellierung der Spee-Kurve postoperativ. Voraussetzung dafür ist eine stabile 3-Punkt-Abstützung und unmittelbar postoperativ das Einhängen vertikaler Gummizüge zum Schluss des anfangs seitlich offenen Bisses. Anhand eines Fallbeispiels wird das kieferorthopädische und kieferchirurgische Vorgehen verdeutlicht.

Abstract

The treatment goal in orthognathic surgery is the correction of the facial skeleton with the aim of restoring normal anatomical and functional conditions. Patients with Angle Class II, deep bite and pronounced Spee curve pose a special challenge. A preoperative leveling of the curve of Spee is possible only via bite blockage with occlusal onlays. As an alternative and proven technique, leveling of Spee’s curve can be conducted postoperatively. Prerequisite for this is a stable 3-point-support and immediately postoperative treatment with vertical elastics in order to close the initially lateral open bite. Orthodontic and maxillofacial surgery procedures are illustrated by means of a case report.

Schlüsselwörter

Dysgnathiechirurgie - interdisziplinäre KFO-Chirurgische Therapie

Key words

Dysgnathia Surgery - interdisciplinary orthodontic-surgical treatment

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