Highlight the major clinical studies on orthognathic surgery in the correction of anomalies in Class III patients: a systematic review

Abstract

Introduction: In the setting of orthognathic surgery, malocclusion is the third most common oral health problem after caries and periodontal diseases. Malocclusion is found in ages between 7 and 15 years with a prevalence of 6% in Brazil. Objective: The present study aimed to highlight the main considerations and findings of clinical studies on the importance of orthognathic surgery in the correction of anomalies in class III patients. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles with different dates up to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 112 articles were found, 70 articles were evaluated and 56 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 20 studies that did not meet GRADE. Based on the results, the treatment of Class III must be fundamentally based on the diagnosis so that the treatment can be installed in order to correct the compromised structures instead of being compensated in places not affected by this malocclusion. In other words, the degree of involvement of the maxilla and mandible must be evaluated so that the treatment is directed to that bone base and really achieves its goals and impacts of facial improvement. Redirection of growth in Class III cases is indicated as soon as the anomaly is diagnosed, as the displacement processes that occur in the middle face can only be affected with treatment while the growth zones are able to respond to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the facial correction effects.