Ocena zdravljenja mandibularnega prognatizma in izdelava intraoperativne akrilne okluzijske opornice : diplomsko delo

Marinčič, Jerica (author), Kansky, Andrej (mentor), Rojko, Franc (co-mentor)

Uvod: Pri ljudeh z razvojnimi ali prirojenimi nepravilnostmi obraznega skeleta je za izboljšanje estetskih in funkcionalnih nepravilnosti potrebna poleg ortognatsko kirurškega posega še ortodontska obravnava. S tem pristopom lahko pridemo do želenih rezultatov in uspešnega zdravljenja nepravilnosti, ki so bile nedavno nazaj še nerešljive. Namen: Želeli smo ugotoviti, kakšne rezultate pridobimo z meritvami mavčnih modelov zgornje in spodnje čeljustnice, pri pacientih, ki so bili zdravljeni zaradi mandibularnega prognatizma. Namen diplomskega dela je bil predstaviti pristop pri zdravljenju zobnih in čeljustnih nepravilnosti, prikazati, kako pomembno je tesno sodelovanje različnih strokovnjakov za dosego želenega rezultata, in opisati postopek izdelave intraoperativne akrilne okluzijske opornice. Metode dela: Izbrali smo osem pacientov, ki so bili zdravljeni zaradi mandibularnga prognatizma. Na mavčnih modelih smo izvedli meritve sprednje in zadnje transverzalne širine ter meritve incizalnega previsa in incizalne stopnice. Ugotavljali smo, do kakšnih razlik pride med samim potekom zdravljenja in katera vrsta zdravljenja ima pri različnih meritvah največji vpliv. Metode dela, uporabljene za izdelavo diplomskega dela, so bile poleg meritev še pregled in študij strokovne literature, priprava slikovnega gradiva, praktično laboratorijsko delo ter posvet z mentorjem. Rezultati: Meritve smo na modelih izvedli v začetnem stanju - pred samim pričetkom zdravljenja, po ortodontski obravnavi – pred operativnim posegom in na koncu zdravljenja. Pri začetnem ortodontskem zdravljenju in pripravi na operativni poseg pride do sprememb v transverzalni širini čeljustnic, pri operativnem posegu pa pride do sagitalnih premikov, medtem ko ostanejo transverzalne širine enakih vrednosti kot pred operativnim posegom. Nanje lahko v majhni meri vplivamo s končnim ortodontskim zdravljenjem. Predstavili smo tudi postopek in potek izdelave intraoperativne akrilne okluzijske opornice, ki se uporablja med operativnim posegom. Izdelali smo jo v zobnem laboratoriju. Razprava in zaključek: Rezultati so pokazali, kako zelo pomembno je temeljno načrtovanje in sodelovanje vseh strokovnjakov ter pacienta samega. Ortodontska predpriprava je ključnega pomena za nadaljnji operativni poseg in s sodelovanjem obeh strok, tako ortodontske kot kirurške pridemo do zastavljenih rezultatov pri zdravljenju mandibularnega prognatizma.

• Language: Slovenian
• Keywords: ortodontsko kirurško zdravljenje, mandibularni prognatizem, transverzalna širina, okluzijska opornica
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-103794
• COBISS.SI-ID: 5495915
• Publication date in RUL: 26.09.2018

Secondary language

• Language: English
• Title: The evaluation of mandibular prognathism treatment and the fabrication of an intraoperative acrylic occlusal splint : diploma work

Abstract

Introduction: People with developmental and congenital anomalies of facial skeleton need orthognathic surgery as well orthodontic treatment in order to improve their aesthetic and functional abnormalities. Including orthodontic treatment in the healing process leads to desired results and enables us to treat anomalies that were thought insoluble only a while ago. Purpose: Our aim was to discover what results can be achieved when measuring dental gypsum models of both upper and lower jaw of patients who were treated for mandibular prognathism. The purpose of this diploma paper was primarily to introduce an approach for the treatment of dental and skeletal irregularities as well as to underline the importance of cooperation between various experts in order to reach the optimal results and describe a procedure of fabrication of intraoperative acrylic occlusal splint. Methods: We have selected eight patients that had previously been treated for mandibular prognathism. Using a dental gypsum model we carried out measurements of front and back transversal width, overjet and overbite. We examined the differences that occurred in the process of healing and determined the type of healing that was most suitable during various stages of measurements. Work methods used for the purpose of diploma paper were not limited to measurements but included also an overview of academic and scientific literature, preparation of visual materials, practical lab work and consultations with mentor. Results: The measurements on dental models were carried out four times: measurements before the treatment (initial stage), following orthodontic treatment, before surgical procedure and at the end of therapy. During the initial orthodontic treatment and while preparation for surgical procedure some changes occur in the transversal width of jaws, however sagittal shifts occurs during the surgical procedure alone, while in this stage the transversal width remains the same as beforehand. The latter can be influenced to a small extent with a final orthodontic treatment. The paper presents the technique of the production of intraoperative acrylic occlusal splint that is used during the surgery. The occlusal splint presented in the diploma paper was produced in a dental laboratory. Discussion and conclusion: The results have underlined and exposed great importance of careful planning and cooperation between experts from various fields and the patient. Orthodontic pre-treatment is of key importance for the subsequent surgical procedure. Only when there is cooperation between orthodontic and surgical experts, the optimal results in treating of mandibular prognathism can occur.

• Keywords: orthodontic surgical treatment, mandibular prognathism, transversal width, occlusal splint