Kubagwa mu kibuno ni iki? Impamvu, uburyo bwo gukora & ibisubizo

Kubagwa mu kibuno, byitwa kandi kubagwa kwa orthognathic, ni uburyo bunoza ibibazo byo mu magufwa y'akabuno kawe no gushyira amenyo mu murongo. Bitekereze nk'uko ushyira akabuno kawe k'inyuma, akabuno k'imbere, cyangwa byombi kugira ngo utunganye uko bikorana n'uko isura yawe isa.

Ubu bwoko bwo kubagwa bushobora gukemura ibibazo ibikoresho byonyine bitashobora gukemura. Umuganga wawe ubaga mu kanwa akorana bya hafi n'umuganga wawe w'amenyo kugira ngo akore gahunda yo kuvura ikemura imikorere n'imbonereho. Intego ni ukugufasha guhekenya, kuvuga, no guhumeka neza mu gihe kandi unonosora imiterere y'isura yawe.

Kubagwa mu kibuno ni iki?

Kubagwa mu kibuno ni uburyo bwihariye bwo gushyira amagufwa y'akabuno kawe mu myanya myiza. Umuganga ubaga aratema kandi akagabanya amagufwa, hanyuma akayashyiraho ibyuma bito n'imisumari biguma mu mubiri wawe burundu.

Hariho ubwoko butandukanye bwo kubagwa mu kibuno bitewe n'igice gikeneye kunozwa. Kubagwa akabuno k'inyuma (maxillary osteotomy) byimura akabuno kawe k'inyuma, mu gihe kubagwa akabuno k'imbere (mandibular osteotomy) byongera gushyira akabuno kawe k'imbere. Abantu bamwe bakeneye ko akabuno kabo kose gahindurwa, ibyo bita kubagwa bimaxillary.

Kubagwa bikunze kubera mu bitaro hakoreshejwe anesthesia rusange. Uburyo bwinshi bumara hagati y'amasaha 2 kugeza kuri 4, nubwo ibibazo bigoye bishobora gutwara igihe kirekire. Umuganga wawe ubaga akoresha ingero zizewe kandi rimwe na rimwe akoresha amashusho ya mudasobwa kugira ngo ategure neza aho akabuno kawe kagomba gushyirwa.

Kuki kubagwa mu kibuno bikorwa?

Kubagwa mu kibuno kunoza ibibazo by'imiterere bigira ingaruka ku buzima bwawe bwa buri munsi n'ubuzima muri rusange. Ibi bibazo bikunze kuvuka mu gihe cyo gukura kandi ntibishobora gukemurwa n'ibikoresho byonyine.

Impamvu zisanzwe zo kubagwa mu kibuno zirimo ibibazo bikomeye byo guhekenya aho amenyo yawe atahura neza. Ibi bishobora gutuma guhekenya bigorana kandi bigatuma amenyo yawe yangirika cyane. Ushobora kandi kugira ikibazo cyo kuvuga neza cyangwa ukagira ububabare mu kibuno n'umutwe.

Dore ibibazo nyamukuru bishobora gusaba kubagwa mu kibuno:

• Kugira amenyo yegereye cyane cyangwa yegereye cyane bigira ingaruka ku mikorere
• Amenyo afunguye aho amenyo yo imbere atagerana iyo ufunze umunwa wawe
• Kugira amenyo yambukiranya bitera ko amenyo yangirika nabi
• Ubusumbane cyangwa kutaringanira mu maso
• Uburibwe buhoraho mu ruhanga cyangwa indwara ya TMJ
• Kugorana guhekenya, kumira, cyangwa kuvuga
• Kugira ububabare bwo mu muhogo bujyanye n'uko uruhanga rumeze
• Indwara zivukira nka cleft palate

Rimwe na rimwe kubagwa uruhanga birasabwa kubera impamvu z'ubwiza iyo imiterere y'amaso igira ingaruka zikomeye. Ariko, abaganga benshi bashyira imbere cyane cyane kunoza imikorere byongera ubuzima bwawe.

Ni iki gikorerwa kubagwa uruhanga?

