Changes in the pattern of patients receiving surgical-orthodontic treatment

Abstract

Introduction The characteristics of patients who seek and accept orthognathic surgery appear to be changing over time but have not been well documented in the 21st century. Methods Records for patients who had orthognathic surgery at the University of North Carolina from 1996 to 2000 and from 2006 to 2010 were reviewed to collect data for changes in the prevalence of patients with mandibular deficiency (Class II), maxillary deficiency or mandibular prognathism (Class III), long face, and asymmetry problems. The changes were compared with those in previous time periods and at other locations. Results Between 1996 and 2000 and between 2006 and 2010, the percentage of Class III patients increased from 35% to 54%, and the percentage of Class II patients decreased from 59% to 41%, while the percentages for long face and asymmetry showed little change. The decrease in Class II patients was accentuation of a long-term trend; the increase in Class III patients occurred only after the turn of the century. Conclusions A similar but less-marked change has been noted at some but not all other locations in the United States. It appears to be related primarily to an increase in the numbers of African Americans, Native Americans, Hispanics, and Asians who now are seeking surgical treatment, but it also has been affected by changes in where orthognathic surgery is performed, decisions by third-party payers (insurance and Medicaid) about coverage for treatment, and the availability of nonsurgical orthodontic treatment options for Class II patients.

Extraction frequencies at a university orthodontic clinic in the 21st century: Demographic and diagnostic factors affecting the likelihood of extraction

“…Importantly, these data align with a recently published report of patients undergoing surgical-orthodontic treatment from 2006-2010. That study found that the proportion of Class III patients undergoing surgical treatment had increased, while the proportion of surgical Class II patients had decreased compared to a time period ten years earlier 15 .…”

External cervical resorption‐part 1: histopathology, distribution and presentation

“…Mavridou et al (2017a) detected ECR more frequently in younger age groups than reported by Heithersay (1999b). This may be due to a combination of factors including increased uptake of orthodontic treatment, increased visits to general dentists for check-ups and more awareness of the clinical and radiographic appearance of ECR (Proffit et al 2013, Van der Heyden 2013, RIZIV 2017. ECR does not seem to be related to the gender of the patient (Heithersay 1999b, Mavridou et al 2017a).…”

3D Airway changes using CBCT in patients following mandibular setback surgery ± maxillary advancement

“…Despite this relatively small figure, a high percentage of those patients seek treatment due to the resulting functional and aesthetic concerns. Recent data indicate that over half of the patients presenting with skeletal Class III malocclusion will require surgical intervention …”

“…Recent data indicate that over half of the patients presenting with skeletal Class III malocclusion will require surgical intervention. 2 A Class III skeletal pattern involves a relative or absolute protrusion of the mandible compared to the maxilla. This can be due to true mandibular prognathism, true maxillary retrognathism, or a combination of the two.…”