Kieferorthopädische Behandlung behinderter Kinder

Zusammenfassung

Bei behinderten Personen treten Fehlbisslagen besonders häufig und besonders schwer auf. Bei vielen dieser Patienten gibt es medizinische ­Einschränkungen für die Durchführung der unter­schiedlichen Maßnahmen, die für eine ausgezeichnete kieferorthopädische Behandlung erforderlich sind. Fast alle haben mittelschwere bis schwere Verhaltensprobleme, die eine Behandlung erschweren und sogar unmöglich machen können. Dennoch sind die Eltern hoch motiviert, wünschen sich „das Beste für ihr Kind“ und sind bereit, zu einem integralen Bestandteil des Behandlungsteams zu werden. Der vorliegende Beitrag analysiert die damit verbundenen Schwierigkeiten und unterbreitet auf Grundlage der umfangreichen Erfahrungen der Verf. und der von ihnen veröffentlichten Berichte Vor­schläge, wie solche Schwierigkeiten umgangen werden können. Ein Schwerpunkt ist dabei der Einsatz von Medikamenten als Möglichkeit, therapeutischen Zugang zu vielen der schwierigeren Patienten zu erlangen. Anhand zweier Fall­beispiele werden schließlich viele der bei der ­Behandlung solcher Patienten wichtigen Prinzi­pien vorgeführt. 

Abstract

The prevalence and severity of malocclusion is especially high in special needs individuals. Many have medical limitations to the various proce­dures that are often needed in the pursuit of excellence from orthodontic treatment and almost all have moderate to severe behavioural problems that make treatment delivery difficult or even impossible to achieve, with any degree of reliability. Nevertheless, the parents are highly motivated to “do the best for their child” and are prepared to become integral members of the treatment deliv­ery team. The present article analyzes the difficulties involved and makes recommendations as to how these may be overcome, based on the authors’ published studies in this area and on their broad experience in treating these compromised individuals. Emphasis is placed on the use of pharmacological modalities as the means to providing therapeutic access to many of the more difficult patients. Two case reports are provided to illustrate many of the important principles that pertain to these cases. 

Schlüsselwörter

verhaltensauffällige behinderte Kinder - Medikation - kieferorthopädische Behandlung

Key words

special needs children - medication - orthodontic treatment

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