Dental and skeletal changes following sagittal split osteotomy for correction of mandibular prognathism

Vasir, N. S.; Thompson, Robin; Davies, Tom

doi:10.1093/ejo/13.2.134

Cited by 12 publications

(9 citation statements)

References 16 publications

(20 reference statements)

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“…Because of the uprighting of lower anterior teeth after decompensation, the reverse overjet was increased. That means the occlusal relationship and profile appearance will be even worse after decompensation, which increases the present discrepancy [22]. This has been proved in this study and it is necessary to explain this phenomenon to patients before treatment.…”

Section: Investigation Of the Incisor Inclination And Arch Width Chansupporting

confidence: 56%

Incisor Inclination and Arch Width Changes Following Mandibular Setback Surgery for Correction of Mandibular Prognathism

Ning¹

2014

CMR

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Purpose: The aim of this study was to investigate and evaluate the changes of incisor inclination and arch width in the surgical-orthodontic treatment to correct a Class Ⅲ malocclusion resulting from skeletal mandibular prognathism. Materials and methods: The skeletal mandibular prognathism subjects consisted of 25 males and 20 females (mean age:22.8±4.2years). A lateral cephalogram was taken for each subject before preoperative orthodontic treatment (T1), presurgical (T2), and at completion of the postoperative orthodontic treatment (T3). Skeletal and dental values and arch width measurements at T1, T2 and T3 were obtained. Each cephalogram was traced and digitized twice. For statistical evaluation, all the data were expressed as Mean±Standard deviation and analyzed with SPSS software. Results: At pretreatment, dental compensation was normally found in both dental arches, including anterior and posterior teeth. During presurgical orthodontic treatment, most of the patient's mandibular incisors were significantly decompensated (P<0.05), while no significant changes were noted in the maxillary incisors (P ≥ 0.05). The increase in maxillary inter-first molar width were statistically significant (P<0.05). With effective dental decompensation, the relationship between teeth and basal bone was improved obviously. It is beneficial for moving bone bulk in surgery. After the surgery, most of the patients (97.8%) finished with proper overjet and overbite, establish stable and harmony occlusion. Conclusion: By effective and proper dental decompensation, desired teeth positions could be achieved before surgery, which could lead to better surgical results.

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Section: Investigation Of the Incisor Inclination And Arch Width Chansupporting

confidence: 56%

Incisor Inclination and Arch Width Changes Following Mandibular Setback Surgery for Correction of Mandibular Prognathism

Ning¹

2014

CMR

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“…The superimposition method applied here 14 is different from other studies that have used coordinates 16,17 and partial structures for registration 18 . By using the entire cranial base as a reference, both the inclination and position in three planes of space are corrected.…”

Section: Discussionmentioning

confidence: 99%

One-year assessment of surgical outcomes in Class III patients using cone beam computed tomography

Paula¹,

Ruellas²,

Paniagua³

et al. 2013

International Journal of Oral and Maxillofacial Surgery

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The purpose of this study was to apply a novel method to evaluate surgical outcomes at 1 year after orthognathic surgery for Class III patients undergoing two different surgical protocols. Fifty patients divided equally into two groups (maxillary advancement only and combined with mandibular setback) had cone beam computed tomography (CBCT) scans taken pre-surgery, at splint removal, and at 1-year post-surgery. An automatic cranial base superimposition method was used to register, and shape correspondence was applied to assess, the overall changes between pre-surgery and splint removal (surgical changes) and between splint removal and 1-year post-surgery at the end of orthodontic treatment (post-surgical adaptations). Post-surgical maxillary adaptations were exactly the same for both groups, with 52% of the patients having changes >2 mm. Approximately half of the post-surgical changes in the maxilla for both groups were vertical. The two-jaw group showed significantly greater surgical and post-surgical changes in the ramus, chin, and most of the condylar surfaces (P < 0.05). Post-surgical adaptation on the anterior part of the chin was also more significant in the two-jaw group (P < 0.05). Regardless of the type of surgery, marked post-surgical adaptations were observed in the regions evaluated, which explain the adequate maxillary–mandibular relationship at 1-year post-surgery on average, with individual variability.

