Is skeletal stability after bimaxillary surgery for skeletal class III deformity related to surgical occlusal contact?

Modern Surgery-First Approach Concept in Cleft-Orthognathic Surgery: A Comparative Cohort Study with 3D Quantitative Analysis of Surgical-Occlusion Setup

“…Moreover, patients with variable degree of the dental presentation (curve of Spee, anterior-teeth alignment, incisor inclination, and present dentition) were included in this study. This represents the orthognathic surgery practice in this center and further details of the patient-specific approach have previously been described [22,23,28,[32][33][34][35][36][37]39,[57][58][59]. This study presented 3D quantitative data derived from the final surgical-occlusion setups of patients who actually received orthognathic treatment and presented no need for revision procedure during follow-up, which denoted satisfactory results.…”

“…In this center, the indication of surgery-first orthognathic surgery treatment has been variable [22,23,[57][58][59]. In our orthognathic surgery workflow, the combination of accurate clinical examinations and high-quality 3D imaging has permitted a precise preoperative diagnosis that encompasses the many deviations of involvement of the dental, skeletal, and facial soft tissue elements, with less favorable patterns of dental characteristics being not considered contraindication for the surgery-first approach.…”

“…In our orthognathic surgery workflow, the combination of accurate clinical examinations and high-quality 3D imaging has permitted a precise preoperative diagnosis that encompasses the many deviations of involvement of the dental, skeletal, and facial soft tissue elements, with less favorable patterns of dental characteristics being not considered contraindication for the surgery-first approach. The rate of indication of this surgery-first protocol has mainly been determined by level of orthodontic experiences to evaluate the accomplishment of a workable surgical-occlusion setup and to anticipate an achievable postoperative orthodontic treatment planning [22,23,[57][58][59], with senior experienced professionals (not included as co-authors of this current study) reaching a rate of 100% for surgery-first-based treatments [59]. Therefore, due to the accumulated experience of our team with a high-volume of surgery-first noncleft orthognathic-surgery procedures [22,23,28,[32][33][34][35][36][37], the surgery-first approach has progressively been adopted for cleft-skeletofacial deformity.…”

Three-dimensional evaluation of postsurgical stability of Surgery-first approach in Skeletal Class III patients with two-jaw surgery and maxillary premolar extraction and study of the influencing factors.

“…Regard with the amount of mandibular sagittal relapse after the bimaxillary surgery, Ko EW et al 6 reported a mean of 1.44mm in non-extraction patients after debonding, and the means ranging from 0.9mm to 2.3mm were reported in studies that might be mixed with premolar-extraction patients 11,15,23,24 . In this study, the mean amount of mandibular sagittal relapse within 12 month of observation was 3.02mm(showed in Table 2), indicating that the postsurgical stability of SFA might be worse in patients needed maxillary bilateral premolar extraction.…”

“…This study has also showed that the interoperative downward movement of anterior maxilla (A point) was unfavourable for mandibular postsurgical stability. It might be due to the secondary bone remodeling to the maxillary downward movement 11 which further increase the mandibular pronation space. However, the mean intraoperative vertical change and vertical relapse from T1 to T4 of anterior maxilla were minimal(0.9mm and 0.48mm) in this study.…”