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Correlation between skeletal and dental changes after mandibular setback surgery-first orthodontic treatment: Cone-beam computed tomography-generated half-cephalograms

  • Rhee, Chang-Hoon (Private Practice) ;
  • Choi, Youn-Kyung (Department of Orthodontics, Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Yong-Il (Department of Orthodontics, Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Seong-Sik (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Park, Soo-Byung (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Son, Woo-Sung (Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital)
  • Received : 2014.04.24
  • Accepted : 2014.09.24
  • Published : 2015.03.25

Abstract

Objective: To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion. Methods: A retrospective study of 34 patients (23 men, 11 women; mean age, $26.2{\pm}6.6years$) with skeletal Class III deformities, who underwent surgery-first orthodontic treatment, was conducted. Skeletal landmarks in the maxilla and mandible at three time points, pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2), were analyzed using cone-beam computed tomography (CBCT)-generated half-cephalograms. Results: The significant T0 to T1 mandibular changes occurred $-9.24{\pm}3.97mm$ horizontally. From T1 to T2, the mandible tended to move forward $1.22{\pm}2.02mm$, while the condylar position (Cd to Po-perpendicular plane) shifted backward, and the coronoid process (Cp to FH plane) moved vertically. Between T1 and T2, the vertical dimension changed significantly (p < 0.05). Changes in the vertical dimension were significantly correlated to T1 to T2 changes in the Cd to Po-perpendicular plane (r = -0.671, p = 0.034), and in the Cp to FH plane (r = 0.733, p = 0.016), as well as to T0 to T1 changes in the Cp to Po-perpendicular plane (r = 0.758, p = 0.011). Conclusions: Greater alterations in the vertical dimension caused larger post-treatment (T2) stage skeletal changes. Studying the mandibular position in relation to the post-surgical vertical dimension emphasized the integral importance of vertical dimension control and proximal segment management to the success of surgery-first orthodontic treatment.

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References

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