Zusammenfassung
Die kieferorthopädische Chirurgie ist ein wichtiges Element bei der Behandlung von
kraniofazialen Fehlbildungen wie beispielsweise Lippen-Kiefer-Gaumenspalten, kraniofazialen
und mandibulofazialen Dysostosen. Mit den entsprechenden chirurgischen Eingriffen
lassen sich die Lagebeziehungen der Kiefer zueinander und Fehlbisslagen korrigieren,
Obstruktionen der Atemwege beseitigen, die Ästhetik des Gesichtes und die Sprechfähigkeit
verbessern sowie die psychische und die soziale Entwicklung der Patienten fördern.
Zwar werden sie in der Regel erst durchgeführt, wenn die Wachstumsperiode abgeschlossen
ist, allerdings kann es in Einzelfällen auch erforderlich sein, aus funktionellen
und psychosozialen Gründen früher chirurgisch zu intervenieren. Die Mund-Kiefer-Gesichtschirurgen,
die solche Eingriffe durchführen, sollten einem Team angeschlossen sein, das die Patienten
interdisziplinär versorgt und betreut. Die Distraktionsosteogenese ist zwar ein sehr
hilfreiches Verfahren bei der Behandlung von schweren kraniofazialen Fehlbildungen,
sie kann jedoch die konventionellen chirurgischen Techniken nicht ersetzen, die zu
stabilen und vorhersagbaren Ergebnissen führen. Die jüngsten Fortschritte in der dreidimensionalen
Bilderzeugung und bei den Planungsmethoden erlauben es heute, erforderliche chirurgische
Korrekturen genauer und vorhersagbarer zu planen.
Abstract
Orthognathic surgery is a critical component of surgical management of craniofacial
deformities such as CLP, craniofacial dysostoses, and mandibulofacial dysostoses.
These operations can correct discrepancy in jaw relationship and malocclusion, relieve
airway obstruction, correct facial asymmetry, optimize facial aesthetics, improve
speech articulation, improve ability to masticate, and enhance psychological development
and social interaction. It is generally performed after completion of growth; however,
in selective cases it may be considered earlier to address functional and psychosocial
problems. Oral and maxillofacial surgeons who treat these deformities should be part
of a craniofacial team to provide interdisciplinary care for the patient. Distraction
osteogenesis is a useful technique in the management of severe craniofacial deformities
but does not replace conventional orthognathic surgery, which is safe and predictable.
Recent advances in three-dimensional imaging and planning tools have made it possible
to plan surgery more accurately and predictably.
Schlüsselwörter
KFO-Chirurgie - LKG-Spalten - dreidimensionale Bilderzeugung
Key words
orthognathic surgery - cleft lip and palate - three-dimensional imaging
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1 Abdruck erfolgt mit Genehmigung von Elsevier Inc. © 2005 Oral Maxillofacial Surgery
Clinics of North America 17: 503-517
Dr. R. Chigurupati
Department of Oral and Maxillofacial Surgery · University of California · San Francisco
· School of Dentistry
521 Parnassus Ave. C-522
USA - San Francisco CA 94143-0440
Email: radhika.chigurupati@ucsf.edu
