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Comparative study of postoperative stability between conventional orthognathic surgery and a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy for skeletal class III correction

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¸¶µæÇö, ±è¼ö°ü, ¿ÀÁö¼ö, À¯Àç½Ä, Á¤¼­À±, ±è¿ø±â, Yu Kyung-Hwan,
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¸¶µæÇö ( Mah Deuk-Hyun ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
±è¼ö°ü ( Kim Su-Gwan ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
¿ÀÁö¼ö ( Oh Ji-Su ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
À¯Àç½Ä ( You Jae-Seek ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
Á¤¼­À± ( Jung Seo-Yun ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
±è¿ø±â ( Kim Won-Gi ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
 ( Yu Kyung-Hwan ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery

Abstract


Objectives: The purpose of this study is to compare the postoperative stability of conventional orthognathic surgery to a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy (BSSRO).

Materials and Methods: The study included 20 patients who underwent BSSRO for skeletal class III conventional orthognathic surgery and 20 patients who underwent a surgery-first orthognathic approach. Serial lateral cephalograms were analyzed to identify skeletal changes before surgery (T0), immediately after surgery (T1), and after surgery (T2, after 1 year or at debonding).

Results: The amount of relapse of the mandible in the conventional orthognathic surgery group from T1 to T2 was 2.23¡¾0.92 mm (P<0.01) forward movement and ?0.87¡¾0.57 mm (non-significant, NS) upward movement on the basis of point B and 2.54¡¾1.37 mm (P<0.01) forward movement and ?1.18¡¾0.79 mm (NS) upward movement on the basis of the pogonion (Pog) point. The relapse amount of the mandible in the surgery-first orthognathic approach group from T1 to T2 was 3.49¡¾1.71 mm (P<0.01) forward movement and ?1.78¡¾0.81 mm (P<0.01) upward movement on the basis of the point B and 4.11¡¾1.93 mm (P<0.01) forward movement and ?2.40¡¾0.98 mm (P<0.01) upward movement on the basis of the Pog.

Conclusion: The greater horizontal and vertical relapse may appear because of counter-clockwise rotation of the mandible in surgery-first orthognathic approach. Therefore, careful planning and skeletal stability should be considered in orthognathic surgery.

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Deformity; Prognathism

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