Skeletal Stability After 2-jaw Surgery Via Surgery-first Approach in Facial Asymmetry Patients Using CBCT

Overview

Journal Maxillofac Plast Reconstr Surg

Publisher Springer Nature

Date 2020 Apr 17

PMID 32296663

Citations 4

Authors

Dae Seok Hwang

Jeong Seok Seo

Hong Seok Choi

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study is to compare the skeletal stability of two-jaw surgery via surgery-first approach with conventional two-jaw surgery in facial asymmetry patients by measuring the skeletal changes after surgery from a three-dimensional analysis. From January 2010 to January 2014, 40 patients with facial asymmetry who underwent two-jaw surgery in Pusan National University Hospital were included in this study. They were classified into experimental group ( = 20) who underwent two-jaw surgery via surgery-first approach and control group ( = 20) who underwent conventional two-jaw surgery. After selection of 24 landmarks and the construction of horizontal and sagittal, coronal reference planes, changes in 10 linear measurements and 2 angular measurements were compared between the surgery-first approach and conventional groups in the preoperative, immediate postoperative, and postoperative periods. The paired test and Student test were used for statistical analysis. The mean and standard deviation of the measurement were calculated for the experimental and control groups.

Results: The statistical analysis showed that changes in skeletal measurements were similar between the surgery-first approach and conventional groups, according to each period. However, U1-SRP measurement showed statistically significant changes in surgery-first approach groups at postsurgical change (T1 to T2). Also, the mean treatment duration in the treatment group was 15.9 ± 5.48 months whereas that in the control group was 32.9 ± 14.05 months.

Conclusion: In facial asymmetry patients, similar results were observed in the postoperative skeletal stability when 2-jaw surgery via surgery-first approach was compared with conventional 2-jaw surgery. However, significant lateral deviation of upper incisor midline was observed. In addition, a shorter average treatment duration was observed. To stabilize the unstable occlusion after surgery, increased wearing of the stent and proactive rubber guidance will be needed.

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References

Luther F, Morris D, Hart C . Orthodontic preparation for orthognathic surgery: how long does it take and why? A retrospective study. Br J Oral Maxillofac Surg. 2003; 41(6):401-6. DOI: 10.1016/s0266-4356(03)00163-3. View

Liou E, Chen P, Wang Y, Yu C, Huang C, Chen Y . Surgery-first accelerated orthognathic surgery: orthodontic guidelines and setup for model surgery. J Oral Maxillofac Surg. 2011; 69(3):771-80. DOI: 10.1016/j.joms.2010.11.011. View

Samman N, Tong A, Cheung D, Tideman H . Analysis of 300 dentofacial deformities in Hong Kong. Int J Adult Orthodon Orthognath Surg. 1992; 7(3):181-5. View

Bergersen E . Enlargement and distortion in cephalometric radiography: compensation tables for linear measurements. Angle Orthod. 1980; 50(3):230-44. DOI: 10.1043/0003-3219(1980)050<0230:EADICR>2.0.CO;2. View

You K, Lee K, Lee S, Baik H . Three-dimensional computed tomography analysis of mandibular morphology in patients with facial asymmetry and mandibular prognathism. Am J Orthod Dentofacial Orthop. 2010; 138(5):540.e1-8. DOI: 10.1016/j.ajodo.2010.04.025. View

Huang C, Hsu S, Chen Y . Systematic review of the surgery-first approach in orthognathic surgery. Biomed J. 2014; 37(4):184-90. DOI: 10.4103/2319-4170.126863. View

Peck H, Peck S . A concept of facial esthetics. Angle Orthod. 1970; 40(4):284-318. DOI: 10.1043/0003-3219(1970)040<0284:ACOFE>2.0.CO;2. View

Ko E, Huang C, Chen Y . Characteristics and corrective outcome of face asymmetry by orthognathic surgery. J Oral Maxillofac Surg. 2009; 67(10):2201-9. DOI: 10.1016/j.joms.2009.04.039. View

Brachvogel P, Berten J, Hausamen J . [Surgery before orthodontic treatment: a concept for timing the combined therapy of skeletal dysgnathias]. Dtsch Zahn Mund Kieferheilkd Zentralbl. 1991; 79(7):557-63. View

10.

Nagasaka H, Sugawara J, Kawamura H, Nanda R . "Surgery first" skeletal Class III correction using the Skeletal Anchorage System. J Clin Orthod. 2009; 43(2):97-105. View

11.

Severt T, Proffit W . The prevalence of facial asymmetry in the dentofacial deformities population at the University of North Carolina. Int J Adult Orthodon Orthognath Surg. 1997; 12(3):171-6. View

12.

Liou E, Chen P, Wang Y, Yu C, Huang C, Chen Y . Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement. J Oral Maxillofac Surg. 2011; 69(3):781-5. DOI: 10.1016/j.joms.2010.10.035. View

13.

Yaffe A, Fine N, Binderman I . Regional accelerated phenomenon in the mandible following mucoperiosteal flap surgery. J Periodontol. 1994; 65(1):79-83. DOI: 10.1902/jop.1994.65.1.79. View

14.

Lai W, Yamada K, Hanada K, Ali I, Takagi R, Kobayashi T . Postoperative mandibular stability after orthognathic surgery in patients with mandibular protrusion and mandibular deviation. Int J Adult Orthodon Orthognath Surg. 2002; 17(1):13-22. View

15.

Liao Y, Chiu Y, Huang C, Ko E, Chen Y . Presurgical orthodontics versus no presurgical orthodontics: treatment outcome of surgical-orthodontic correction for skeletal class III open bite. Plast Reconstr Surg. 2010; 126(6):2074-2083. DOI: 10.1097/PRS.0b013e3181f52710. View

16.

Vannier M, Marsh J, Warren J . Three dimensional CT reconstruction images for craniofacial surgical planning and evaluation. Radiology. 1984; 150(1):179-84. DOI: 10.1148/radiology.150.1.6689758. View

17.

Melnik A . A cephalometric study of mandibular asymmetry in a longitudinally followed sample of growing children. Am J Orthod Dentofacial Orthop. 1992; 101(4):355-66. DOI: 10.1016/S0889-5406(05)80329-4. View

18.

Lee J, Han S, Ryu H, Lee H, Kim S . Cone-beam computed tomography analysis of transverse dental compensation in patients with skeletal Class III malocclusion and facial asymmetry. Korean J Orthod. 2018; 48(6):357-366. PMC: 6234112. DOI: 10.4041/kjod.2018.48.6.357. View

19.

Ko E, Hsu S, Hsieh H, Wang Y, Huang C, Chen Y . Comparison of progressive cephalometric changes and postsurgical stability of skeletal Class III correction with and without presurgical orthodontic treatment. J Oral Maxillofac Surg. 2011; 69(5):1469-77. DOI: 10.1016/j.joms.2010.07.022. View

20.

Choi J, Lee J, Yang S, Koh K . The reliability of a surgery-first orthognathic approach without presurgical orthodontic treatment for skeletal class III dentofacial deformity. Ann Plast Surg. 2013; 74(3):333-41. DOI: 10.1097/SAP.0b013e318295dcce. View