Abstract
Bimaxillary protrusion is a dentofacial deformity common in the East Asian population.
It is often difficult to decide between orthodontic and surgical retraction to treat
patients with bimaxillary protrusion, especially if surgery to correct skeletal base
discrepancies is also required. The objective of this study was to investigate the
treatment outcomes of surgical versus orthodontic retraction in patients with bimaxillary
protrusion undergoing orthognathic surgery. A retrospective cohort study was conducted,
where the medical records and radiographs of 51 patients with bimaxillary protrusion
who had an anterior segmental osteotomy concomitant with orthognathic surgery were
examined. Patients who had bimaxillary anterior segmental osteotomies were more likely
to achieve an inter-incisal angle of 135 ± 5° at the end of treatment, when compared
to patients who had orthodontic retraction (P < 0.01). The total treatment duration of patients who had bimaxillary anterior segmental
osteotomies was significantly shorter as compared to that of the patients who only
had these osteotomies in the maxilla (P < 0.001) or mandible (P = 0.012). Complications and permanent long-term sequelae following anterior segmental
osteotomies were uncommon. It is concluded that bimaxillary anterior segmental osteotomies
are a viable alternative for patients with concomitant bimaxillary protrusion and
skeletal base discrepancies. This allows for a significantly shorter treatment time
and greater correction of inter-incisal angles, without a significant increase in
complications.
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
- Bimaxillary protrusion: an overview of the surgical-orthodontic treatment.Semin Plast Surg. 2009; 23: 32-39
- Bimaxillary dentoalveolar protrusion: traits and orthodontic correction.Angle Orthod. 2005; 75: 333-339
- Bimaxillary protrusion in the Caucasian: a cephalometric study of the morphological features.Br J Orthod. 1985; 12: 193-201
- Profile changes following orthodontic treatment of bimaxillary protrusion in adults with the Begg appliance.Eur J Orthod. 1989; 11: 375-381
- Profile changes following orthodontic correction of bimaxillary protrusion with a preadjusted edgewise appliance.Int J Adult Orthod Orthognath Surg. 1996; 11: 239-251
- A comparative assessment of the perception of Chinese facial profile esthetics.Am J Orthod Dentofac Orthop. 2005; 127: 692-699
- Esthetic evaluation of Asian-Chinese profiles from a white perspective.Am J Orthod Dentofac Orthop. 2008; 133: 532-538
- Segmental maxillary osteotomies in conjunction with bimaxillary orthognathic surgery: indications – safety – outcome.J Oral Maxillofac Surg. 2016; 74: 1422-1440
- Comparison between anterior segmental osteotomy versus conventional orthodontic treatment in root resorption: a radiographic study using cone-beam computed tomography.Maxillofac Plast Reconstr Surg. 2017; 3934
- Combined multisegmental surgical-orthodontic treatment of bialveolar protrusion and chin retrusion with severe facial asymmetry.Am J Orthod Dentofac Orthop. 2013; 143: S148-S160
- The surgery-first approach in orthognathic surgery: a retrospective study of 50 cases.Int J Oral Maxillofac Surg. 2015; 44: 1463-1467
- Anterior decompensation using segmental osteotomy for patients with mandibular asymmetry.J Oral Maxillofac Surg. 2015; 73: 1392.e1-1392.e22
- Treatment outcomes of orthodontic treatment, corticotomy-assisted orthodontic treatment, and anterior segmental osteotomy for bimaxillary dentoalveolar protrusion.Plast Reconstr Surg. 2007; 120: 1027-1036
- Determinants of successful treatment of bimaxillary protrusion: orthodontic treatment versus anterior segmental osteotomy.J Craniofac Surg. 2005; 16: 234-246
- Soft tissue changes following combined anterior segmental bimaxillary orthognathic procedures.J Maxillofac Oral Surg. 2019; 18: 93-99
- Effects of bimax and segmental surgeries for correction of bimaxillary dentoalveolar protrusion Class I on soft tissue parameters: upper lip thickness and curvature, nasolabial angle and nasal prominence.J Contemp Dent Pract. 2013; 14: 1087-1093
- The frontal soft tissue changes in the lower facial portion after orthodontic treatment combined with anterior segmental osteotomy.Orthodontics. 2011; 12: 232-241
- Stability and surgical complications in segmental Le Fort I osteotomy: a systematic review.Int J Oral Maxillofac Surg. 2017; 46: 1071-1087
- Prevalence of postoperative complications after orthognathic surgery: a 15-year review.J Oral Maxillofac Surg. 2007; 65: 984-992
- Surgical complications of segmental Le Fort I osteotomy.Br J Oral Maxillofac Surg. 2011; 49: 562-566
- Intra- and early postoperative complications of the Le Fort I osteotomy. A retrospective study on 410 cases.J Craniomaxillofac Surg. 1991; 19: 217-222
- Periodontal disease associated with interdental osteotomies after orthognathic surgery.J Oral Maxillofac Surg. 1998; 56: 414-417
- Facial soft tissue response to anterior segmental osteotomies: a systematic review.Int J Oral Maxillofac Surg. 2010; 39: 1050-1058
- Evaluation of the soft and hard tissue changes after anterior segmental osteotomy on the maxilla and mandible.J Oral Maxillofac Surg. 2008; 66: 98-103
- Comparison of landmark identification in traditional versus computer-aided digital cephalometry.Angle Orthod. 2000; 70: 387-392
- The effects of differences in landmark identification on the cephalometric measurements in traditional versus digitized cephalometry.Angle Orthod. 2004; 74: 155-161
- Soft tissue changes following the extraction of premolars in nongrowing patients with bimaxillary protrusion. A systematic review.Angle Orthod. 2010; 80: 211-216
- The control of vertical overbite in clinical orthodontics.Angle Orthod. 1968; 38: 19-39
- Treatment satisfaction and its influencing factors among adult orthodontic patients.Am J Orthod Dentofac Orthop. 2018; 153: 808-817
- Satisfaction with orthodontic treatment outcome.Angle Orthod. 2014; 84: 581-587
- Factors affecting patients’ adherence to orthodontic appointments.Am J Orthod Dentofac Orthop. 2016; 149: 319-324
- Factors associated with patient and parent satisfaction after orthodontic treatment: a systematic review.Am J Orthod Dentofac Orthop. 2015; 148: 652-659
- Blood supply of the Le Fort I maxillary segment: an anatomic study.Plast Reconstr Surg. 1997; 100: 843-851
- A survey of complications in segmental orthognathic surgical procedures.Oral Surg Oral Med Oral Pathol. 1984; 58: 537-539
- Dentoalveolar compensation related to variations in sagittal jaw relationships.Angle Orthod. 1999; 69: 534-538
- Dentoalveolar compensation in negative overjet cases.Angle Orthod. 2000; 70: 145-148
- Cone beam computed tomography evaluations of marginal alveolar bone before and after orthodontic treatment combined with premolar extractions.Eur J Oral Sci. 2012; 120: 201-211
- Mandibular incisors, alveolar bone, and symphysis after orthodontic treatment. A retrospective study.Am J Orthod Dentofac Orthop. 1996; 110: 239-246
- Morphological changes of the anterior alveolar bone due to retraction of anterior teeth: a retrospective study.Head Face Med. 2021; 1730
Article info
Publication history
Published online: August 22, 2022
Accepted:
August 15,
2022
Identification
Copyright
© 2022 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.