About the Operation
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RECEDING CHIN, PROTRUDING CHIN
The chin and nose are the most prominent three-dimensional features of our face. When viewed from the side profile, the harmony between the nose and chin emphasizes the overall beauty; however, the lack of harmony between these two organs can detract from the overall beauty.
In this context, I will discuss issues in chin aesthetics where problems related to dental alignment do not contribute to chin disorders. When the lower and upper teeth are in a normal bite position, with the lower teeth slightly behind or the upper teeth partially in front, it is called normal occlusion. In chin aesthetics, occlusion should be normal. If occlusion is not normal, such as when the lower teeth are behind or the upper teeth are behind, dental reshaping treatment is performed first, followed by jaw surgery. I have discussed this topic under the heading of orthodontic surgery.
JAW TIP ESTHETICS
Jaw tip aesthetics, much like the nose, should be proportional and harmonious with the other facial features. In situations where this harmony is lacking, especially in side profiles, an aesthetically displeasing profile may emerge. If the jaw tip is larger than normal, it can result in a coarse and elongated face, which can be corrected through surgery to aesthetically reduce the jaw tip in accordance with established principles. To achieve an aesthetic facial appearance, excess bone may be removed, or the jaw tip may be repositioned backward. The repositioned jaw tip is secured in its new position with the aid of plates or screws.
Having a jaw tip smaller than normal is a more common deformity. If combined with a prominent and large nose, the deformity becomes more pronounced, giving the person a bird-like appearance. In such cases, the support of the tissues under the jaw tip decreases, leading to faster sagging of the soft tissues under the jaw tip, and the person may also develop a chin deformity. Enlarging a small jaw tip can be done by cutting the jaw tip bone and advancing it forward or by placing various implants such as silicone, Medpor, or titanium in the jaw tip. Enlarging the jaw tip also resolves the person’s jaw problem.
These surgeries are referred to as genioplasty. The intervention is performed through the mouth, leaving no visible scars on the face. The surgery is done under general anesthesia and takes approximately one hour. Patients are discharged without the need for hospitalization. Pain is generally mild, well-tolerated with the use of pain relievers. Swelling in the mouth and jaw typically diminishes within an average of 7-10 days.
JAW JOINT DISORDERS TEMPOROMANDIBULAR JOINT DISORDERS TMD
The jaw joint is an articulation that enables the opening and closing of our mouth, situated where the head and the lower jaw bone come into contact. The term “joint” refers to the point of contact between two distinct main bone structures in our body, and the joint surface, like in all joints in our body, is composed of cartilage.
Applying pressure to these cartilage structures for any reason can lead to the loss of moisture in the cartilage and a decrease in its volume. Since cartilage lacks the ability to regenerate, continued pressure on the cartilage cells results in dysfunction of the joint. Temporomandibular joint dysfunction (TMD) refers to functional disorders in the jaw joint. TMD causes may include accidents, injuries, rheumatism, sudden excessive opening of the mouth, tooth decay, and teeth grinding.
During jaw opening, the jaw joint performs two different movements: a simple hinge movement and forward sliding and rotating movements. Its primary function is the chewing and speaking of the lower jaw.
Malocclusions that cause deviations from the normal position of the mouth can lead to spasms in the chewing muscles, a significant factor in jaw joint dysfunction. There is a classical triad of pain seen in jaw joint dysfunction. Pain, noise coming from the joint, and limited jaw movement can provide preliminary information about the onset of pain. Joint pain intensifies with movement and is continuous. Jaw muscle pain increases with stress and occurs intermittently. The nature of the sound coming from the joint can also provide information about its cause. If a single clicking sound is present, it may be innocent and can resolve spontaneously. If a clicking sound occurs both when opening and closing the mouth, it may be due to the compression of the joint disc as it moves during mouth opening and closing. The sound resembling a crunch from the joint may indicate that the joint surfaces are worn, losing their softness, and undergoing degeneration.
In advanced stages, limited jaw movement may occur due to irreversibly protruded joint discs, joint adhesions, and calcifications, or fractures of the cheekbone.
TMD diagnosis may require comparisons such as joint graphs, CT, or MRI. Treatment methods vary widely, including medication use, physical therapy, manipulation of the joint with maneuvers, joint lavage, and open joint surgery.