Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Comparative study of postoperative stability between conventional orthognathic surgery and a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy for skeletal class III correction

  • Mah, Deuk-Hyun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Kim, Su-Gwan (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Oh, Ji-Su (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • You, Jae-Seek (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Jung, Seo-Yun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Kim, Won-Gi (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Yu, Kyung-Hwan (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University)
  • Received : 2016.01.04
  • Accepted : 2016.04.05
  • Published : 2017.02.28
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Abstract

Objectives: The purpose of this study is to compare the postoperative stability of conventional orthognathic surgery to a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy (BSSRO). Materials and Methods: The study included 20 patients who underwent BSSRO for skeletal class III conventional orthognathic surgery and 20 patients who underwent a surgery-first orthognathic approach. Serial lateral cephalograms were analyzed to identify skeletal changes before surgery (T0), immediately after surgery (T1), and after surgery (T2, after 1 year or at debonding). Results: The amount of relapse of the mandible in the conventional orthognathic surgery group from T1 to T2 was $2.23{\pm}0.92mm$ (P<0.01) forward movement and $-0.87{\pm}0.57mm$ (non-significant, NS) upward movement on the basis of point B and $2.54{\pm}1.37mm$ (P<0.01) forward movement and $-1.18{\pm}0.79mm$ (NS) upward movement on the basis of the pogonion (Pog) point. The relapse amount of the mandible in the surgery-first orthognathic approach group from T1 to T2 was $3.49{\pm}1.71mm$ (P<0.01) forward movement and $-1.78{\pm}0.81mm$ (P<0.01) upward movement on the basis of the point B and $4.11{\pm}1.93mm$ (P<0.01) forward movement and $-2.40{\pm}0.98mm$ (P<0.01) upward movement on the basis of the Pog. Conclusion: The greater horizontal and vertical relapse may appear because of counter-clockwise rotation of the mandible in surgery-first orthognathic approach. Therefore, careful planning and skeletal stability should be considered in orthognathic surgery.

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