Stability of mandibular setback surgery with and without presurgical orthodontics.

Abstract

PURPOSE:

The purpose of this study was to compare stability after mandibular setback surgery in patients with skeletal Class III malocclusion with and without presurgical orthodontics.

MATERIALS AND METHODS:

This retrospective cohort study included consecutive patients with skeletal Class III malocclusion who underwent only mandibular surgery. Patients treated with the surgery-first approach without presurgical orthodontics (SF group) were compared with a control group (conventional surgery with presurgical orthodontics; CS group) using lateral cephalograms taken preoperatively, immediately postoperatively, and at the time of debonding. Predictor variables (group and timing), outcome variables (cephalometric measurements over time), and other variables, such as baseline characteristics, were evaluated to determine the difference in stability of mandibular positions such as the B point.

RESULTS:

Sixty-one patients were enrolled in this study (CS group, n = 38; SF group, n = 23). Baseline demographic variables were similar in the 2 groups except for orthodontic treatment period. The mean setback of the mandible at the B point was similar (CS group, 8.7 mm; SF group, 9.1 mm; difference, P > .05), but the horizontal relapse in the SF group (2.4 mm) was significantly greater than in the CS group (1.6 mm; P < .05). Patients with a horizontal relapse greater than 3 mm comprised 39.1% of the SF group compared with 15.8% of the CS group (P < .05).

CONCLUSION:

Mandibular sagittal split ramus osteotomy without presurgical orthodontic treatment was less stable than conventional orthognathic surgery for mandibular prognathism. Before performing a surgery-first approach, skeletal stability needs to be considered.

• Authors: Chin-Soo Kim, Sang-Chang Lee, Hee-Moon Kyung, Hyo-Sang Park, Tae-Geon Kwon
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 72 Issue 4 Pg. 779-87 (Apr 2014) ISSN: 1531-5053 [Electronic] United States
• PMID: 24268965 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Cephalometry (methods)
• Cohort Studies
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Humans
• Image Processing, Computer-Assisted (methods)
• Incisor (pathology)
• Male
• Malocclusion, Angle Class III (surgery, therapy)
• Mandible (pathology, surgery)
• Maxilla (pathology)
• Molar (pathology)
• Orthodontic Brackets
• Orthognathic Surgical Procedures (methods)
• Osteotomy, Sagittal Split Ramus (methods)
• Prognathism (surgery, therapy)
• Recurrence
• Retrospective Studies
• Tooth Movement Techniques (instrumentation, methods)
• Treatment Outcome
• Vertical Dimension
• Young Adult