Long-term outcomes of bimaxillary surgery for treatment of asymmetric skeletal class III deformity using surgery-first approach

Liao, Yu‐Fang; Chen, Yunfang; Yao, Chuan-Fong; Chen, Yinan; Chen, Yu-Ray

doi:10.1007/s00784-018-2603-y

Cited by 46 publications

(50 citation statements)

References 31 publications

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“…In another study conducted by Liao et al, the long term outcomes of bimaxillary surgery were examined in patients with asymmetric skeletal class III deformity, who were treated using surgery-first approach [40]. These findings are in agreement with the results of Pachêco-Pereira et al, mentioned above.…”

Section: Discussionsupporting

confidence: 81%

Satisfaction with Orthodontic Care Provided in a University Orthodontic Clinic

Lyros¹,

Pavi²,

Tsolakis³

et al. 2019

TODENTJ

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Objective: To evaluate patients’ satisfaction with their orthodontic care at the Department of Orthodontics of University of Athens. Materials and Methods: The study sample comprised of 100 individuals whose orthodontic treatment had been completed during the period May to October 2010. A questionnaire was designed and piloted before the telephone interviews were carried out. Questions concerned socio-demographic characteristics, reason for seeking care at the Dental School, level of satisfaction with treatment outcome, fees paid for treatment, and various aspects of organisation of care provision, assessed on 1-very dissatisfied to 5-very satisfied Likert type items. Results: Satisfaction score was particularly high as far as treatment outcome (53% were “very satisfied” and 31% were “satisfied”), dentist’s response to an emergency (81% were “very satisfied”), and personnel’s behavior at initial examination (81% were “very satisfied”) were concerned. Factors appearing to require improvement were the waiting time from initial examination to the beginning of treatment, the waiting room and the duration of treatment. Overall satisfaction was found to be significantly associated with total duration of treatment, fees paid by patients, treatment outcome, the behaviour of personnel who conducted first clinical examination, and dentist’s response to an emergency. Overall satisfaction was confirmed as the vast majority of patients (97%) would recommend the Orthodontic Clinic. Conclusion: While the Orthodontics Clinic enjoys overall highly satisfied patients, there is scope for improvement of organizational aspects of care provision like the waiting time between the initial examination and the beginning of treatment, the waiting room and the duration of treatment.

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Section: Discussionsupporting

confidence: 81%

Satisfaction with Orthodontic Care Provided in a University Orthodontic Clinic

Lyros¹,

Pavi²,

Tsolakis³

et al. 2019

TODENTJ

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“…Liao et al 25 defined facial asymmetry as ≥4 mm of deviation of menton from the facial midline. They Scans were obtained before surgery (T0), 3 days postoperatively (T1), and 6 months postoperatively (T2).…”

Section: General Guidelines and Information Regarding The Short-termmentioning

confidence: 99%

Facial asymmetry correction: From conventional orthognathic treatment to surgery-first approach

Nik

Gholamrezaei

Keshvad

2019

J Dent Res Dent Clin Dent Prospects

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The surgery-first approach (SFA), which proceeds without presurgical orthodontic treatment, is assumed to shorten the treatment course because the direction of post-surgical orthodontic tooth movement conforms to the normal muscular forces. Moreover, the regional acceleratory phenomenon (RAP), evoked by surgery, helps in tooth alignment and compensation in a faster way. Although SFA has definite advantages, especially in class III individuals, there is a lack of data about its indications in patients with facial asymmetry. In this article, we reviewed recently published articles on the treatment of asymmetric patients using the SFA. Different aspects, including the three-dimensional assessment of stability in different planes, approaches for fabrication of a surgical splint, predictability of the results, skills needed for bimaxillary surgery, indications as the treatment of choice for condylar hyperplasia, and combination with distraction osteogenesis in candidates with severe asymmetries were found to be the main topics discussed for patients presenting with facial asymmetry

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“…A combination of patients' desires and professionals' judgements have been considered important in decision-making process for surgical correction of asymmetries considered "borderline" with values close to the discriminative threshold 7,34 . However, in severe asymmetries (most perceptible), the decision for treatment is usually simple with higher indication for surgical management [1][2][3]15,16,18,30 . Our RMSD threshold-related finding would allow OGS professionals to counsel future patients based on objective 3D photogrammetric-based data.…”

