Surgery first approach in orthodontics: An updated review

Gailot, Akshata; Bulsara, Hiral; Parakh, Anushka; Sangar, Ramandeep Singh; Fernandes, Gabriela

doi:10.15761/docr.1000267

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…The study also proposed that dental as well as skeletal midlines must coincide or be close to it with proper bilateral buccal overjet in the selection criteria. [31] However, in our study, we found SFOA equally effective even in cases of severe transverse skeletal discrepancies with midline shift and even in those patients with severe crowding. We were also able to achieve ideal occlusion even in the presence of pretreatment multiple dental interferences.…”

Section: Discussioncontrasting

confidence: 61%

“…A recent study[31] has contraindicated this treatment approach in patients who need definite decompression, patients with severe crowding, arch incoordination, and patients with severe vertical or transverse discrepancies and jaw asymmetries. The study also proposed that dental as well as skeletal midlines must coincide or be close to it with proper bilateral buccal overjet in the selection criteria.…”

Section: Discussionmentioning

confidence: 99%

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Rationale, relevance, and efficacy of “surgery first, orthodontics later” approach in the management of cases of severe malocclusion with skeletal discrepancy

Jeyaraj¹,

Chakranarayan²

2019

Ann Maxillofac Surg

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A good esthetic outcome and optimal functional occlusion is the goal of management of any dentofacial anomaly. Conventional orthognathic surgery, as commonly practiced, entails a rather long-drawn management protocol comprising a triphasic treatment approach, with the surgical procedure being both preceded and followed by pre- and post-surgical orthodontics, respectively. This has numerous well-known drawbacks such as an uncertain and unpredictable patient compliance and poor motivation due to the inevitably long duration of orthodontic therapy; a transient and temporary worsening of the facial appearance brought about by presurgical orthodontic decompensation of occlusal relationships; and the inevitably prolonged time frame involved in ultimately achieving the desired esthetic and functional results. Further, unforeseen interruptions along the course of the long treatment period can result in unfavorable and even disastrous outcomes. The newer concept and technique of “Surgery First Orthodontics After” (SFOA) approach or “surgery-first approach” (SFA) entails first performing orthognathic surgery, thereafter following it up and finishing the case with postsurgical orthodontic settling and correction of the occlusion. It has two very distinct advantages over the erstwhile approach, first, an immediate and early correction of the facial deformity resulting in a remarkable improvement in facial appearance, which in most cases was what had prompted the patient to seek treatment for, in the first place. The patient, encouraged and motivated by the obvious and appreciable esthetic results, complies willingly and well with the subsequent postsurgical orthodontic treatment, even if it is lengthy or inconvenient, thus ensuring an optimal ultimate occlusion with complete functional rehabilitation as well. The second advantage of SFA is a markedly reduced overall treatment time, which is greatly appreciated by the patients. This article presents three cases of severe malocclusion with associated skeletal discrepancies, treated expeditiously and effectively using the SFA protocol. The overviews of SFA, including its rationale and relevance, indications, general and specific guidelines, different protocol variations, clinical outcome and success rate, as well as possible complications and potential problems encountered with this novel treatment protocol are also discussed.

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Rationale, relevance, and efficacy of “surgery first, orthodontics later” approach in the management of cases of severe malocclusion with skeletal discrepancy

Jeyaraj¹,

Chakranarayan²

2019

Ann Maxillofac Surg

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“…Contraindications for SFA include patients that needs definite decompression, patients with severe crowding, arch incoordination and patients with severe vertical or transverse discrepancies [9] . Advantages of SFA [10]  Immediate change in facial profile  Chief complaint of the patient is addressed since the beginning of treatment  Faster results  Future orthodontic treatment becomes less complicated  Easier to deal with relapses as compared to routine orthodontic treatment because decompensation is completed before surgery Disadvantages of SFA [10]  Planning may be time consuming as it needs to be very accurate to prevent any errors  Predicting final occlusion is difficult  Ideal occlusion may be hard to achieve if there are multiple dental interferences  Patient selection is of utmost importance Pre-surgical orthodontics in SFA Timing of bonding Bonding brackets in SFA cases can follow various guidelines given by different authors which are enlisted and according to the need of case and requirements they can me modified. Sugawara and Nagasaka [7] -just before surgery.…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

Surgery first approach in orthognathic surgery: An overview

Yadav,

Loshali,

Mohan

et al. 2022

Int. J. Surg. Sci.

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The "Surgery-first" approach, defined as a team approach between surgeons and orthodontists for orthognathic surgery without preoperative orthodontic treatment, is aimed at dental decompensation. The surgery first approach provides an alternative treatment protocol in orthognathic surgery cases. The conventional ortho-surgical approach includes preoperative orthodontics which requires 7 to 20 months and will result into temporary worsening of facial profile. Surgery first approach shortens the treatment period and reduces facial profile worsening by addressing skeletal discrepancy first and makes use of the regional acceleratory phenomenon and the natural forces from the soft tissues and helps in greatly reducing the treatment time. This article will provide an overview of the surgical first orthodontic approach.

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Surgery first approach in orthodontics: An updated review

Cited by 2 publications

References 10 publications

Rationale, relevance, and efficacy of “surgery first, orthodontics later” approach in the management of cases of severe malocclusion with skeletal discrepancy

Rationale, relevance, and efficacy of “surgery first, orthodontics later” approach in the management of cases of severe malocclusion with skeletal discrepancy

Surgery first approach in orthognathic surgery: An overview

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