Positional Changes in the Mandibular Proximal Segment After Intraoral Vertical Ramus Osteotomy: Surgery-first Approach Versus Conventional Approach

Overview

Journal Korean J Orthod

Date 2020 Sep 17

PMID 32938825

Citations 3

Authors

Seoyeon Jung

Yunjin Choi

Jung-Hyun Park

Young-Soo Jung

Hyoung-Seon Baik

Affiliations

Soon will be listed here.

Abstract

Objective: To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion.

Methods: Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment: CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed.

Results: The mean amounts of mandibular setback and maxillary posterior impaction were similar in both groups. At T2, the posterior portion of the mandible moved upward in both groups. In the SF group, the anterior portion of the mandible moved upward by a mean distance of 0.9 ± 1.0 mm, which was statistically significant ( < 0.001). There were significant between-group differences in occlusal changes ( < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables.

Conclusions: Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.

Citing Articles

Volumetric changes in temporomandibular joint space following trans-oral vertical ramus osteotomy in patients with mandibular prognathism: a one-year follow-up study.

Kim J, Yong H, Kim T, Kim J, Jeon K, Huh J Sci Rep. 2024; 14(1):942.

PMID: 38200085 PMC: 10781718. DOI: 10.1038/s41598-023-51050-y.

Enhancing skeletal stability and Class III correction through active orthodontist engagement in virtual surgical planning: A voxel-based 3-dimensional analysis.

Barone S, Cevidanes L, Miranda F, Gurgel M, Anchling L, Hutin N Am J Orthod Dentofacial Orthop. 2023; 165(3):321-331.

PMID: 38010236 PMC: 10923113. DOI: 10.1016/j.ajodo.2023.09.016.

Incidence and management of condylar resorption after orthognathic surgery: An overview.

Barone S, Cosentini G, Bennardo F, Antonelli A, Giudice A Korean J Orthod. 2022; 52(1):29-41.

PMID: 35046140 PMC: 8770964. DOI: 10.4041/kjod.2022.52.1.29.

References

Kim J, Jung H, Kim S, Park H, Jung Y . Postoperative stability for surgery-first approach using intraoral vertical ramus osteotomy: 12 month follow-up. Br J Oral Maxillofac Surg. 2014; 52(6):539-44. DOI: 10.1016/j.bjoms.2014.03.011. View

Ko E, Lin S, Chen Y, Huang C . Skeletal and dental variables related to the stability of orthognathic surgery in skeletal Class III malocclusion with a surgery-first approach. J Oral Maxillofac Surg. 2013; 71(5):e215-23. DOI: 10.1016/j.joms.2012.12.025. View

Jacobs J, Sinclair P . Principles of orthodontic mechanics in orthognathic surgery cases. Am J Orthod. 1983; 84(5):399-407. DOI: 10.1016/0002-9416(93)90003-p. View

Jung H, Jung Y, Park J, Park H . Recovery pattern of mandibular movement by active physical therapy after bilateral transoral vertical ramus osteotomy. J Oral Maxillofac Surg. 2012; 70(7):e431-7. DOI: 10.1016/j.joms.2012.02.033. View

Ohba S, Nakao N, Awara K, Tobita T, Minamizato T, Kawasaki T . The three-dimensional assessment of dynamic changes of the proximal segments after intraoral vertical ramus osteotomy. Cranio. 2015; 33(4):276-84. DOI: 10.1080/08869634.2015.1097297. View

Wilcko W, Wilcko T, Bouquot J, Ferguson D . Rapid orthodontics with alveolar reshaping: two case reports of decrowding. Int J Periodontics Restorative Dent. 2002; 21(1):9-19. View

Alsafadi A, Alabdullah M, Saltaji H, Abdo A, Youssef M . Effect of molar intrusion with temporary anchorage devices in patients with anterior open bite: a systematic review. Prog Orthod. 2016; 17:9. PMC: 4803715. DOI: 10.1186/s40510-016-0122-4. View

Kim C, Lee S, Kyung H, Park H, Kwon T . Stability of mandibular setback surgery with and without presurgical orthodontics. J Oral Maxillofac Surg. 2013; 72(4):779-87. DOI: 10.1016/j.joms.2013.09.033. View

Uribe F, Janakiraman N, Shafer D, Nanda R . Three-dimensional cone-beam computed tomography-based virtual treatment planning and fabrication of a surgical splint for asymmetric patients: surgery first approach. Am J Orthod Dentofacial Orthop. 2013; 144(5):748-58. DOI: 10.1016/j.ajodo.2012.10.029. View

10.

Park S, Yu H, Kim K, Lee K, Baik H . A proposal for a new analysis of craniofacial morphology by 3-dimensional computed tomography. Am J Orthod Dentofacial Orthop. 2006; 129(5):600.e23-34. DOI: 10.1016/j.ajodo.2005.11.032. View

11.

Arimoto S, Hasegawa T, Kaneko K, Tateishi C, Furudoi S, Shibuya Y . Observation of osseous healing after intraoral vertical ramus osteotomy: focus on computed tomography values. J Oral Maxillofac Surg. 2013; 71(9):1602.e1-1602.e10. DOI: 10.1016/j.joms.2013.02.021. View

12.

Jung H, Jung Y, Kim S, Kim D, Park H . Postoperative stability following bilateral intraoral vertical ramus osteotomy based on amount of setback. Br J Oral Maxillofac Surg. 2013; 51(8):822-6. DOI: 10.1016/j.bjoms.2013.02.001. View

13.

Ghali G, Sikes Jr J . Intraoral vertical ramus osteotomy as the preferred treatment for mandibular prognathism. J Oral Maxillofac Surg. 2000; 58(3):313-5. DOI: 10.1016/s0278-2391(00)90063-6. View

14.

Wilcko M, Wilcko W, Pulver J, Bissada N, Bouquot J . Accelerated osteogenic orthodontics technique: a 1-stage surgically facilitated rapid orthodontic technique with alveolar augmentation. J Oral Maxillofac Surg. 2009; 67(10):2149-59. DOI: 10.1016/j.joms.2009.04.095. View

15.

Nihara J, Takeyama M, Takayama Y, Mutoh Y, Saito I . Postoperative changes in mandibular prognathism surgically treated by intraoral vertical ramus osteotomy. Int J Oral Maxillofac Surg. 2012; 42(1):62-70. DOI: 10.1016/j.ijom.2012.06.024. View

16.

Choi S, Hwang C, Baik H, Jung Y, Lee K . Stability of Pre-Orthodontic Orthognathic Surgery Using Intraoral Vertical Ramus Osteotomy Versus Conventional Treatment. J Oral Maxillofac Surg. 2015; 74(3):610-9. DOI: 10.1016/j.joms.2015.07.012. View

17.

Kang S, Kim M, You T, Lee J . Modification of planned postoperative occlusion in orthognathic surgery, based on computer-aided design/computer-aided manufacturing-engineered preoperative surgical simulation. J Oral Maxillofac Surg. 2014; 73(1):134-51. DOI: 10.1016/j.joms.2014.07.021. View

18.

Lee J, Kim Y, Hwang D, Kim K, Park S . Effect of occlusal vertical dimension changes on postsurgical skeletal changes in a surgery-first approach for skeletal Class III deformities. Am J Orthod Dentofacial Orthop. 2014; 146(5):612-9. DOI: 10.1016/j.ajodo.2014.07.024. View

19.

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

20.

Bell W, Yamaguchi Y, POOR M . Treatment of temporomandibular joint dysfunction by intraoral vertical ramus osteotomy. Int J Adult Orthodon Orthognath Surg. 1990; 5(1):9-27. View