Uburyo bwo kubagwa uruhanga butangira mbere y'amezi mbere yo kubagwa kwawe nyako hamwe no gutegura no gutegura neza. Umuganga wawe akorana n'umuganga wawe w'amenyo kugirango akore gahunda yuzuye yo kuvura akoresheje X-ray, CT scans, hamwe n'imiterere ya digitale y'amenyo yawe.

Mbere yo kubagwa, mubisanzwe wambara ibikoresho byo mu kanwa mu gihe cy'amezi 12 kugeza kuri 18 kugirango uhuze amenyo yawe neza. Ibi bikoresho byo kubagwa mbere bishyira amenyo yawe kugirango ajyane neza nyuma yuko amagufa yawe yimuwe.

Ibi nibyo bibaho mugihe cyo kubagwa ubwacyo:

1. Uhabwa anesthesia rusange kugirango wemeze ko utazi na gato
2. Umuganga wawe akora ibikomere imbere mumunwa wawe kugirango agere kumagufa yuruhanga
3. Amagufa yuruhanga atandukanywa neza kandi akimurirwa ahantu hashyashya
4. Ibice bito bya titanium hamwe n'imisumari bifata amagufa ahantu
5. Umuganga wawe areba niba ururimi rwawe ruhuye neza
6. Ibikomere bifungwa hamwe n'imitsi isenyuka

Kubagwa uruhanga kenshi bikorwa rwose binyuze mumunwa wawe, bityo ntuzagira ibikomere bigaragara mumaso yawe. Mu bihe bidasanzwe bikubiyemo imikorere igoye, ibikomere bito byo hanze bishobora kuba ngombwa.

Nyuma yo kubagwa, uzamara mu bitaro umunsi umwe cyangwa ibiri kugira ngo bakurikirane. Urushingo rwawe rushobora gufungwa n'insinga cyangwa imikanda by'agateganyo, nubwo ibi bidakunze gukoreshwa cyane mu buryo bwa none. Gukira mubisanzwe bifata ibyumweru 6 kugeza kuri 12, gukira neza bikaba bikorwa mu mezi menshi.

Ni gute witegura kubagwa urushingo?

Kwitegura kubagwa urushingo bikubiyemo intambwe zombi z'umubiri n'izikorwa kugira ngo hazaboneke umusaruro mwiza. Itsinda ry'abaganga bazakubwira amabwiriza yihariye yagenewe uko ubuzima bwawe bumeze.

Uburyo bwo kwitegura akenshi butangira mbere y'ibyumweru byinshi mbere y'itariki yo kubagwa. Ukeneye kurangiza mbere ya mbere ibijyanye n'ivurwa ry'amenyo, bishobora gufata amezi 12 kugeza kuri 18. Muri iki gihe, amenyo yawe ashyirwa mu mwanya uzahura neza nyuma yuko amagufa y'urushingo rwawe ashyizwe ahantu hashyashya.

Dore intambwe z'ingenzi zo kwitegura ukeneye gukurikiza:

• Kuzuza ibizamini byose by'ubuvuzi bisabwa n'ibyangombwa
• Kureka itabi byibuze mu byumweru 2 mbere yo kubagwa
• Kwimuka ku miti imwe n'imwe n'ibyongerera imbaraga nkuko byategetswe
• Gutegura igihe cyo kuruhuka ku kazi cyangwa ku ishuri (mubisanzwe ibyumweru 2-4)
• Kugura ibiryo byoroshye n'ibyongerera imbaraga bifite amazi
• Gutegura urugo rwawe kugira ngo rukire hamwe n'imitozo y'umutwe yinyongera n'ibikoresho byo gukonjesha
• Gutegura umuntu wo kukujyana mu rugo no gufasha mugihe cyo gukira kwa mbere

Umuvuzi wawe azanaganira ku buryo bwo kugabanya ububabare kandi atange amabwiriza arambuye nyuma yo kubagwa. Menya neza ko usobanukiwe n'intambwe zose zikubiyemo kandi ubaze ibibazo kubintu byose bitumvikana.

Ni gute usoma ibisubizo byo kubagwa urushingo rwawe?

