Aim: The main objective of the study is to assess and compare the skeletal and dental changes obtained before and after treatment using centrographic analysis in patients with class II skeletal base using three different treatment modalities-Functional, Fixed Functional and Surgical (BSSO advancement). Materials and methods: A sample of 240 retrospectively collected pre-and post-treatment lateral cephalograms of class II malocclusion treated by orthodontics or orthodontic-surgical combined approach are included. The samples are grouped as Group I-Functional appliances (Twin Block appliance), Group II-Fixed functional appliances (AdvnSync II) and Group III-Surgical (BSSO advancement). The lateral cephalograms are traced and analysed using Centro-graphic analysis on FACAD 3.10 (Ilexis AB, Sweden). The post-treatment cephalograms are analysed to compare the treatment outcomes amongst the groups. Results: The results show high statistical significance in post-treatment class II skeletal correction among the three groupsalso, a sharp reduction in the prognathic maxilla in the fixed functional group. The post-treatment mandibular prognathism was observed in the functional and surgical group. In terms of vertical component, the most significant neutral position of FC was found to be in the fixed functional group. Conclusion: This study primarily establishes a non-numerical method of evidence of highly significant mandibular changes were observed across the three groups. The most effectively treated subjects were found to be of the BSSO advancement group followed by functional and fixed functional groups, respectively.

Introduction This case report illustrates the treatment of a skeletal class III patient with the surgery-first orthognathic approach (SFOA) protocol. Background “Surgery-first orthognathic approach” is a growing trend that provides an immediate facial change. The SFOA protocol utilizes dentoalveolar compensation as the key advantage to effect immediate facial change, which in conjunction with the rapid acceleratory phenomenon (RAP) augments the intended tooth movement, thereby reducing the total treatment duration. Case description A 24-year-old male presented with forwardly placed lower jaw with associated difficulty during eating. Clinical examination revealed severe lip incompetency, mandibular excess, class III skeletal malocclusion, severe bimaxillary incisor proclination, posterior crossbite, and lower midline shift toward right on an average mandibular plane angle. Conclusion The SFOA protocol involving bilateral sagittal split osteotomy (BSSO) mandibular setback along with the correction of the pitch and yaw was performed and the orthodontic phase was followed. Clinical significance The total treatment time was 5 months and 15 days, following which excellent facial transformation and stable occlusion was achieved. How to cite this article Divakar RR, Parameswaran R, Jayapal J, et al. “Surgery-first Orthognathic Approach” for Correction of Skeletal Class III with Open Bite. J Contemp Dent 2019;9(3):144–149.

Bac kground:The principlegoal of orthognathic surgery is to establish a balanced and stable dento-skeleto facial complex. This mandates the surgeon and the orthodontist to be able to predict the soft tissue changes to the orthognathic surgery precisely, which is accurately possible using 3-D imaging. Aims: To evaluate the soft tissue changes following class III orthognathic surgery using 3-D imaging. Settings and Design: Systematic review. Methods and Material:This review was conducted according to Preferred Reporting Items for Systematic Reviews and meta-Analyses guidelines systematically searching the six databases including PubMed, Cochrane, Google Scholar, LILACS, Directory of Open Access Journals, and OpenGrey. Statistical analysis used:Not applicable. Results: This systematic review comprises of most UpTo Date evidence from eleven articles answering the review questions. Conclusion: Le Fort I advancement shows significant increase in the alar width, alar cinch, upper lip, chelion, labiale superius, crista philtri, pronasale and subnasale. Mandibular setback shows significant backward movement of soft tissue point B, labialeinferius and subnasale and chin.

Objectives: To evaluate the changes in the pharyngeal airway space (PAS) before and after bi-lateral sagittal split osteotomy (BSSO) surgery using a three-dimensional cone-beam computed tomography (3D-CBCT). Material and Methods:The sample consisted of patients (n=7), aged between 21-30 years, having a skeletal Class II with retrognathic mandible and orthognathic maxilla who underwent orthodontic treatment and were advised for BSSO advancement surgery. Pre-surgical CBCT scans were taken a week before the surgery (T0) and the post-treatment records, three months after the surgery (T1). The 3D PAS was reconstructed from the CBCT scans, and the volumetric changes were evaluated.

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