The number of clients in the office is shown in this image. Most patients (provided they are seen at the appropriate age) are referred periodically with some preventive measures in connection with the pediatric dentist and the start of treatment is postponed as long as possible when delays are not allowed. Over the course of nearly three decades of educational and clinical experience, this idea has minimized the need for surgery in patients who receive regular periodic visits. Of course, this ratio does not apply to patients who refer to Sensen above, and the diagnosis in them is based on the current situation, and in some cases we have no choice but to treat surgery (some patients who refer to the initial diagnosis of the need for surgery in this office without surgery Are treated).

What is the need for surgery? In other words, why should surgery be accepted?

In one sentence, it should be said that the only way to achieve a dental system with correct, beautiful and healthy function in this group of patients is to accept surgery. Of course, this treatment also plays a role in improving the patient’s appearance, improving speech, and possibly improving the patient’s breathing.

Apart from these results, after surgery one should expect improvement in many social relationships, education, business. During the years of treatment of patients, I have witnessed many changes in the quality of life of people after surgery.

What group of office clients need surgical-orthodontic treatment?

Patients in need of combined surgical-orthodontic treatment can be referred for treatment with several problems. In most cases, this group is over the age of eighteen. (Of course, there are a few cases under the age of eighteen.) But before introducing the groups in need of this type of treatment, I must present a scientific discussion in simple language. .

In general, regardless of the existing skeletal problem, patients in need of surgery in two different situations refer for counseling:

• First, those who have had the problem for a long time and the patient’s body has not changed to reduce its appearance, and therefore the patient and those around him are largely aware of the problem and that they may need surgery in addition to orthodontic treatment. A percentage of this group are treated in the office without the need for surgery.)

To explain the second group, I must first explain a few points:

Our body has special protective processes to maintain its internal state. For example, if we use acceptable forces, the tooth will not simply come out of its bony environment. The body prevents this by increasing the amount of bone in the tooth pathway, which is called homeostasis. This phenomenon operates within a certain range.
When there is a skeletal problem, sometimes certain dental movements occur that lead to the concealment of the existing skeletal problem. This set of events “compensates” for the skeletal problem. This “compensation” in some cases covers a high percentage of skeletal problems and in some cases a lower percentage.
In addition, the teeth can not be moved as much as we want. The teeth can be moved by orthodontic force within a defined range.

Oral orthopedic treatments are also prescribed at certain ages

I found it necessary to mention this introduction in order to continue the discussion in order to state that sometimes we encounter patients whose dental movements have largely hidden the existing skeletal problem. Explaining the need for surgery in this group is somewhat difficult and in some cases very difficult. Relying on these items can make the explanation somewhat easier.

Initiation of treatment in this group of patients can aggravate the condition and apparently worsen the problem. It should be explained that (at least in very simple terms) one of the goals of orthodontic treatment before referring the patient for surgery is to eliminate the compensatory movements performed.

Groups in need of combined orthodontic treatment and surgery

Deviation of the jaw from normal growth
Disorders of the front and back of the jaw relative to each other more than compensable cases in adults
Impaired vertical junction of the jaw relative to each other more than compensable cases in adults.
Moderate to severe transverse dimension disorder in both jaws
Chin deformity (small or bulging)
Nasty smiles due to the gums being seen a lot in old age
Lips that are normally far apart and difficult to meet.
Temporomandibular joint disorders
Blows in the form of accidents

Treatment in these groups is a team therapy in addition to the need for sufficient experience and knowledge, requires constructive interaction with a respected maxillofacial surgeon. Other members of this team, physiotherapist (who has sufficient experience in the field of maxillofacial) and as the case may be They specialize in counseling, speech therapy, etc.

It should be noted that surgery transforms the orthodontic treatment of the patient into two parts before and after surgery, which are completely interrelated and there should be no interruption between them.

Work steps

It is the patient’s right to know the steps clearly before entering treatment and to make a timely decision.

Initiating orthodontic-surgical treatment without such a definite decision on the part of the patient is not only not beneficial but can also be harmful.

It simply cannot be accepted that “we will start the treatment and reach the final decision during the steps.

Preoperative orthodontics

At this stage, the teeth are aligned, which takes about a year (on average). During this period, we sometimes need to remove the tooth (s) according to the need for treatment.

At the end of this period, during the molding process, we conclude that the patient is ready for surgery.