Affiliation:
1. National Medical and Surgical Center named after N.I. Pirogov
2. Russian University of Medicine
Abstract
Relevance. Temporomandibular joint (TMJ) pathology, along with the resultant facial asymmetry, is a common condition within maxillofacial disorders. Addressing the rehabilitation of these patients within specialised medico-social care is a crucial and challenging task.Purpose. To develop a comprehensive rehabilitation protocol for patients with severe asymmetric jaw deformities caused by TMJ pathology.Materials and methods. From 2018 to 2023, ten patients with defects and deformities of the TMJ condylar process, presenting with severe asymmetric jaw deformities, were treated. An assessment of subjective and objective facial aesthetic parameters was conducted based on photographic protocols, as well as 2D and 3D cephalometric facial measurements. Comprehensive preparation for orthognathic surgery with simultaneous endoprosthesis replacement was performed based on the collected data. A regimen of postoperative therapeutic procedures was prescribed following the surgery.Results. All patients achieved the intended statistically significant outcomes: in the sagittal plane, an improvement in facial profile was noted based on the position of the chin (Pog) relative to the true vertical line passing through the subnasale point. In the frontal plane, alignment of the occlusal plane and normalization of the central line of the upper and lower incisors relative to the midline of the face were observed.Conclusion. The algorithm for the comprehensive preparation of patients with asymmetric jaw deformities, developed during growth, prior to performing orthognathic surgery with simultaneous TMJ endoprosthesis replacement should include: orthodontic treatment aimed at aligning teeth position and dental arches, eliminating rotations and pathological inclinations of teeth using a bracket system, fully restoring interocclusal height with temporary implant-supported structures, using occlusal splints and temporary composite restorations, as well as employing separating orthodontic plates. These stages enabled the achievement of good aesthetic results and improved patients' quality of life.
Publisher
Periodontal Association - RPA
Reference9 articles.
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