DOI QR코드

DOI QR Code

Comparison of changes in the transverse dental axis between patients with skeletal Class III malocclusion and facial asymmetry treated by orthognathic surgery with and without presurgical orthodontic treatment

  • Song, Han-Sol (Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University) ;
  • Choi, Sung-Hwan (Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University) ;
  • Cha, Jung-Yul (Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University) ;
  • Lee, Kee-Joon (Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University) ;
  • Yu, Hyung-Seog (Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University)
  • Received : 2016.08.09
  • Accepted : 2016.12.07
  • Published : 2017.07.25

Abstract

Objective: To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. Methods: This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. Results: The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, $-1.8^{\circ}{\pm}2.8^{\circ}$, p = 0.044; nondeviated side, $-3.7^{\circ}{\pm}3.3^{\circ}$, p = 0.001) and the lower canine inclined lingually on the nondeviated side ($4.0^{\circ}{\pm}5.4^{\circ}$, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. Conclusions: POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

Keywords

References

  1. Jacobs JD, Sinclair PM. Principles of orthodontic mechanics in orthognathic surgery cases. Am J Orthod 1983;84:399-407. https://doi.org/10.1016/0002-9416(93)90003-P
  2. Tompach PC, Wheeler JJ, Fridrich KL. Orthodontic considerations in orthognathic surgery. Int J Adult Orthodon Orthognath Surg 1995;10:97-107.
  3. Sabri R. Orthodontic objectives in orthognathic surgery: state of the art today. World J Orthod 2006;7:177-91.
  4. 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.
  5. 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.
  6. 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
  7. Ann HR, Jung YS, Lee KJ, Baik HS. Evaluation of stability after pre-orthodontic orthognathic surgery using cone-beam computed tomography: a comparison with conventional treatment. Korean J Orthod 2016;46:301-9. https://doi.org/10.4041/kjod.2016.46.5.301
  8. 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
  9. Park JK, Choi JY, Yang IH, Baek SH. Patient's satisfaction in skeletal class III cases treated with two-jaw surgery using orthognathic quality of life questionnaire: conventional three-stage method versus surgery-first approach. J Craniofac Surg 2015;26:2086-93. https://doi.org/10.1097/SCS.0000000000001972
  10. Frost HM. The biology of fracture healing. An overview for clinicians. Part I. Clin Orthop Relat Res 1989;(248):283-93.
  11. 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
  12. 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
  13. Park KH, Sandor GK, Kim YD. Skeletal stability of surgery-first bimaxillary orthognathic surgery for skeletal class III malocclusion, using standardized criteria. Int J Oral Maxillofac Surg 2016;45:35-40. https://doi.org/10.1016/j.ijom.2015.09.015
  14. 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 tomographygenerated half-cephalograms. Korean J Orthod 2015;45:59-65. https://doi.org/10.4041/kjod.2015.45.2.59
  15. 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
  16. Kim YK, Yun PY, Moon SW, Lee YS, Lee NK. Influence of the changes in arch width on postsurgical relapse after mandibular setback surgery with minimal orthodontics. J Oral Maxillofac Surg 2014;72:1820-31. https://doi.org/10.1016/j.joms.2014.02.035
  17. Lee KM, Hwang HS, Cho JH. Comparison of transverse analysis between posteroanterior cephalogram and cone-beam computed tomography. Angle Orthod 2014;84:715-9. https://doi.org/10.2319/072613-555.1
  18. Ryu HS, An KY, Kang KH. Cone-beam computed tomography based evaluation of rotational patterns of dentofacial structures in skeletal Class III deformity with mandibular asymmetry. Korean J Orthod 2015;45:153-63. https://doi.org/10.4041/kjod.2015.45.4.153
  19. Lee RT. The benefits of post-surgical orthodontic treatment. Br J Orthod 1994;21:265-74. https://doi.org/10.1179/bjo.21.3.265
  20. Vanarsdall RL Jr. Transverse dimension and longterm stability. Semin Orthod 1999;5:171-80. https://doi.org/10.1016/S1073-8746(99)80008-5
  21. 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
  22. 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
  23. Park SH, Yu HS, Kim KD, Lee KJ, Baik HS. A proposal for a new analysis of craniofacial morphology by 3-dimensional computed tomography. Am J Orthod Dentofacial Orthop 2006;129:600.e23-34.
  24. Hwang HS, Youn IS, Lee KH, Lim HJ. Classification of facial asymmetry by cluster analysis. Am J Orthod Dentofacial Orthop 2007;132:279.e1-6.
  25. Baek C, Paeng JY, Lee JS, Hong J. Morphologic evaluation and classification of facial asymmetry using 3-dimensional computed tomography. J Oral Maxillofac Surg 2012;70:1161-9. https://doi.org/10.1016/j.joms.2011.02.135
  26. Tyan S, Park HS, Janchivdorj M, Han SH, Kim SJ, Ahn HW. Three-dimensional analysis of molar compensation in patients with facial asymmetry and mandibular prognathism. Angle Orthod 2016;86:421-30. https://doi.org/10.2319/030915-142.1

Cited by

  1. Comparison of Changes in the Condylar Volume and Morphology in Skeletal Class III Deformities Undergoing Orthognathic Surgery Using a Customized versus Conventional Miniplate: A Retrospective Analysis vol.9, pp.9, 2017, https://doi.org/10.3390/jcm9092794
  2. Three-dimensional evaluation of dental decompensation and mandibular symphysis remodeling on orthodontic-surgical treatment of Class III malocclusion vol.159, pp.2, 2017, https://doi.org/10.1016/j.ajodo.2019.12.020