Section: Lateral Lower Chin N (%)mentioning

confidence: 99%

“…Skeletal mature patients with clefts frequently presents with maxillomandibular disharmony (maxillary hypoplasia and skeletal class III malocclusion) which requires OGS treatment 7-15 . As residual facial asymmetry after OGS treatment may negatively impact patients' perceptions about outcome requiring further revisionary surgical interventions [16][17][18][19] , the significance of preoperative prediction of this deformity should not be underestimated 15,16,20 . Therefore, it is of paramount that an accurate diagnosis of asymmetry is accomplished preoperatively for that a precise surgical planning and execution is performed 7,15,16,20 .In this setting, OGS planning has evolved over the past decades 15-24 .…”

mentioning

confidence: 99%

Outcome of facial contour asymmetry after conventional two-dimensional versus computer-assisted three-dimensional planning in cleft orthognathic surgery

Hsu

Denadai

Pai

et al. 2020

Sci Rep

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Computer-assisted 3D planning has overcome the limitations of conventional 2D planning-guided orthognathic surgery (OGS), but difference for facial contour asymmetry outcome has not been verified to date. This comparative study assessed the facial contour asymmetry outcome of consecutive patients with unilateral cleft lip and palate who underwent 2D planning (n = 37)-or 3D simulation (n = 38)-guided OGS treatment for correction of maxillary hypoplasia and skeletal Class III malocclusion between 2010 and 2018. Normal age-, gender-, and ethnicity-matched individuals (n = 60) were enrolled for comparative analyses. 2D (n = 60, with 30 images for each group) and 3D (n = 43, with 18 and 25 images for 2D planning and 3D simulation groups, respectively) photogrammetric-based facial contour asymmetry-related measurements were collected from patients and normal individuals. The facial asymmetry was further verified by using subjective perception of a panel composed of 6 blinded raters. On average, the facial contour asymmetry was significantly (all p < 0.05) reduced after 3D virtual surgery planning for all tested parameters, with no significant differences between post-OGS 3D simulation-related values and normal individuals. No significant differences were observed for pre-and post-OGS values in conventional 2D planning-based treatment, with significant (all p < 0.05) differences for all normal individuals-related comparisons. This study suggests that 3D planning presents superior facial contour asymmetry outcome than 2D planning.Orthognathic surgery (OGS) plays a key role for successful management of a myriad of facial deformities associated with malocclusion, with facial asymmetry feature being most frequently associated with skeletal class III malocclusion 1-3 . Particularly, patients with unilateral cleft lip and palate differ from the noncleft population, because they have a congenital orofacial defect compromising both the bone and soft tissues on the lesion side 4-6 , which may be expressed as facial asymmetry 7-15 . Skeletal mature patients with clefts frequently presents with maxillomandibular disharmony (maxillary hypoplasia and skeletal class III malocclusion) which requires OGS treatment 7-15 . As residual facial asymmetry after OGS treatment may negatively impact patients' perceptions about outcome requiring further revisionary surgical interventions [16][17][18][19] , the significance of preoperative prediction of this deformity should not be underestimated 15,16,20 . Therefore, it is of paramount that an accurate diagnosis of asymmetry is accomplished preoperatively for that a precise surgical planning and execution is performed 7,15,16,20 .In this setting, OGS planning has evolved over the past decades 15-24 . Traditionally, OGS planning has been constructed on two-dimensional (2D) cephalometry, 2D photographic analysis, articulators, and dental models 21,22 . However, this planning modality presents limitations for challenging clinical scenarios such as patients with clefts associated with malocclusion a...

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Long-term outcomes of bimaxillary surgery for treatment of asymmetric skeletal class III deformity using surgery-first approach

Abstract: The surgery-first approach for improving facial asymmetry using the guidelines described for setups of the models is a feasible alternative to the classic orthodontic-first approach for bimaxillary orthognathic surgery.

Cited by 46 publications

References 31 publications

Satisfaction with Orthodontic Care Provided in a University Orthodontic Clinic

Satisfaction with Orthodontic Care Provided in a University Orthodontic Clinic

Facial asymmetry correction: From conventional orthognathic treatment to surgery-first approach

Outcome of facial contour asymmetry after conventional two-dimensional versus computer-assisted three-dimensional planning in cleft orthognathic surgery

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