Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Current concept of the surgery-first orthognathic approach

  • Choi, Jong-Woo (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jang-Yeol (Smile Again Orthodontic Center)
  • Received : 2020.09.07
  • Accepted : 2021.02.17
  • Published : 2021.03.15
Download PDF
⟨ Previous Next ⟩

Abstract

Traditional orthognathic surgery has long been performed after presurgical orthodontic treatment. Despite some concerns, the surgery-first orthognathic approach (SFOA) or surgery-first approach (SFA) without presurgical orthodontic treatment has gradually gained popularity. In recent years, several articles dealing with the concepts of the SFA have been published worldwide. However, the SFA has not yet been standardized, and many surgeons use slightly different protocols and concepts. This review article discusses the beginning and evolution of the SFA and its current concepts, including some opinions based on the authors' clinical experiences over the last 15 years. According to recent investigations, the SFA could be applied effectively in several situations including class III malocclusion, class II malocclusion, and facial asymmetry. However, debate on the SFA continues and many issues remain to be resolved. This review article addresses the current issues regarding the SFOA, including its advantages and disadvantages, as well as its indications and contraindications. The authors summarize various aspects of the SFA and expect that this review article will help surgeons and orthodontists better understand the current status of the SFA.

Keywords

References

  1. Obwegeser HL. Orthognathic surgery and a tale of how three procedures came to be: a letter to the next generations of surgeons. Clin Plast Surg 2007;34:331-55. https://doi.org/10.1016/j.cps.2007.05.014
  2. Choi JW, Lee JY, Yang SJ, et al. 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
  3. Sugawara J, Aymach Z, Nagasaka DH, et al. "Surgery first" orthognathics to correct a skeletal class II malocclusion with an impinging bite. J Clin Orthod 2010;44:429-38.
  4. Ko EW, Lin SC, Chen YR, et al. 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
  5. Oh CO, Son HB. Functional orthognathic surgery (1). Korean J Clin Orthod 2002;1:32-9.
  6. Choi JW, Bradley JP. Surgery first orthognathic approach without presurgical orthodontic treatment: questions and answers. J Craniofac Surg 2017;28:1330-3. https://doi.org/10.1097/SCS.0000000000003733
  7. Jeong WS, Choi JW, Kim DY, et al. Can a surgery-first orthognathic approach reduce the total treatment time? Int J Oral Maxillofac Surg 2017;46:473-82. https://doi.org/10.1016/j.ijom.2016.12.006
  8. Jeong WS, Choi JW, Kim DY, et al. Can a surgery-first orthognathic approach reduce the total treatment time? Int J Oral Maxillofac Surg 2017;46:473-82. https://doi.org/10.1016/j.ijom.2016.12.006
  9. Jeong WS, Lee JY, Choi JW. Large-scale study of long-term anteroposterior stability in a surgery-first orthognathic approach without presurgical orthodontic treatment. J Craniofac Surg 2017;28:2016-20. https://doi.org/10.1097/SCS.0000000000003853
  10. Jeong WS, Lee JY, Choi JW. Large-scale study of long-term vertical skeletal stability in a surgery-first orthognathic approach without presurgical orthodontic treatment: part II. J Craniofac Surg 2018;29:953-8. https://doi.org/10.1097/SCS.0000000000004433
  11. Kim JY, Jung HD, Kim SY, et al. 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
  12. Liao YF, Chen YF, Yao CF, et al. Long-term outcomes of bimaxillary surgery for treatment of asymmetric skeletal class III deformity using surgery-first approach. Clin Oral Investig 2019;23:1685-93. https://doi.org/10.1007/s00784-018-2603-y
  13. Yaffe A, Fine N, Binderman I. Regional accelerated phenomenon in the mandible following mucoperiosteal flap surgery. J Periodontol 1994;65:79-83. https://doi.org/10.1902/jop.1994.65.1.79
  14. Peiro-Guijarro MA, Guijarro-Martinez R, Hernandez-Alfaro F. Surgery first in orthognathic surgery: a systematic review of the literature. Am J Orthod Dentofacial Orthop 2016;149:448-62. https://doi.org/10.1016/j.ajodo.2015.09.022
  15. Uribe F, Adabi S, Janakiraman N, et al. Treatment duration and factors associated with the surgery-first approach: a two-center study. Prog Orthod 2015;16:29. https://doi.org/10.1186/s40510-015-0101-1
  16. Luther F, Morris DO, Hart C. Orthodontic preparation for orthognathic surgery: how long does it take and why? A retrospective study. Br J Oral Maxillofac Surg 2003;41:401-6. https://doi.org/10.1016/S0266-4356(03)00163-3