ORTOGNATİK CERRAHİ TEDAVİDE ÖNCE CERRAHİ (ÖC) YAKLAŞIMI

Son zamanlarda, öncelikli kaygıları estetik ve sınırlı zamanı olan ortognatik cerrahi hastalarının sayısı artmıştır. Geleneksel ortognatik cerrahi tedavilerinde genelde cerrahi öncesi ortodontik tedavi uzun sürmekle beraber cerrahi sonrası 7-12 ay arasında sürmekte; hayat kalitesi de ciddi anlamda bozulmaktadır. Son dönemde, ortognatik cerrahi tedavi konseptleri yeniden ve derinden gözden geçirilmiştir. Özellikle, cerrahi öncesi ortodontik hazırlık süreci, cerrahi ve genel olarak cerrahi sonrası kalıcı ortodontik tedavinin stabilitesi gibi faktörler, cerrahi operasyon zamanlaması açısından yeni akımlar ortaya çıkarmıştır 1. Cerrahi öncesi yapılan dekompanzasyon tedavisi tedaviyi uzatmakta ve yapılan son çalışmalarda, dekompanzasyonun fayda/zarar oranı ciddi anlamda sorgulanmaktadır. Diğer taraftan, önce cerrahi işlem gerçekleştirilirse, total tedavi zamanı önemli ölçüde azalmakta ve iskeletsel sorun baştan çözümlenmekte olacağından hasta konforu ve genel hasta memnuniyeti de önemli düzeyde artacaktır. Bundan daha da önemli olan, ortodonti alanında ‘önce cerrahi’ her geçen gün daha fazla yaygınlaşmakta ve kabul görmektedir. Bu derlemenin amacı; ortognatik cerrahi alanında uygulanmaya ve yaygınlaşmaya başlamış olan ‘Önce Cerrahi (ÖC)’ yaklaşımı hakkında bilgi vermek, endikasyonları/ kontrendikasyonları, sınırlamaları ve konu ile ilgili yapılan güncel çalışmalardan bahsetmektir.

Anahtar Kelimeler:

Ortodonti, Ortognatik cerrahi, Önce cerrahi yaklaşımı

'Surgery First' (SF) approach in Orthognatic Surgery

Recently the number of the orthognatic patients with aesthetic concern priorities and limited time has increased. In conventional orthognatic surgical interventions, pre-surgical orthodontic treatment takes long time, the orthodontic treatment after surgery last from 7 to 12 months; which significantly decreases the health quality of the patients. Nowadays the concepts of the orthognatic surgery have been deeply reviewed. Taking into consideration factors like the stability of orthognatic and orthodontic results, in the terms of time there have been introduced new concepts. Pre-surgical decompensation treatment takes time and according to the recent studies, the benefit/loss ratio has been questioned. On the other hand if the surgical procedure is done at the beginning, the total treatment time is decreased and the patient's general satisfaction is increased. More importantly, the Surgery First (SF) approach is widespread and accepted in the orthodontic field. The purpose of this review is to give information about the SF - recent approach applied in orthognatic surgery; indication and contraindication and limitations.

Keywords:

orthodontics, orthognatic surgery, surgery first approach,

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