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Abordagem cirúrgica no tratamento da mordida aberta esquelética
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Abstract(s)
Esta revisão de literatura tem como objetivo demonstrar através da mais recente evidência científica, a abordagem cirúrgica no tratamento da mordida aberta esquelética.
A mordida anterior aberta é uma discrepância oclusal vertical com descrições variadas na literatura. A etiologia, tendo uma vertente multifatorial, inclui hábitos orais parafuncionais, padrões de crescimento facial desfavoráveis, distrofia muscular, macroglossia e respiração oral.
O tratamento da mordida aberta nas crianças e jovens à partida apresenta previsibilidade e bons resultados com correção ortodôntica, devido ao facto destes pacientes ainda se encontrarem num processo de formação e desenvolvimento craniofacial, possuírem dentição mista e esta ter um potencial de autocorreção.
A mordida aberta esquelética no adulto apresenta-se como um maior desafio, pois por já ter cessado a idade de desenvolvimento craniofacial e devido às diferentes etiologias que esta maloclusão pode ter no adulto, o tratamento ortodôntico, por vezes, mostra-se ineficaz, sendo a abordagem pela cirurgia ortognática a única solução para a mordida aberta esquelética.
No entanto, o tratamento da mordida aberta anterior esquelética ainda é um dos desafios mais difíceis para o ortodontista, porque as abordagens mecânicas e cirúrgicas devem estar associadas à motivação pessoal e à quebra de hábitos parafuncionais por parte do paciente.
A cirurgia ortognática é utilizada para corrigir deformidades dentofaciais de origem esquelética por meio de osteotomias realizadas separadamente na maxila, mandíbula ou por meio de técnicas bimaxilares; de forma a restituir a função e estética do paciente.
This literature review aims to demonstrate, using the latest scientific evidence, the surgical approach in the treatment of skeletal open bite. The anterior open bite is a vertical occlusal discrepancy with varying descriptions in the literature. The etiology, having a multifactorial aspect, includes parafunctional oral habits, unfavorable facial growth patterns, muscular dystrophy, macroglossia and oral breathing. The treatment of open bite in children and young people at the beginning presents predictability and good results with orthodontic correction, due to the fact that these patients are still in a process of craniofacial formation and development, have mixed dentition and this has a potential for self-correction. The skeletal open bite in adults presents itself as a greater challenge, as the age of craniofacial development has already ceased and due to the different etiologies that this malocclusion may have in adults, orthodontic treatment is sometimes ineffective, being the orthognathic surgery approach is the only solution for skeletal open bite. However, the treatment of skeletal anterior open bite is still one of the most difficult challenges for orthodontists, because mechanical and surgical approaches must be associated with personal motivation and the breaking of parafunctional habits by the patient. Orthognathic surgery is used to correct dentofacial deformities of skeletal origin by means of osteotomies performed separately in the maxilla, mandible or by bimaxillary techniques; in order to restore the patient's function and aesthetics.
This literature review aims to demonstrate, using the latest scientific evidence, the surgical approach in the treatment of skeletal open bite. The anterior open bite is a vertical occlusal discrepancy with varying descriptions in the literature. The etiology, having a multifactorial aspect, includes parafunctional oral habits, unfavorable facial growth patterns, muscular dystrophy, macroglossia and oral breathing. The treatment of open bite in children and young people at the beginning presents predictability and good results with orthodontic correction, due to the fact that these patients are still in a process of craniofacial formation and development, have mixed dentition and this has a potential for self-correction. The skeletal open bite in adults presents itself as a greater challenge, as the age of craniofacial development has already ceased and due to the different etiologies that this malocclusion may have in adults, orthodontic treatment is sometimes ineffective, being the orthognathic surgery approach is the only solution for skeletal open bite. However, the treatment of skeletal anterior open bite is still one of the most difficult challenges for orthodontists, because mechanical and surgical approaches must be associated with personal motivation and the breaking of parafunctional habits by the patient. Orthognathic surgery is used to correct dentofacial deformities of skeletal origin by means of osteotomies performed separately in the maxilla, mandible or by bimaxillary techniques; in order to restore the patient's function and aesthetics.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Mordida aberta no adulto Tratamento da mordida aberta no adulto Cirurgia ortognática Mordida aberta esquelética