Maxillary stability in patients with skeletal class III malocclusion treated by bimaxillary orthognathic surgery: comparison of mandible-first and maxilla-first approaches in a randomised controlled study

Mahmoud, Mohamed Hamdy; Elfaramawi, Tarek; El-Tabarany, Kareem Samir; Askar, Niveen

doi:10.1016/j.bjoms.2021.10.001

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…An additional consideration is the extent to which the choice of a surgical sequence could influence the treatment accuracy. Some authors stated that the two sequences are equally accurate, as both adhere to virtual surgical planning with comparable precision [5,19,21]. In contrast, other authors reported that the conventional sequence achieves more accurate results [12], with differences in specific surgical movements.…”

Section: Discussionmentioning

confidence: 99%

Sequencing in Orthognathic Bimaxillary Surgery: Which Jaw Should Be Operated First? A Scoping Review

Trevisiol,

Bersani,

Lobbia

et al. 2023

JCM

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Bimaxillary orthognathic surgery is widely used for the correction of dentoskeletal deformities. Surgery sequencing (maxilla or mandible first) remains debated, and guidelines and consensus are lacking. This scoping review summarizes the state of the art and compares the advantages and disadvantages of both approaches. The review was conducted following PRISMA-ScR guidelines. Three electronic databases (PubMed, Scopus, Web of Science) were searched using the PICO protocol and key words in orthognathic surgical sequencing. Four reviewers screened the records independently, and disagreement was resolved by consensus. A total of 23 records met the inclusion criteria. The advantages and disadvantages of the two approaches were compared and assessed for accuracy of reporting. Within the limitations of the present study, available evidence for the intrinsic advantages and the accuracy of the mandible-first sequence supports the choice of this approach in most cases. Nevertheless, each clinical case needs to be evaluated individually, as no dogmatic recommendations can be given for sequencing in bimaxillary orthognathic surgery.

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Section: Discussionmentioning

confidence: 99%

Sequencing in Orthognathic Bimaxillary Surgery: Which Jaw Should Be Operated First? A Scoping Review

Trevisiol,

Bersani,

Lobbia

et al. 2023

JCM

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“…[26], in a randomized clinical trial, testing maxillary protraction in a group with expansion and in another without previous maxillary expansion concluded that the changes produced to the dentofacial complex were equivalent to an improvement in malocclusion Class III, and there is no change in the total treatment time. Maxillary expansion is only necessary in cases of posterior crossbite or space deficiency [27][28][29][30][31][32][33][34][35][36][37][38]. These data are also according to the systematic review conducted by Kurt et al ( 2022) [39].…”

Section: Summary Of Literary Findingsmentioning

confidence: 97%

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

Augusto,

Viudes,

Rezende

et al. 2023

MedNEXT

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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.

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“…Additionally, both mono-maxillary and bimaxillary surgery were used in the study; the differences in surgical methods can influence the stability and long-term results of each procedure. Furthermore, the mandible-first approach in bimaxillary orthognathic surgery achieves more stability [44,45]. Therefore, in future research to further study the stability or whether it is different when performing mandibular setback in skeletal class III, the study should be designed with a large number of subjects, be carried out with the same surgical approach and provide dietary control for bone and muscular recovery that can affect the stability following orthognathic surgery [46].…”

Section: Relationships Between Masticatory Muscle Volume Changes Mand...mentioning

confidence: 99%

Relationship between Changes in Condylar Morphology and Masticatory Muscle Volume after Skeletal Class II Surgery

Lekroengsin,

Tachiki,

Takaki

et al. 2023

JCM

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The treatment of dentofacial deformities generally includes orthognathic surgery in which mandibular condyle changes following surgery are a common cause of relapse. This study investigated the changes in the mandibular condyle and related muscles to identify the factors that affected the changes in the mandibular condyle after orthognathic surgery in skeletal class II patients. This research studied 60 joints in 30 patients with skeletal class II dentofacial deformities who received surgical orthodontic treatment, including bilateral sagittal split ramus osteotomy, and underwent computed tomography before and after orthodontic treatment. The mandibular condyle, masseter, and medial pterygoid muscles were reconstructed and measured in 3D. Condylar positional and morphology changes, masseter and medial pterygoid muscle volume, temporomandibular joint (TMJ) pain, and distal segment movement were analyzed. The study observed that both the masseter and medial pterygoid muscle volumes decreased with statistical significance. The changes in the horizontal direction were positively correlated with the amount of movement. The findings indicated that mandibular condyle changes were significantly affected by the movement of the distal segment, the medial pterygoid muscle volume, and the direction of the distal segment, which influenced the treatment’s long-term stability after orthognathic surgery.

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Maxillary stability in patients with skeletal class III malocclusion treated by bimaxillary orthognathic surgery: comparison of mandible-first and maxilla-first approaches in a randomised controlled study

Cited by 6 publications

References 12 publications

Sequencing in Orthognathic Bimaxillary Surgery: Which Jaw Should Be Operated First? A Scoping Review

Sequencing in Orthognathic Bimaxillary Surgery: Which Jaw Should Be Operated First? A Scoping Review

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

Relationship between Changes in Condylar Morphology and Masticatory Muscle Volume after Skeletal Class II Surgery

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