Kieferorthopädie als Fachdisziplin im Zentrum für Seltene Erkrankungen

Zusammenfassung

In diesem Artikel wird beispielhaft die Betreuung von Patientinnen und Patienten mit Lippen-Kiefer-Gaumen-Spalten und Robin Sequenz von der pränatalen Diagnostik bis zum Wachstumsabschluss beschrieben. Das kieferorthopädische Behandlungsmanagement bei Betroffenen mit oro- und kraniofazialen Fehlbildungen ist komplex, zeitintensiv und erfordert eine interdisziplinäre Koordination. Vernetzte Zentrumsstrukturen bieten eine bestmögliche interdisziplinäre Expertise bei diesen seltenen Erkrankungen. Ziel und Aufbau dieser spezialisierten Zentren sollen hier erläutert werden. Unter anderem sollten sie niederschwellig als Ansprechpartner zur Verfügung stehen und niedergelassene Kieferorthopädinnen und Kieferorthopäden in Therapieplanung, Timing und Trouble-Shooting unterstützen. Das Grundverständnis der häufigsten oro- und kraniofazialen Anomalien und die Kenntnis über frühe Behandlungsschritte wie der Versorgung mit einer Gaumenplatte oder Spornplatte sind für kieferorthopädisch Behandelnde wichtig. Denn nur so kann eine sichere, effektive Therapie und eine stabile ästhetische und funktionelle Rehabilitation gewährleistet werden. Funktionelle Beeinträchtigungen sowie skelettale und dentale Anomalien erfordern bei dieser Patientengruppe eine vorausschauende kieferorthopädische Planung. Eventuell notwendige chirurgische Eingriffe müssen im Ablauf mit bedacht und Therapieentscheidungen immer mit dem Ziel getroffen werden, die Behandlung möglichst effektiv zu gestalten.

Abstract

This article describes the management of patients with cleft lip and palate and Robin Sequence from prenatal diagnosis to the end of growth. Orthodontic treatment management of patients with oro- and craniofacial malformations is complex, time-consuming and needs an interdisciplinary coordination. A network of specialized centers offers the best possible interdisciplinary expertise in rare diseases. The goals and organization of these specialized centers will be explained in the following. A central aim is to be available as a low-threshold contact and to support resident orthodontists in treatment planning, timing and trouble-shooting. A basic knowledge of the most common cranio- and orofacial anomalies and knowledge of early treatment steps such as the early therapy with a palatal plate (with or without extended spur) are important for orthodontic practitioners. This is the only way to ensure safe, effective therapy and stable esthetic and functional rehabilitation. Functional impairments, as well as skeletal and dental anomalies, require anticipatory orthodontic planning in this patient group. Any surgical procedures that may be necessary must be considered in the treatment sequence, and treatment decisions should always be made with the goal of making the treatment as effective as possible.

Schlüsselwörter

Seltene kranio- und orofaziale Fehlbildungen - Lippen-Kiefer-Gaumenspalten - Robin Sequenz - pränatale Diagnostik - (prächirurgische) kieferorthopädische Frühbehandlung

Key words

Rare cranio- and orofacial malformations - cleft lip and palate - Robin Sequence - prenatal diagnosis - presurgical infant orthopedics

Publication History

Article published online:
23 September 2022

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