The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
권호 표지
DOI QR코드

DOI QR Code

Evaluation of stability after pre-orthodontic orthognathic surgery using cone-beam computed tomography: A comparison with conventional treatment

  • Ann, Hye-Rim (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Jung, Young-Soo (Department of Oral and Maxillofacial Surgery, Oral Science Research center, College of Dentistry, Yonsei University) ;
  • Lee, Kee-Joon (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Baik, Hyoung-Seon (Department of Orthodontics, College of Dentistry, Yonsei University)
  • Received : 2016.05.16
  • Accepted : 2016.07.22
  • Published : 2016.09.25
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The aim of this study was to evaluate the skeletal and dental changes after intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontics by using cone-beam computed tomography (CBCT). Methods: This retrospective cohort study included 24 patients (mean age, 22.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery with IVRO. The patients were divided into the preorthodontic orthognathic surgery (POGS) group (n = 12) and conventional surgery (CS) group (n = 12). CBCT images acquired preoperatively, 1 month after surgery, and 1 year after surgery were analyzed to compare the intergroup differences in postoperative three-dimensional movements of the maxillary and mandibular landmarks and the changes in lateral cephalometric variables. Results: Baseline demographics (sex and age) were similar between the two groups (6 men and 6 women in each group). During the postsurgical period, the POGS group showed more significant upward movement of the mandible (p < 0.05) than did the CS group. Neither group showed significant transverse movement of any of the skeletal landmarks. Moreover, none of the dental and skeletal variables showed significant intergroup differences 1 year after surgery. Conclusions: Compared with CS, POGS with IVRO resulted in significantly different postsurgical skeletal movement in the mandible. Although both groups showed similar skeletal and dental outcomes at 1 year after surgery, upward movement of the mandible during the postsurgical period should be considered to ensure a more reliable outcome after POGS.

