An Esthetic Treatment Outcome of Orthognathic Surgery and Dentofacial Orthopedics in Class II Treatment: A Cephalometric Study

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The main objective of any orthodontic treatment is to achieve well-established stable occlusal relationship with a definite positive change in facial profile. The purpose of this study was to determine, if such a goal is achievable for patients who could be classified as borderline surgical cases without the invasive use of the actual surgery or, with the use of the recently developed and rapidly spreading fixed functional appliance system (Forsus) and a comparison of the esthetic treatment outcome with the two systems. Twelve postadolescent borderline skeletal class II patients with a deficient mandible. All the patients used in the study were treated by a preadjusted edgewise appliance for presurgical decompensation with or without extractions and for postsurgical finishing and detailing. Out of the 12 patients six were treated with bilateral saggital split osteotomy (BSSO) and six were treated with fixed functional appliance (Forsus). The results suggested that although surgical patients had a better mandibular advancement, profile reduction, and marked improvements in soft tissue structures, the patients who had undergone fixed functional therapy also had comparable improvement in the above aspects. In the maxilla there was no change in cases treated with surgery but in case of Forsus some retraction of anterior dental segment was evident. In surgical group, class II malocclusion correction was more skeletal than dental, whereas in functional group class II malocclusion correction was more dental than skeletal. Looking at the common surgical risks, cost-effective and postsurgical problems and patients with borderline class II malocclusion, fixed functional therapy is a valuable adjunct in the management of class II malocclusion.