Clinical outcome assessment of surgery first orthodontics after approach for skeletal malocclusions: A pilot study

Abstract

Background: To investigate treatment outcome of skeletal malocclusion managed employing SFOA. Material and Methods: The study sample (n=10) requiring mandibular orthognathic surgery was categorised as Group 1 (GP 1) – Skeletal Class II & Group 2 (GP 2) – Skeletal Class III. Pre (T0) and post (T1) treatment records were analyzed using the CCA Index to assess the clinical outcome of the treatment. Lateral cephalogram was analyzed using WITS Appraisal and McNamara analysis to quantify treatment changes. The total duration of treatment was recorded from the case records of patients. Pain perceived by the patients was assessed using Visual Analogue Scale (VAS) after 03 days of surgical procedure, 03 weeks and 03 months. Results: Mean change in SNB angle was significantly higher in Group 2 compared to Group 1 (P value<0.05). The mean change in ANB angle was significantly higher in Group 1 compared to Group 2 (P value<0.05). The mean change in facial aesthetics score and dental aesthetics score did not differ significantly between two study groups (P value>0.05). For both groups, mean pain response on 3rd day post-surgery was moderate to severe on the VAS which improved to mild to moderate by 3rd week and after 3 months majority of the patients had no pain. The mean total treatment duration from surgery to orthodontic finishing and detailing was 12.2 months, with a range of 8.4 months to 14.6 months. Conclusions: SFOA results in an immediate and marked improvement in skeletal component of the malocclusion along with significantly improved facial and dental aesthetics.