Gusobanukirwa ibisubizo byo kubagwa urushingo rwawe bikubiyemo kureba impinduka zombi zikora neza n'iterambere ryo gukira. Umuvuzi wawe azakurikirana gukira kwawe binyuze mu nama zisanzwe zo gukurikirana n'ubushakashatsi bw'amashusho.

Nyuma y’ububabare bw’ububabare, uzagira umubyimbirwe n’ububabare, ibyo bikaba bisanzwe. Ibisubizo bya mbere bigaragara cyane uko umubyimbirwe ugabanuka mu byumweru bike bya mbere. Ariko, ibisubizo bya nyuma bishobora gufata amezi 3 kugeza kuri 6 kugira ngo bigere ku rwego rwo hejuru.

Ibi nibyo bigaragaza ibisubizo by’ububabare bw’ububabare:

• Imikorere myiza yo guhekenya no guhekenya
• Ubwiza bwiza bw'isura n'imibare
• Kugabanya ububabare bwo mu ruhu n'ibimenyetso bya TMJ
• Umuvugire usobanutse kandi woroshye guhumeka
• Imbonerahamwe yongereweho n'icyizere
• Gukira neza kw'amagufa bigaragara kuri X-ray

Umuvuzi wawe w'amenyo azakomeza kuvura nyuma yo kubagwa kugira ngo anonosore ururimi rwawe. Ubuvuzi bwa nyuma yo kubagwa busanzwe bufata amezi 6 kugeza kuri 12 kandi butuma amenyo yawe ahura neza mu myanya mishya.

Ni gute wakemura ibibazo byo guhuza ururimi?

Gukemura ibibazo byo guhuza ururimi bisaba uburyo bwuzuye akenshi buhuza imikorere y'amenyo no gukosora kubagwa. Umugambi wo kuvura uterwa n'uburemere bw'ikibazo cyawe n'imyaka yawe.

Ibibazo bito byo guhuza rimwe na rimwe birashobora gukosorwa hamwe na braces gusa, cyane cyane mu bana bakura n'urubyiruko. Ariko, ibibazo bikomeye bya skeletal mu bantu bakuru bisaba uburyo bwo kubagwa buvanze n'imikorere y'amenyo.

Uburyo bwiza bwo gukemura ibibazo bikomeye byo guhuza ururimi burimo inzira yo kuvura mu byiciro bitatu. Mbere na mbere, uzanyura mu mikorere y'amenyo mbere yo kubagwa kugira ngo ushyire amenyo yawe neza. Hanyuma haza igihe cyo kubagwa aho amagufa yawe y'ururimi asubizwa. Amaherezo, imikorere y'amenyo nyuma yo kubagwa inonosora ururimi rwawe kandi irangiza guhuza.

Uburyo butari ubwo kubagwa burahari kubibazo byoroheje kandi birimo imikorere y'amenyo, ibikoresho byo kuruma, cyangwa imyitozo y'ururimi. Ariko, ubu buryo bufite imbogamizi kandi ntibushobora gutanga imikorere yuzuye kubagwa bishobora kugeraho.

Ni iyihe myanya myiza y'ururimi?

Uburyo bwiza bw'akagufwa k'umushyi ni uburyo butuma imikorere ikora neza mugihe hakomeza ubwuzuzanye n'uburinganire bw'isura. Ubu buryo bwiza butandukanye ku muntu ku muntu bitewe n'imiterere y'isura ye bwite n'ibyo akeneye.

Mu mikorere, amagufwa yawe y'umushyi agomba gutuma urya neza, uvuga neza, kandi uhumeka neza. Amenyo yawe agomba guhura neza adateje kwangirika cyangwa guhagarara cyane ku ngingo z'umushyi wawe. Amagufwa yo hejuru n'ayo hasi y'umushyi agomba gukorana neza mugihe cyose cyo gukora imvugo.

