J Korean Assoc Oral Maxillofac Surg 2017; 43(1): 23~28
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
Deuk-Hyun Mah, Su-Gwan Kim, Ji-Su Oh, Jae-Seek You, Seo-Yun Jung, Won-Gi Kim, Kyung-Hwan Yu
Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
Su-Gwan Kim
Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, 303 Pilmun-daero, Dong-gu, Gwangju 61452, Korea
TEL: +82-62-220-3815   FAX: +82-62-228-7316
E-mail: sgckim@chosun.ac.kr
ORCID: http://orcid.org/0000-0002-0424-9984
Received January 4, 2016; Revised March 31, 2016; Accepted April 5, 2016.; Published online February 28, 2017.
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 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±0.92 mm (P<0.01) forward movement and –0.87±0.57 mm (non-significant, NS) upward movement on the basis of point B and 2.54±1.37 mm (P<0.01) forward movement and –1.18±0.79 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±1.71 mm (P<0.01) forward movement and –1.78±0.81 mm (P<0.01) upward movement on the basis of the point B and 4.11±1.93 mm (P<0.01) forward movement and –2.40±0.98 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.
Keywords: Deformity, Prognathism


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