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Analysis of postsurgical relapse patterns in one-jaw surgery: skeletal factors and clustering analysis in patients with mandibular setback

  • Jong-Wan Kim (Department of Orthodontics, School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Nam-Ki Lee (Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Pil-Young Yun (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Jong-Ho Lee (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Hye-Young Sim (Department of Dentistry, SMG-SNU Boramae Medical Center)
  • Received : 2024.06.05
  • Accepted : 2024.07.14
  • Published : 2024.10.31

Abstract

Objectives: To compare presurgical skeletal factors and postsurgical relapse patterns between more relapsed (MR) and less relapsed (LR) groups. Materials and Methods: This study retrospectively examined patients who underwent mandibular setback surgery, classifying them into two groups based on the amount of relapse of the pogonion using K-means analysis. Comparisons were conducted by analyzing cephalometric radiographs presurgically (T0), at 1-month post-surgery (T1), and immediately after orthodontic treatment (T2). Results: The MR group at T0 had a lower articular angle and AB to the mandibular plane angle (MPA), higher gonial angle, shorter anterior and posterior facial heights, and shorter Frankfort horizontal plane to the upper incisor and first molar. The articular angle in the MR group increased postoperatively. The Frankfort MPA (FMA) did not differ significantly between the MR and LR groups. Conclusion: Acute articular angle and short facial height with a high gonial angle in the presurgical stage can predict surgical relapse regardless of the FMA.

Keywords

References

  1. Trauner R, Obwegeser H. The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty: Part I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 1957;10:677-89. https://doi.org/10.1016/S0030-4220(57)80063-2
  2. Moose SM. Surgical correction of mandibular prognathism by intra-oral sub-condylar osteotomy. Br J Oral Surg 1964;1:172-6. https://doi.org/10.1016/S0007-117X(63)80068-2
  3. Proffit WR, Phillips C, Dann C 4th, Turvey TA. Stability after surgical-orthodontic correction of skeletal Class III malocclusion. I. Mandibular setback. Int J Adult Orthodon Orthognath Surg 1991;6:7-18.
  4. Tseng YC, Lai S, Lee HE, Chen KK, Chen CM. Are hyoid bone and tongue the risk factors contributing to postoperative relapse for mandibular prognathism? Biomed Res Int 2016;2016:5284248. https://doi.org/10.1155/2016/5284248
  5. Kobayashi T, Watanabe I, Ueda K, Nakajima T. Stability of the mandible after sagittal ramus osteotomy for correction of prognathism. J Oral Maxillofac Surg 1986;44:693-7. https://doi.org/10.1016/0278-2391(86)90037-6
  6. Reitzik M. Skeletal and dental changes after surgical correction of mandibular prognathism. J Oral Surg 1980;38:109-16.
  7. Yoshida K, Rivera GA, Matsuo N, Takaishi M, Inamoto H, Kurita K. Long-term prognosis of BSSO mandibular relapse and its relation to different facial types. Angle Orthod 2000;70:220-6.
  8. Joss CU, Thuer UW. Stability of hard tissue profile after mandibular setback in sagittal split osteotomies: a longitudinal and longterm follow-up study. Eur J Orthod 2008;30:352-8. https://doi.org/10.1093/ejo/cjn008
  9. Jakobsone G, Stenvik A, Sandvik L, Espeland L. Three-year follow-up of bimaxillary surgery to correct skeletal Class III malocclusion: stability and risk factors for relapse. Am J Orthod Dentofacial Orthop 2011;139:80-9. https://doi.org/10.1016/j.ajodo.2009.03.050
  10. Lee JH, Kim SO, Jeon JH. The assessment of the stability in mandibular setback surgery related to spatial factors under rotational control of the proximal segment. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;117:560-6. https://doi.org/10.1016/j.oooo.2014.01.012
  11. Tseng YC, Hsu KJ, Chen KK, Wu JH, Chen CM. Relationship between frontal gap and postoperative stability in the treatment of mandibular prognathism. Biomed Res Int 2016;2016:7046361. https://doi.org/10.1155/2016/7046361
  12. Ricketts RM. Philosophies and methods of facial growth prediction. Proc Found Orthod Res 1971:11-30.
  13. Hsu SS, Huang CS, Chen PK, Ko EW, Chen YR. The stability of mandibular prognathism corrected by bilateral sagittal split osteotomies: a comparison of bi-cortical osteosynthesis and monocortical osteosynthesis. Int J Oral Maxillofac Surg 2012;41:142-9. https://doi.org/10.1016/j.ijom.2011.10.029
  14. 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
  15. Lee HG, Agpoon KJ, Besana AN, Lim HK, Jang HS, Lee ES. Mandibular stability using sliding or conventional four-hole plates for fixation after bilateral sagittal split ramus osteotomy for mandibular setback. Br J Oral Maxillofac Surg 2017;55:378-82. https://doi.org/10.1016/j.bjoms.2016.11.318
  16. 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
  17. Xiangdong QI, Limin MA, Shizhen Z. The influence of the closing and opening muscle groups of jaw condyle biomechanics after mandible bilateral sagittal split ramus osteotomy. J Craniomaxillofac Surg 2012;40:e159-64. https://doi.org/10.1016/j.jcms.2011.07.024