Ku ruhande rw'ubwiza, amagufwa y'umushyi ashyizwe neza atanga imiterere y'isura yuzuye. Imiterere yawe igomba kugaragaza ubwuzuzanye hagati y'igice cy'igihanga cyawe, izuru, iminwa, n'umushyi. Igice cya gatatu cyo hasi cy'isura yawe kigomba kuba gihuye n'ibice bibiri byo hejuru n'ibice byo hagati.

Umuganga ubaga akoresha ibipimo byihariye n'isesengura kugirango amenye uburyo bwiza bw'akagufwa k'umushyi kawe. Ibi birimo gusuzuma imiterere y'isura yawe, imibanire y'amenyo, n'imikorere y'inzira y'umwuka. Ifoto ya mudasobwa ifasha kumenya uko uburyo butandukanye bw'akagufwa k'umushyi buzahindura imiterere yawe n'imikorere.

Ni ibihe bintu byongera ibyago byo kubagwa mu mushyi?

Gusobanukirwa ibintu byongera ibyago byo kubagwa mu mushyi bifasha gufata ibyemezo bifitiye akamaro no gukora intambwe zo kugabanya ibibazo bishoboka. Nubwo ibibazo bikomeye bidasanzwe, ibintu bimwe na bimwe bishobora kongera ibyago byawe.

Imyaka igira uruhare mukuvura no gukira, abarwayi bakuze mubisanzwe bahura n'igihe kirekire cyo gukira. Ariko, imyaka yonyine ntibuza kubagwa neza. Ubuzima bwawe muri rusange ni ingenzi kurusha imyaka yawe.

Ibintu byinshi bishobora kongera ibyago byo kugira ibibazo mugihe cyangwa nyuma yo kubagwa mu mushyi:

• Gukoresha itabi cyangwa kunywa itabi, bigira ingaruka ku gukira
• Indwara ya diyabete idafashwe neza cyangwa izindi ndwara zidakira
• Isuku yo mu kanwa idahagije cyangwa indwara z'amenyo zikiriho
• Imiti imwe n'imwe igira ingaruka ku kuvura amaraso
• Amateka y'imirasire yakoreshejwe ku mutwe cyangwa mu ijosi
• Imirire mibi ikabije cyangwa indwara zo kurya
• Indwara ziterwa n'umubiri w'umuntu ubwawo zigira ingaruka ku gukira

Umuvuzi wawe uzasuzuma ibi bintu bigira uruhare mu kugira ingaruka mbi mugihe cyo kugushyira hamwe kandi ashobora kugusaba gukora ibishoboka byose kugirango umubiri wawe ukore neza mbere yo kubagwa. Ibi bishobora kuba birimo kureka kunywa itabi, gukoresha neza diyabete, cyangwa kuvura ibibazo byose by'amenyo.

Ese ni byiza kubagwa urwasaya ukiri muto cyangwa umaze gukura?

Igihe cyo kubagwa urwasaya giterwa n'uko umuntu ahagaze, ariko hari inyungu z'imyaka itandukanye. Ikintu cy'ingenzi ni niba amagufa yawe y'urwasaya yarangije gukura, ibyo bikaba bikunze kuba ku myaka 16 ku bakobwa na 18 ku bahungu.

Kubagwa urwasaya nyuma yo gukura biratanga inyungu nyinshi. Ibisubizo byawe bizaba byoroshye kumenya kandi bihamye kuko amagufa yawe ntazakomeza guhinduka. Uburyo bwo kubaga n'inzira yo gukira na byo birazwi neza ku barwayi bakuze.

Abantu bakiri bato bakunze gukira vuba kandi bashobora kutagira ibibazo byinshi nyuma yo kubagwa. Ariko kandi, bashobora kugira impungenge nyinshi ku ngaruka zo mu mibereho no mu burezi byo kubagwa no gukira. Gupanga ibijyanye n'ishuri cyangwa imirimo yo hambere bisaba gutekereza neza.

Abantu bakuze baracyashobora kubagwa urwasaya neza, nubwo gukira bishobora gutwara igihe kirekire. Inyungu zo kunoza imikorere n'ihumure akenshi ziruta igihe gito cyo gukira. Ubuzima bwawe rusange bufite agaciro kurusha imyaka yawe mugihe cyo gushaka kumenya niba wemerewe kubagwa.

