What are the advanced operative techniques in orthognathic surgery
Posted on 3/21/2022 by Dr. Shaun Rai
Orthognathic surgeries are procedures done to reposition jaws used traditionally in dentate patients to correct malocclusion in the skeleton.
techniques used in orthognathic surgery are discussed below
Soft tissue reflection and bone cut are where an incision that is `u` shaped is made across the mucosa and buccal sulcus; from the first step, a mucoperiosteal flap will be raised, exposing the maxilla to the energy. Maxilla from the pyriform aperture .The orbital nerves are identified and protected, mucoperiosteum nasal is reflected from the floor. The maxilla`s outer surface is marked using a marker pen before the cutting using a surgical bur forward and upward to the pterygoid maxillary. The nasal wall is cut from the palate using a nasal chisel. The septum is separated from the palate.
Separation and mobilization this is where the bone [maxillary] is unconnected from the skull`s base with the help of a smith spreader. Disarticulation of ptergyo maxillary is accomplished by Rowe`s forceps, which are dismasted. Depending on the surgeon, osteotomies can be used.
Final fixation and adjustment, closure this is where the occlusal wafer is seated on the surfaces of mandibular teeth and incisal edges. The maxilla is put in the anteroposterior occlusal is kept in place with intermaxillary fixation. For maxillary impaction, the bone is removed. When lip lengthening is required, a `v`-y` closure is needed. It can be accomplished by suturing the mid-line of the mucal surface, which is followed by suturing the labially. A stitch can be applied, which maintains the desired shape of the altar. It is done by a non-restorable suture passed from the inner side of the mouth to the alar cartilage.
Presprothetic technique is the orthognathic surgery that can be conducted on the patient`s edentulous to correct discrepancies between the jaws, followed by implants being replaced to rehabilitate maxillary bone.