Keywords

References

  1. 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.
  2. Villegas C, Uribe F, Sugawara J, Nanda R. Expedited correction of significant dentofacial asymmetry using a "surgery first" approach. J Clin Orthod 2010;44:97-103; quiz 105.
  3. 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
  4. Hernandez-Alfaro F, Guijarro-Martinez R, Peiro-Guijarro MA. Surgery first in orthognathic surgery: what have we learned? A comprehensive workflow based on 45 consecutive cases. J Oral Maxillofac Surg 2014;72:376-90. https://doi.org/10.1016/j.joms.2013.08.013
  5. Min BK, Choi JY, Baek SH. Comparison of treatment duration between conventional three-stage method and surgery-first approach in patients with skeletal Class III malocclusion. J Craniofac Surg 2014;25:1752-6. https://doi.org/10.1097/SCS.0000000000001002
  6. Lee NK, Kim YK, Yun PY, Kim JW. Evaluation of post-surgical relapse after mandibular setback surgery with minimal orthodontic preparation. J Craniomaxillofac Surg 2013;41:47-51. https://doi.org/10.1016/j.jcms.2012.05.010
  7. Kim JW, Lee NK, Yun PY, Moon SW, Kim YK. Postsurgical stability after mandibular setback surgery with minimal orthodontic preparation following upper premolar extraction. J Oral Maxillofac Surg 2013;71:1968.e1-11. https://doi.org/10.1016/j.joms.2013.07.004
  8. Kim CS, Lee SC, Kyung HM, Park HS, Kwon TG. Stability of mandibular setback surgery with and without presurgical orthodontics. J Oral Maxillofac Surg 2014;72:779-87. https://doi.org/10.1016/j.joms.2013.09.033
  9. Ko EW, Lin SC, Chen YR, Huang CS. 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:e215-23. https://doi.org/10.1016/j.joms.2012.12.025
  10. Joh B, Bayome M, Park JH, Park JU, Kim Y, Kook YA. Evaluation of minimal versus conventional presurgical orthodontics in skeletal class III patients treated with two-jaw surgery. J Oral Maxillofac Surg 2013;71:1733-41. https://doi.org/10.1016/j.joms.2013.06.191
  11. Ko EW, Hsu SS, Hsieh HY, Wang YC, Huang CS, Chen YR. Comparison of progressive cephalometric changes and postsurgical stability of skeletal Class III correction with and without presurgical orthodontic treatment. J Oral Maxillofac Surg 2011;69:1469-77. https://doi.org/10.1016/j.joms.2010.07.022
  12. Liao YF, Chiu YT, Huang CS, Ko EW, Chen YR. Presurgical orthodontics versus no presurgical orthodontics: treatment outcome of surgical-orthodontic correction for skeletal class III open bite. Plast Reconstr Surg 2010;126:2074-83. https://doi.org/10.1097/PRS.0b013e3181f52710
  13. Choi JW, Lee JY, Yang SJ, Koh KS. The reliability of a surgery-first orthognathic approach without presurgical orthodontic treatment for skeletal class III dentofacial deformity. Ann Plast Surg 2015;74:333-41. https://doi.org/10.1097/SAP.0b013e318295dcce
  14. Choi SH, Hwang CJ, Baik HS, Jung YS, Lee KJ. Stability of pre-orthodontic orthognathic surgery using intraoral vertical ramus osteotomy versus conventional treatment. J Oral Maxillofac Surg 2016;74:610-9. https://doi.org/10.1016/j.joms.2015.07.012
  15. Gribel BF, Gribel MN, Frazao DC, McNamara JA Jr, Manzi FR. Accuracy and reliability of craniometric measurements on lateral cephalometry and 3D measurements on CBCT scans. Angle Orthod 2011;81:26-35. https://doi.org/10.2319/032210-166.1
  16. Chang ZC, Hu FC, Lai E, Yao CC, Chen MH, Chen YJ. Landmark identification errors on cone-beam computed tomography-derived cephalograms and conventional digital cephalograms. Am J Orthod Dentofacial Orthop 2011;140:e289-97. https://doi.org/10.1016/j.ajodo.2011.06.024
  17. Cevidanes LH, Bailey LJ, Tucker SF, Styner MA, Mol A, Phillips CL, et al. Three-dimensional cone-beam computed tomography for assessment of mandibular changes after orthognathic surgery. Am J Orthod Dentofacial Orthop 2007;131:44-50. https://doi.org/10.1016/j.ajodo.2005.03.029
  18. Cevidanes LH, Motta A, Proffit WR, Ackerman JL, Styner M. Cranial base superimposition for 3-dimensional evaluation of soft-tissue changes. Am J Orthod Dentofacial Orthop 2010;137(4 Suppl):S120-9. https://doi.org/10.1016/j.ajodo.2009.04.021
  19. Rhee CH, Choi YK, Kim YI, Kim SS, Park SB, Son WS. Correlation between skeletal and dental changes after mandibular setback surgery-first orthodontic treatment: Cone-beam computed tomography-generated half-cephalograms. Korean J Orthod 2015;45:59-65. https://doi.org/10.4041/kjod.2015.45.2.59
  20. Chen CM, Lai SS, Wang CH, Wu JH, Lee KT, Lee HE. The stability of intraoral vertical ramus osteotomy and factors related to skeletal relapse. Aesthetic Plast Surg 2011;35:192-7. https://doi.org/10.1007/s00266-010-9582-y
  21. Abeltins A, Jakobsone G, Urtane I, Bigestans A. The stability of bilateral sagittal ramus osteotomy and vertical ramus osteotomy after bimaxillary correction of class III malocclusion. J Craniomaxillofac Surg 2011;39:583-7. https://doi.org/10.1016/j.jcms.2011.01.002
  22. Greebe RB, Tuinzing DB. Overcorrection and relapse after the intraoral vertical ramus osteotomy. A one-year postoperative review of thirty-five patients. Oral Surg Oral Med Oral Pathol 1982;54:382-4. https://doi.org/10.1016/0030-4220(82)90382-6
  23. Jung HD, Jung YS, Kim SY, Kim DW, Park HS. Postoperative stability following bilateral intraoral vertical ramus osteotomy based on amount of setback. Br J Oral Maxillofac Surg 2013;51:822-6. https://doi.org/10.1016/j.bjoms.2013.02.001
  24. Choi SH, Kang DY, Cha JY, Jung YS, Yu HS, Park HS, et al. Major factors contributing to anterior and posterior relapse after intraoral vertical ramus osteotomy. J Craniomaxillofac Surg 2016;44:413-20. https://doi.org/10.1016/j.jcms.2016.01.013
  25. Im J, Kang SH, Lee JY, Kim MK, Kim JH. Surgery-first approach using a three-dimensional virtual setup and surgical simulation for skeletal Class III correction. Korean J Orthod 2014;44:330-41. https://doi.org/10.4041/kjod.2014.44.6.330
  26. Kim JY, Jung HD, Kim SY, Park HS, Jung YS. Postoperative stability for surgery-first approach using intraoral vertical ramus osteotomy: 12 month follow-up. Br J Oral Maxillofac Surg 2014;52:539-44. https://doi.org/10.1016/j.bjoms.2014.03.011
  27. 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 2013;42:62-70. https://doi.org/10.1016/j.ijom.2012.06.024

Cited by

  1. A comparison of 2- and 3-dimensional mandibular superimposition techniques against Björk's structural superimposition method vol.159, pp.3, 2016, https://doi.org/10.1016/j.ajodo.2020.09.022