Ni izihe ngaruka zishobora guterwa no kubagwa urwasaya?

Mugihe kubagwa urwasaya muri rusange bifite umutekano kandi bigenda neza, kimwe n'izindi nshingano zo kubaga, bifite ibyago n'ingorane zishobora kuvuka. Kumva ibyo bishoboka bifasha gufata ibyemezo bifitiye akamaro kandi kumenya igihe cyo gushaka ubufasha bw'ubuvuzi.

Ingorane nyinshi ziba iz'igihe gito kandi zikemurwa no kwitabwaho neza no gutegereza igihe gihagije. Ingorane zikomeye ni gake, zibaho mu buryo butarenze 5% by'imanza. Itsinda ryawe ry'abaganga bakora ingamba nyinshi zo kugabanya ibyago kandi bakagukurikiranira hafi mugihe cyo gukira.

Dore ingorane zishobora kuvuka ugomba kumenya:

• Kutagira ubwumvikane bw'igihe gito mu minwa, umushyi, cyangwa ururimi
• Udukoko ahantu hakorewe kubaga
• Gushirira cyangwa gukora hematoma
• Ibibazo byo guhuza ururimi bisaba kuvurwa bikomeye
• Ibibazo by'ingingo z'urwasaya cyangwa gukanda
• Gusigara ibimenyetso, nubwo akenshi biba bike hamwe n'inzira zo mu kanwa
• Gukenera kubagwa bikomeye mu manza zidakunze kubaho

Ingorane zisanzwe ni ukutagira ubwumvikane bw'imitsi bw'igihe gito, bikaba byibasira abantu bagera kuri 10-15%. Ibi akenshi bigenda neza buhoro buhoro mu byumweru kugeza ku mezi. Kutagira ubwumvikane burambye ni gake ariko birashoboka, cyane cyane hamwe no kubagwa urwasaya rwo hasi.

Umuganga wawe azaganira ku byago byawe byihariye kandi asobanure uburyo bateganya kugabanya ingorane. Gukurikiza amabwiriza nyuma yo kubagwa neza bigabanya cyane ibyago byawe by'ibibazo.

Ni ryari nkwiriye kubona umuganga kubera ibibazo by'urwasaya?

Ugomba kugisha inama umuganga niba ufite ibibazo by'urwasaya bihoraho bigira ingaruka ku buzima bwawe bwa buri munsi cyangwa bigatera kutumva neza cyane. Isuzuma rito rishobora gufasha kumenya ibibazo mbere yuko bikomera.

Ibice bimwe na bimwe by'urwasaya bikura buhoro buhoro kandi bishobora kugaragara nk'ibito mbere na mbere. Ariko, ibimenyetso bimwe na bimwe bikwiriye isuzuma ry'umwuga nubwo bitagaragara nk'ibiremereye. Gufata ibibazo hakiri kare akenshi bituma haboneka uburyo bworoshye bwo kuvura.

Dore ibimenyetso bigaragaza ko ugomba gushaka ubufasha bw'ubuvuzi:

• Uburibwe buhoraho mu ruhu rw'umunwa cyangwa kubabara umutwe kenshi
• Kugorana guhekenya cyangwa kuruma ibiryo bimwe na bimwe
• Umunwa ukanda, uvuga cyangwa ugufunga
• Kugaragara kutaringanira mu maso cyangwa impinduka mu isura
• Kugorana kuvuga cyangwa kuvuga nabi
• Ibibazo byo guhumeka, cyane cyane mu gihe cyo gusinzira
• Amenyo adahura neza
• Amenyo yangirika cyane cyangwa ibibazo byo mu menyo kenshi

Niba ufite uburibwe bukomeye butunguranye mu ruhu rw'umunwa, kudashobora gufungura umunwa wawe, cyangwa kubyimba mu maso, gomba kwihutira gushaka ubufasha bw'abaganga. Ibi bimenyetso bishobora kwerekana ikibazo gikomeye gikeneye kuvurwa byihutirwa.