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“…Decompensation of the lower incisors with combined surgical and orthodontic Class III treatment has been reported to occur with variable success. 10,12,16,21,23,40 Some investigators have observed that lower incisors remain retroclined at the end of treatment, 12,40 others have reported successful pre-surgical decompensation, followed by 'round-tripping' back to the original compensated positions. 10,23 In addition, others have shown that lower incisor pre-surgical decompensation can be maintained until the completion of appliance treatment, which is consistent with the current findings.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…12 A number of authors have attempted to provide specific cephalometric guidelines regarding the most appropriate treatment plan for any given patient. 8,[13][14][15][16] While some treatment effects of orthodontic camouflage [17][18][19][20] and orthognathic surgery 12,[21][22][23] have been documented in the literature, only rarely have these two methods been directly compared. 10,16 Therefore, the present study was undertaken to evaluate differences in pre-and post-treatment characteristics of a group of Class III patients treated with either contemporary orthodontic camouflage or orthognathic surgery, and to compare the range of skeletal, dental and soft tissue changes that are likely to occur as a result of treatment, with a particular reference to the influence of premolar extractions on the resultant incisor positions and angulations.…”

Section: Introductionmentioning

confidence: 99%

A study of Class III treatment: orthodontic camouflage vs orthognathic surgery

Georgalis

Woods

2015

Australasian Orthodontic Journal

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Aim To evaluate the differences in pretreatment and post-treatment characteristics of Class III patients treated with orthodontic camouflage or orthognathic surgery, and to compare the range of skeletal, dental and soft tissue changes that are likely to occur with treatment, with particular reference to the influence of extractions on the resultant incisor angulations. Method Pretreatment and post-treatment cephalograms of 31 Class III orthodontically-camouflaged patients and 36 Class III surgical patients (without genioplasty) were obtained from one specialist practice. From the surgical group, 26 pre-surgical lateral cephalograms were also obtained. Inclusion criteria for the two groups were at least three of the following: (1) an ANB angle of 1 degree or less, (2) a Wits appraisal less than -4 mm, (3) an incisal overjet ≤0 mm, and (4) a Class III molar relationship. All lateral cephalograms were traced and digitised and a number of skeletal, dental and soft tissue variables were measured. The camouflage and surgical groups were also divided into premolar extraction and non-extraction subgroups to allow for a specific analysis of extraction effects. Results Before treatment, the surgical group demonstrated, on average, a more severe skeletal discrepancy and increased dental compensations, compared with the orthodontically camouflaged group. After treatment, the mean SNA angle was greater, the ANB angle was more positive, the Wits appraisal was closer to ideal and the lower incisors were less retroclined in the surgery group. There was a small mean reduction in horizontal chin projection in the surgery group compared with a small increase in the camouflage group. The mentolabial fold and the lower lip curve were deeper, on average, and the lips less retrusive after surgery. There was a mean increase in upper incisor proclination during treatment in both the surgical and camouflage groups with a greater increase in the camouflage group. There was a significant reduction in upper incisor proclination and a subsequent greater increase in the ANB angle associated with upper premolar extractions in the surgical group compared with the non-extraction group. Lower premolar extractions in the camouflage group resulted only in a deeper mentolabial fold compared with those treated without lower extractions. Conclusions Class III patients selected for surgical treatment are likely to have more severe pretreatment dental and skeletal discrepancies than those selected for camouflage treatment. Surgical treatment is associated with significant decompensation of the lower incisors but, ultimately, not the upper incisors. Class III patients treated with either camouflage or surgery treatment are likely to finish with slightly proclined upper incisors. Generally, surgical treatment results in greater skeletal change, involving normalisation of the skeletal base relationship, a reduction in chin prominence, fuller lips, and a more favourable lip and chin contour.

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Dental and skeletal changes following sagittal split osteotomy for correction of mandibular prognathism

Cited by 12 publications

References 16 publications

Incisor Inclination and Arch Width Changes Following Mandibular Setback Surgery for Correction of Mandibular Prognathism

Incisor Inclination and Arch Width Changes Following Mandibular Setback Surgery for Correction of Mandibular Prognathism

One-year assessment of surgical outcomes in Class III patients using cone beam computed tomography

A study of Class III treatment: orthodontic camouflage vs orthognathic surgery

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