Current Trends in Orthognathic Surgery in Poland—A Retrospective Analysis of 124 Cases

Ewa Zawiślak,Anna Olejnik,Szymon Przywitowski,Paweł Golusiński,Rafał Nowak,Hanna Gerber

doi:10.3390/app11146439

Ewa Zawiślak, Anna Olejnik + Show 4 more

Open Access

https://doi.org/10.3390/app11146439

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Abstract

The analysis aims at assessing the current trends in orthognathic surgery. The retrospective study covered a group of 124 patients with skeletal malocclusion treated by one team of maxillofacial surgeons at the University Hospital in Zielona Góra, Poland. Various variables were analysed, including demographic characteristics of the group, type of deformity, type of osteotomy used, order in which osteotomy was performed and duration of types of surgery. The mean age of the patients was 28 (ranging from 17 to 48, SD = 7). The group included a slightly bigger number of females (59.7%), with the dominant skeletal Class III (64.5%), and asymmetries were found in 21.8% of cases. Types of osteotomy performed during surgeries were divided as follows: LeFort I, segmental LeFort I, BSSO, BSSO with genioplasty, LeFort I with BSSO, LeFort I with BSSO and genioplasty, segmental LeFort I with BSSO, isolated genioplasty. Bimaxillary surgeries with and without genioplasty constituted the largest group of orthognathic surgeries (49.1%), and a slightly smaller percentage were one jaw surgeries (46.7%). A statistically significant correlation was found between the type of surgery and the skeletal class. In patients with skeletal Class III, bimaxillary surgeries were performed significantly more often than in patients with skeletal Class II (57.5% vs. 20.0%; p = 0.0002). The most common type of osteotomy in all surgeries was bilateral osteotomy of the mandible modo Obwegeser–Epker in combination with Le Fort I maxillary osteotomy (42.7%). The order of osteotomies in bimaxillary surgeries was mandible first in 61.3% of cases. The longest surgery was bimaxillary osteotomy with genioplasty (mean = 265 min), and the shortest surgery was isolated genioplasty (mean = 96 min). The results of the analysis show a significant differentiation between the needs of orthognathic surgery and the types of corrective osteotomy applied to the facial skeleton.

Highlights

Attempts to define the appearance of an ideal face have been made by scientists since ancient times
The necessity to treat skeletal malocclusion provided a reason for distinguishing a specific medical discipline which is orthognathic surgery [5]
Patients with a history of trauma in the facial skeleton, craniofacial syndromes and patients treated with distraction osteogenesis (DO) were excluded from the study

Summary

Introduction

Attempts to define the appearance of an ideal face have been made by scientists since ancient times. The growing awareness of the society about possibilities of the orthodontic and surgical treatment and the potential of orthognathic surgery means that the requirements imposed on doctors are more demanding and that the needs for such treatment have increased significantly over the last 20 years [3,4]. Treatment of skeletal deformities leads to an improvement in the function of the stomatognathic system and the appearance of the patient’s face as a result of actions of orthognathic surgery combined with elements of plastic surgery. The basis for orthognathic treatment is activation of the craniofacial regions that require correction by osteotomy, and their stabilization in a new position with a selected anastomosis [9,10]

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