Ibibazo bikunze kubazwa ku bijyanye no kubagwa umunwa

Q.1 Ese kubagwa umunwa bifitiye akamaro indwara ya sleep apnea?

Yego, kubagwa umunwa bishobora kugira akamaro kanini mu kuvura sleep apnea mu bihe bimwe na bimwe. Iyo umwanya w'uruhu rw'umunwa wawe ubangamiye inzira yawe y'umwuka, guhindura umwanya w'amagufa bishobora kunoza cyane guhumeka mu gihe cyo gusinzira.

Ubu buvuzi bukora neza cyane ku barwayi bafite sleep apnea iterwa n'ibibazo by'imiterere y'uruhu rw'umunwa aho kuba ibindi bintu nk'umubyibuho cyangwa amashyiga manini. Umuganga ubaga azasuzuma imiterere yawe kugira ngo amenye niba kubagwa umunwa byafasha sleep apnea yawe.

Q.2 Ese kubagwa umunwa bitera ubumuga buhoraho?

Ubumuga buhoraho ni ingorane idakunze kubaho yo kubagwa umunwa, ibaho mu buryo butarenze 5% by'ibihe. Abantu benshi bahura n'ubumuga bw'agateganyo bukemuka buhoro buhoro mu byumweru cyangwa amezi nk'uko imitsi ikira.

Kubagwa uruhu rw'umunwa rwo hasi bifite ibyago byinshi byo guhura n'ubumuga kurusha kubagwa uruhu rw'umunwa rwo hejuru kuko imitsi ikora hafi y'agace kabagirwa. Umuganga ubaga azaganira ku byago byawe byihariye kandi asobanure uburyo bukoreshwa mu kurinda imikorere y'imitsi.

Q.3 Kubagwa umunwa bifata igihe kingana iki kugira ngo umuntu akire?

Kugira ngo umuntu akire bwa mbere nyuma yo kubagwa umunwa bifata hafi ibyumweru 6 kugeza ku 8, ariko gukira neza bikomeza mu mezi menshi. Abantu benshi basubira mu kazi cyangwa mu ishuri mu gihe cy'ibyumweru 2 kugeza kuri 4, bitewe n'ibyo akazi kabo gasaba.

Icyumweru cya mbere kirimo kutumva neza cyane no kubahiriza cyane ibyo kurya. Ukabyimba bikomeye ku munsi wa 3 hanyuma bigenda bigabanuka mu byumweru bikurikira. Imikorere yuzuye y'uruhanga isanzwe igaruka mu mezi 2 kugeza kuri 3.

Q.4 Mbese nshobora kurya bisanzwe nyuma yo kubagwa uruhanga?

Bizakenera gukurikiza imirire yahinduwe mu byumweru byinshi nyuma yo kubagwa uruhanga, ariko amaherezo ushobora gusubira kurya bisanzwe. Iterambere risanzwe riva mu byo kunywa bigana mu biryo byoroshye bigana mu mirire isanzwe uko gukira kugenda gutera imbere.

Abantu benshi barwaye bashobora kurya ibiryo byoroshye mu byumweru 2 kugeza kuri 3 hanyuma bagasubira mu mirire isanzwe mu byumweru 6 kugeza kuri 8. Muganga wawe azatanga amabwiriza yihariye yerekeye imirire ashingiye ku iterambere ryawe ryo gukira n'ubwoko bw'ubuganga bwakozwe.

Q.5 Mbese kubagwa uruhanga birishyurwa n'ubwishingizi?

Ubwishingizi bwo kubagwa uruhanga buterwa niba bifatwa nk'ibikenewe mu buvuzi cyangwa mu bwiza. Iyo kubagwa gukosora ibibazo by'imikorere nk'ibibazo bikomeye byo guhekenya, indwara za TMJ, cyangwa apnea yo gusinzira, ubwishingizi akenshi butanga ubwishyu.

Bizakenera inyandiko ivuye ku muganga wawe n'umuganga w'amenyo yerekana ibikenewe by'ubuvuzi by'icyo gikorwa. Kwemezwa mbere na sosiyete y'ubwishingizi bisanzwe bisabwa mbere yo gutegura kubagwa.