Ikrom Mukimov
Tashkent State Dental Institute , Tashkent
Title: TECHNIQUE OF BIMAXILLARY OSTEOTOMY USING INTERMEDIATE CAPPA SPLINTS FOR THE ELIMINATION OF UPPER RETROGNATHIA IN PATIENTS WITH CONGENITAL CLEFT LIP AND PALATE
Biography
Biography: Ikrom Mukimov
Abstract
Actuality. Congenital cleft lip and palate - a severe malformation of the maxillofacial region, which is characterized by severe structural and functional disorders. The large number of patients with facial skeleton deformities primarily determines the importance of the problem of developing and improving surgical treatment methods for patients with jaw deformities after eliminating cleft lip and palate.
Keywords: maxillary osteotomy, retrognathia of upper jaw .
Purpose of the study. To increase the efficiency of rehabilitation of patients with CLP, accompanied by functional and aesthetic disorders of the middle zone of the face after chielo – and palatoplasty, due to the development of planning algorithms and complex surgical treatment.
Material and methods. To prevent technical errors during bimaxillary osteotomy, we proposed the use of intermediate mouthguards. To obtain the optimal result of surgical treatment before surgery , the optimal position of the upper and lower jaw was planned together with the orthodontist . The first kappa is the new position of the upper jaw and the old position of the lower jaw (for the exact placement of the upper jaw in a new final position). The second kappa is the new position of the upper and lower jaws ( for the final fixations of the lower jaw in the new position of the upper jaw)
The results of the study. After an osteotomy of the upper jaw according to Lefort I and extension to a new position using intermediate kappa cotter pins, the SNA angle was 82.1 ± 2.1 degrees, the ANB angle was 2.1 ± 1.2 degrees, and after the lower jaw was displaced posteriorly, the SNB angle was 79.4 ± 2.2 degrees. Control cephalometric measurements in the dynamics of observation, performed after 12 (T3) and 24 (T4) months, showed a stable position of the upper and lower jaw. In 20 patients, relapses of angular and linear parameters were not observed.
According to clinical and radiological studies and assessment of the state of occlusion, bimaxillary surgical treatment gives a stable anatomical and functional result in 87% of patients. An increase in U 6- Ptv and a significant improvement in the angular parameters of ANB , SNA , SNB and SNPog indicate a change in the position of the upper and lower jaws relative to the base of the skull and relative to each other. In 13% of patients in whom the reverse sagittal displacement of the upper jaw was noted, the deformation became less pronounced than before the operation. After bimaxillary surgery the proposed method patients improved cephalometric indicators SNA , which from left 82,5 ± 2 , 1 , SNB 79.4 ± 2.2, ANB 2 , 1 ± 0.3 . Cephalometric measurements in dynamics after 12 and 24 months revealed a stable position of the upper and lower jaws.