Abstract
The aim of this study was to evaluate postoperative relapse after the surgical correction
of skeletal Class III deformities of various facial patterns as a guide to surgical
planning. A retrospective cohort study of 90 consecutive patients with skeletal Class
III malocclusion who underwent bimaxillary surgery was performed. The surgical outcomes
and postoperative stability were compared. The primary predictor variable was vertical
facial type, which was classified into three groups according to the Frankfort mandibular
plane angle (FMA). The primary outcome of angular and linear measurements was obtained
using serial cone beam computed tomography scans obtained at time points of preoperative,
1 week after surgery, and orthodontic debonding. No significant difference in skeletal
relapse was observed in patients with the different vertical facial types. The mandible
displayed a forward and upward relapse in all three groups postoperatively. The patients
with a low FMA exhibited a more consistent mandibular relapse pattern than those with
a normal or high FMA. These findings suggest that bimaxillary surgery is clinically
stable for mandibular prognathism regardless of the vertical facial pattern. However,
1–1.5 mm of overcorrection in the mandible setback should be considered in patients
with a low FMA, because of the greater facial depth and consistent forward and upward
mandibular relapse pattern.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to International Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Impacts of orthognathic surgery on patient satisfaction, overall quality of life, and oral health-related quality of life: a systematic literature review.Int J Dent. 2019; 20192864216
- Stability after bilateral sagittal split osteotomy advancement surgery with rigid internal fixation: a systematic review.J Oral Maxillofac Surg. 2009; 67: 301-313
- Factors contributing to relapse in rigidly fixed mandibular setbacks.J Oral Maxillofac Surg. 1989; 47: 451-456
- Three-year follow-up of bimaxillary surgery to correct skeletal Class III malocclusion: stability and risk factors for relapse.Am J Orthod Dentofacial Orthop. 2011; 139: 80-89
- Stability factors after double-jaw surgery in Class III malocclusion. A systematic review.Angle Orthod. 2008; 78: 1141-1152
- Orthognathic surgery: a hierarchy of stability.Int J Adult Orthodon Orthognath Surg. 1996; 11: 191-204
- Long-term prognosis of BSSO mandibular relapse and its relation to different facial types.Angle Orthod. 2000; 70: 220-226
- Comparison of the stability after mandibular setback with minimal orthodontics of Class III patients with different facial types.J Oral Maxillofac Surg. 2016; 74: 1464.e1-1464.e10
- Is there a difference in stability after intraoral vertical ramus osteotomy between vertically high-angle and normal-angle patients?.J Oral Maxillofac Surg. 2016; 74: 2252-2260
- Three-dimensional cephalometric norms of Chinese adults in Hong Kong with balanced facial profile.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 112: e56-e73
- Statistical methods for medical and biological students.Phys Ther. 1941; 21124
- The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension.Head Face Med. 2007; 321
- Craniofacial morphological characteristics of Chinese adults with normal occlusion and different skeletal divergence.Eur J Orthod. 2011; 33: 198-204
- Bio-progressive therapy.J Clin Orthod. 1977; 11 (contd): 674-682
- Normal and abnormal growth of the mandible: a synthesis of longitudinal cephalometric implant studies over a period of 25 years.Eur J Orthod. 1983; 5: 1-46
- Evaluation of post-surgical relapse after mandibular setback surgery with minimal orthodontic preparation.J Craniomaxillofac Surg. 2013; 41: 47-51
- Comparison of progressive cephalometric changes and postsurgical stability of skeletal Class III correction with and without presurgical orthodontic treatment.J Oral Maxillofac Surg. 2011; 69: 1469-1477
- Alteration of masticatory electromyographic activity and stability of orthognathic surgery in patients with skeletal Class III malocclusion.J Oral Maxillofac Surg. 2013; 71: 1249-1260
- Is skeletal stability after bimaxillary surgery for skeletal Class III deformity related to surgical occlusal contact?.Int J Oral Maxillofac Surg. 2019; 48: 1329-1336
- Three-dimensional evaluation of positional change of the condyle after mandibular setback by means of bilateral sagittal split ramus osteotomy.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94: 305-309
- Horizontal changes of the proximal mandibular segment after mandibular setback surgery using 3-dimensional computed tomography data.Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 125: 14-19
Article info
Publication history
Published online: June 21, 2022
Accepted:
May 27,
2022
Identification
Copyright
© 2022 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.