Evaluation of Skeletal Stability Following Two-jaw Surgery via Surgery First Orthodontic Treatment in Class III Malocclusion

III급 부정교합에서 선수술 교정치료를 통한 양악 수술 후 안정성

  • Hwang, Dae-Seok (Department of Oral and Maxillofacial Surgery, Pusan National University) ;
  • Kim, Yong-Il (Department of Orthodontics, Pusan National University) ;
  • Lee, Jae-Yeol (Department of Oral and Maxillofacial Surgery, Pusan National University) ;
  • Lee, Seong-Tak (Department of Oral and Maxillofacial Surgery, Pusan National University) ;
  • Kim, Tae-Hoon (Department of Oral and Maxillofacial Surgery, Pusan National University) ;
  • Lee, Joo-Min (Department of Oral and Maxillofacial Surgery, Pusan National University) ;
  • Ahn, Kyung-Yong (Department of Oral and Maxillofacial Surgery, Pusan National University)
  • 황대석 (부산대학교 치의학전문대학원 구강악안면외과) ;
  • 김용일 (부산대학교 치의학전문대학원 치과교정과) ;
  • 이재열 (부산대학교 치의학전문대학원 구강악안면외과) ;
  • 이성탁 (부산대학교 치의학전문대학원 구강악안면외과) ;
  • 김태훈 (부산대학교 치의학전문대학원 구강악안면외과) ;
  • 이주민 (부산대학교 치의학전문대학원 구강악안면외과) ;
  • 안경용 (부산대학교 치의학전문대학원 구강악안면외과)
  • Received : 2011.06.02
  • Accepted : 2011.08.11
  • Published : 2011.09.30

Abstract

Purpose: The purpose of the present study was to evaluate the postoperative skeletal stability of two-jaw surgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) via surgery first orthodontic treatment (SFOT) in class III malocclusion. Methods: Thirty-two patients who had two-jaw surgery via SFOT were included in this study. Serial lateral cephalograms were obtained before (T0), immediately after (T1), and six months after (T2) surgery. Twelve variables were measured for horizontal and vertical skeletal stability as well as for dental change. All measurements were evaluated statistically by a paired t-test ($P$ <0.05). Results: The mean skeletal changes were $0.1{\pm}2.5$ mm at point A and $-12.0{\pm}7.4$ mm at the pogonion. The mean horizontal relapse was 11.6% at the pogonion, and the mean vertical surgical changes included an upward displacement of $2.1{\pm}7.1$ mm and a forward displacement of $1.4{\pm}4.6$ mm at the pogonion. Upper incisor inclination decreased after surgery and was maintained at T2, and lower incisors were proclined from T1 to T2 by postsurgical orthodontic treatment. Conclusion: Postoperative skeletal stability of two-jaw surgery via surgery first orthodontic treatment in class III malocclusion was clinically acceptable.

Keywords

References

  1. Juggins KJ, Nixon F, Cunningham SJ. Patient- and clinician-perceived need for orthognathic surgery. Am J Orthod Dentofacial Orthop 2005;128:697-702. https://doi.org/10.1016/j.ajodo.2004.09.022
  2. Bos A, Hoogstraten J, Prahl-Andersen B. Expectations of treatment and satisfaction with dentofacial appearance in orthodontic patients. Am J Orthod Dentofacial Orthop 2003;123:127-32. https://doi.org/10.1067/mod.2003.84
  3. Hyon WS. Surgery-First-Orthognathic-Approach (SFOA) to Prognathism: Indications and Limitations. J Oral Maxillofac Surg 2008;66:39-40. https://doi.org/10.1016/j.joms.2008.05.110
  4. Baek SH, Ahn HW, Kwon YK, Choi JY. Surgery-first approach in skeletal class III malocclusion treated with 2-jaw surgery: evalation of surgical movement and postoperative orthodontic treatment. J Craniofac Surg 2010;21:332-8. https://doi.org/10.1097/SCS.0b013e3181cf5fd4
  5. Yu CC, Chen PH, Liou Eric JW, Huang CS, Chen YR. A surgery-first approach in surgical-orthodontic treatment of mandibular prognathism - a case report. Chang Gung Med J 2010;33:669-705.
  6. Nagasaka H, Sugawara J, Kawamura H, Nanda R."Surgery first" skeletal Class III correction using the Skeletal Anchorage System. J Clin Orthod 2009;43:97-105.
  7. Sugawara J, Aymach Z, Nagasaka DH, Kawamura H, Nanda R. "Surgery first" orthognathics to correct a skeletal class II malocclusion with an impinging bite. J Clin Orthod 2010;44:429-38.
  8. Villegas C, Uribe F, Sugawara J, Nanda R. Expedited correction of significant dentofacial asymmetry using a "surgery first" approach. J Clin Orthod. J Clin Orthod 2010;44:97-103.
  9. Wang YC, Ko EW, Huang CS, Chen YR, Takano-Yamamoto T. Comparison of transverse dimensional changes in surgical skeletal class III patients with and without presurgical orthodontics. J Oral Maxillofac Surg 2010;68:1807-12. https://doi.org/10.1016/j.joms.2009.09.089
  10. Liou EJ, Chen PH, Wang YC, Yu CC, Huang CS, Chen YR. Surgery-first accelerated orthognathic surgery: orthodontic guidelines and setup for model surgery. J Oral Maxillofac Surg 2011;69:771-781. https://doi.org/10.1016/j.joms.2010.11.011
  11. Dahlberg G. Statistical methods for medical and biological students. New York: Interscience Publishers Inc.; 1940. p.122-32.
  12. Tompach PC, Wheeler JJ, Fridrich KL. Orthodontic considerations in orthognathic surgery. Int J Adult Orthodon Orthognath Surg 1995;10:97-107.
  13. Yaffe A, Fine N, Binderman I. Regional accerated phenomenon in the mandible following mucoperiosteal flap surgery. J Periodontol 1994;65:78-83
  14. Liou EJ, Chen PH, Wang YC, Yu CC, Huang CS, Chen YR. Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement. J Oral Maxillofac Surg 2011;69:781-5. https://doi.org/10.1016/j.joms.2010.10.035
  15. Son HB, Oh CW. FOS (Functional orthognatic surgery). Korean J Clin Ortho 2002;1:7-19.
  16. Nam HJ, Son WS, Park SB, Kim SS. Changes of mandibular dental arch during surgical-orthodontic treatment in skeletal class III malocclusion individuals. Korean J Orthod 2008;38:283-97. https://doi.org/10.4041/kjod.2008.38.4.283
  17. Ahn HW, Baek SH. Skeletal anteroposterior discrepancy and vertical type effects on lower incisor preoperative decompensation and postoperative compensation in skeletal Class III patients. Angle Orthod 2011;81:64-74. https://doi.org/10.2319/031710-158.1
  18. Kwon TK, Kim YD, Shin SH, Kim UK, Kim JR, Chung IK. Stability after surgical correction of mandibular prognathism using bilateral saggital split ramus osteotomy and fixation with Poly-L/DL-Lactide copolymer screws (biosorbTMFX). J Korean Assoc Maxillofac Plast Reconstr Surg 2005;27:160-3.