Evaluation of Postoperative Mandibular Positional Changes After Mandibular Setback Surgery in a Surgery-First Approach: Isolated Mandibular Surgery Versus Bimaxillary Surgery

Han, Jeong Joon; Jung, Seunggon; Park, Hong-Ju; Oh, Hee-Kyun; Kook, Min-Suk

doi:10.1016/j.joms.2018.09.008

Cited by 16 publications

(20 citation statements)

References 25 publications

(48 reference statements)

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“…The full texts of 36 articles were retrieved and reviewed, and 27 articles were excluded as they failed to meet the inclusion criteria (Table ). A final sample of nine studies, 23‐31 one RCT 23 and eight retrospective cohort studies 24‐31 were included (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…All included studies collected their data in the form of two‐dimensional cephalometric radiographs. Seven of the included studies reported on post‐operative stability following Class III correction with setback alone and two‐jaw surgery 23‐25,27,29‐31 . The other two focused on the effect of these interventions on the pharyngeal airway, 26,28 yet measured parameters pertinent to the outcomes specified within the review scope.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Stability of single‐jaw vs two‐jaw surgery following the correction of skeletal class III malocclusion: A systematic review and meta‐analysis

Rizk¹,

Torgersbråten

Mohammed

et al. 2020

Orthod Craniofacial Res

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Class III malocclusion of skeletal origin manifests as a result of skeletal imbalances in the sagittal relationship between the maxilla and mandible. These imbalances are either associated with deviations in the size of the jaws or their position. 1 Different components of the craniofacial complex contribute to the development of a skeletal Class III malocclusion, which is mainly characterized by a retrognathic maxilla, prognathic mandible or a combination of both. [2][3][4][5] The aetiology of Class III malocclusion has been attributed to both environmental and genetic

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Stability of single‐jaw vs two‐jaw surgery following the correction of skeletal class III malocclusion: A systematic review and meta‐analysis

Rizk¹,

Torgersbråten

Mohammed

et al. 2020

Orthod Craniofacial Res

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show abstract

“…In another clinical study, Han et al reported additional horizontal relapse of the mandible until the time point of debonding (16.6 months after surgery) after mandibular setback surgery in an SFA [ 19 ]. Therefore, they suggested that it is necessary to consider mandibular forward movement from the increase in the vertical dimension of surgical occlusion and additional relapse in the SFA.…”

Section: Discussionmentioning

confidence: 99%

Surgery-first approach reduces the overall treatment time without damaging long-term stability in the skeletal class III correction: a preliminary study

Park

Kwon

Kang

et al. 2021

Maxillofac Plast Reconstr Surg

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Background Compared to the conventional approach, including preoperative orthodontic preparation, the so-called surgery-first approach (SFA) seems to reduce the overall treatment time in the correction of skeletal class III dentofacial deformity. However, there have been controversies about postoperative skeletal stability with SFA. Therefore, we investigated the long-term stability and the overall treatment time after maxillomandibular surgery for skeletal class III correction with or without preoperative orthodontic preparation. Methods This retrospective study included eight patients who underwent maxillomandibular surgery for class III correction with the SFA (SFA group) and 20 patients who underwent the conventional approach (CA group). A comparative study of the change in the maxillary and mandibular position on preoperative (T1), 1-day (T2), 6-month (T3), and 2-year (T4) postoperative lateral cephalograms. We calculated the overall treatment time for each group. Results At the presurgical stage (T1), there was no bias in the skeletal features between the two groups. In the surgical change from T1 to T2, the mandible (point B) of the CA group was significantly moved superiorly. Short-term changes from T2 to T3 revealed that the mandible moved forward in both groups, whereas the maxillary position showed no significant changes. Long-term changes from T3 to T4 demonstrated that none of the measured parameters showed any significant differences. Finally, the average of overall treatment time was 15.1 months in the SFA group and 26.0 months in the CA group. Conclusions These findings suggest that SFA in bimaxillary orthognathic surgery for skeletal class III correction leads to predictable long-term skeletal stability, similar to surgery with CA. Furthermore, SFA reduced the overall treatment time compared to CA.

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“…However, the stability issue on SFA had been continuously suggested. It had been reported that compared to the conventional approach, mandibular forward relapse was more significant in two-jaw or isolated mandibular surgery with the SFA [16, 18, 35–37]. It has been suggested that more than 50% of SFA patients with class III deformities exhibit greater than 2 mm of relapse at the pogonion [18].…”

Section: Reviewmentioning

confidence: 99%

Current status of surgery first approach (part II): precautions and complications

Kwon

Han

2019

Maxillofac Plast Reconstr Surg

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The choice of surgical technique in orthognathic surgery is based primarily on the surgical treatment objectives (STO), which is a fundamental component of the orthognathic treatment process. In the conventional orthodontics-first approach, presurgical planning can be performed twice, during the preorthodontic (initial STO) and presurgical phases (final STO). Recently, a surgery-first orthognathic approach (SFA) without presurgical orthodontic treatment has been introduced and combined initial and final STO at the same time. In contrast to the conventional surgical-orthodontic treatment protocol that includes preoperative orthodontics for dental decompensations to maximize stable postoperative occlusion, the SFA potentially shortens the treatment period and minimizes esthetic concerns during the decompensation period because skeletal problems are corrected from the beginning. The indications for the SFA have been proposed in the literature, but no consensus exists. Moreover, because dental occlusion of the pre-orthodontic arches cannot be used as a guide for establishing the surgical treatment plan, there are fundamental limitations in accurate prediction of postsurgical results in the SFA. Recently, the concepts of postsurgical orthodontic treatment are continuously changing and evolving to overcome this inherent limitation of the SFA. The elimination of presurgical orthodontics can change the paradigm of orthognathic surgery but still requires cautious case selection and thorough discussion and collaboration between orthodontists and surgeons regarding the goals and postoperative management of the orthognathic procedure.

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Evaluation of Postoperative Mandibular Positional Changes After Mandibular Setback Surgery in a Surgery-First Approach: Isolated Mandibular Surgery Versus Bimaxillary Surgery

Cited by 16 publications

References 25 publications

Stability of single‐jaw vs two‐jaw surgery following the correction of skeletal class III malocclusion: A systematic review and meta‐analysis

Stability of single‐jaw vs two‐jaw surgery following the correction of skeletal class III malocclusion: A systematic review and meta‐analysis

Surgery-first approach reduces the overall treatment time without damaging long-term stability in the skeletal class III correction: a preliminary study

Current status of surgery first approach (part II): precautions and complications

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