Maxillofacial surgery

Thanks to our extensive experience, continuous further training, proven operating methods and new, innovative procedures, we are able to find the best possible, individual solution for you.

Malposition of the jawDistractionTraumatologyTemporomandibular joint pain

The field of maxillofacial surgery (i.e. surgery of the mouth, the jaws and the face) encompasses amongst others the diagnostic and treatment of malpositions of the jaws (dysgnathia), of fractures of the facial skeleton (traumatology) and of disorders of the temporomandibular joint (TMJ-dysfunction). A variety of techniques and procedures are applied such as distraction osteogenesis (DO).

Malposition of the jaw

There is a multitude of different abnormal occlusions (dysgnathias), which develop as a result of poor positioning of the upper jaw, the lower jaw or a combination of the two. The individual sections of the jaw may be too long, too short, too narrow, too wide or even asymmetrical. This can result in functional or aesthetic limitations, leading to the desire or the need for corrective procedure.

As the malposition of the jaw is usually accompanied by defective positioning of the teeth, the treatment is done in close consultation with an orthodontist. Together, we analyse the situation using 3D x-ray images, plaster models and photographs, in order to define the appropriate, individual treatment plan. Using a suitable dental brace or other orthodontic device, in an initial phase the necessary conditions for the surgical corrective procedure will be created. Thanks to new designs, the devices offered are very discreet or even invisible, meaning even adults can look forward to the so-called ‘pre-coordination’ phase without having to worry.

The surgical techniques for correcting dysgnathias (known as osteotomies or bone resections) are every bit as varied as the jaw malpositions themselves. Many techniques have already been in use for decades, and have proven their value in countless patients world-wide.

Distraction

If the dental arch is crowded, or there is insufficient development of sections of the jaw, growth in the desired dimension can be achieved with the aid of an appropriate device (distractor). The procedure was first described in the 1950s, and since then it has been continuously refined and adapted to the various problems, and successfully used countless times.

We combine the highest level of specialist expertise with empathetic and responsible advice. We work in a spirit of partnership, on an equal footing with patients, referring physicians and staff; we are loyal, reliable and strive for respectful collaboration.

Traumatology

Fractures of the zygomatic bone, zygomatic arch, orbital floor or the upper or lower jaw can be diagnosed quickly and precisely using 3D x-ray images (DVT: digital volume tomography). The fractures can be moved into the anatomically correct position and fixed back in place using minute titanium screws and plates. For these procedures, we select the access points in such a way that there is no visible scarring to the face, and we achieve the best possible aesthetic result.

Temporomandibular joint pain

Craniomandibular disorders (CMD) are common and widespread. They range from occasional localised pains to massive symptom sets. They may be accompanied by pronounced limitations on mobility and mouth-opening, or nothing more than a quiet clicking or snapping sound. As the problems often radiate, overlaps do occur with symptoms from otolaryngology, ophthalmology, neurology, rheumatology and dentistry. Psychological and behavioural factors also play a key role, and must be included in the evaluation of temporomandibular joint problems.

Owing to the wide-ranging training I’ve undertaken since completing my studies in human medicine and dentistry, as an oral surgeon I can guarantee the vital overview of the possible diagnoses, and offer the full range of possible therapies.

After a thorough clinical examination and an in-depth discussion with the patient, in many cases the correct diagnosis can be made at this early stage. Where more advanced special examinations are required, these can be arranged quickly and efficiently. In most cases, the problems can be treated through an optimal combination of selective measures in such a way that surgery can be avoided.

The therapy options range from simple exercises for the patient to do at home, to physiotherapy treatments that aim to ease the increased tension in the muscles and ligaments that is usually present. In this way, movement restrictions due to disc displacements can also be alleviated. Sometimes, the temporary use of appropriate medicines is recommended. If grinding or pressing of the teeth is also present, this can likewise be successfully treated using individual dental splints.

As another modern treatment form, at our practice we routinely use Botulinum toxin A for the effective and prolonged relaxation of the masticatory musculature, with good results.

Only if all conservative measures have been exhausted and the individual is still suffering emotional stress do we consider surgical measures. These measures include the simple irrigation of the joint (lavage) under local anaesthetic, or endoscopy (arthroscopy) under general anaesthetic. Less often, open joint surgery may be necessary to reposition a displaced disc, or remodel a deformed mandibular condyle.

Maxillofacial Surgery

Aesthetic Procedures

Oral Surgery

Nasal Surgery

Have we piqued your interest, or do you have any questions?

Dr. Dr. Daniel Brusco
Haus zur Pyramide
Klausstrasse 10
CH-8008 Zurich
Switzerland

T +41 (0)43 336 72 72
F +41 (0)43 336 72 73
praxis@dr-brusco.ch

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