Abstract
This systematic review was performed to investigate the long-term hard tissue stability
in orthognathic surgery patients with skeletal class III malocclusion. A literature
search was conducted using the Embase, Cochrane Central, Web of Science, and PubMed
databases, yielding 3690 articles published up to June 2018. Nine articles met the
inclusion criteria; these reported skeletal changes in 886 patients with between 5
and 12.7 years of follow-up. Risk of bias was assessed according to the Cochrane Handbook.
Results showed variations in stability based on age, facial pattern, surgical procedure,
and fixation type. Young patients showed a greater increase in mandibular length and
higher A-point stability after bimaxillary surgery than older patients. Dolichofacial
patients showed skeletal relapse with a facial clockwise rotation, whereas counterclockwise
rotation was observed in brachyfacial patients. Single mandibular setback surgery
was linked to stability loss with decreased mandibular ramus and gonion angle; meanwhile,
genioplasty fell into the highly stable surgery category. The hyoid bone relapsed
significantly postero-inferiorly, which correlated with suprahyoid muscle changes
but little to no mandibular position changes. Fixation with monocortical miniplates
showed higher patient satisfaction and better stability compared to bicortical screw
fixation. These conclusions should be regarded with caution because of the lack of
current evidence from three-dimensional imaging.
Key words
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Article info
Publication history
Published online: March 26, 2019
Accepted:
February 28,
2019
Identification
Copyright
© 2019 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
