Abstract
BackgroundThis study evaluated the pharyngeal airway space changes up to 1 year after bilateral sagittal split osteotomy mandibular setback surgery and bimaxillary surgery with maxillary posterior impaction through three-dimensional computed tomography analysis.MethodsA total of 37 patients diagnosed with skeletal class III malocclusion underwent bilateral sagittal split osteotomy setback surgery only (group 1, n = 23) or bimaxillary surgery with posterior impaction (group 2, n = 14). Cone-beam computed tomography scans were taken before surgery (T0), 2 months after surgery (T1), 6 months after surgery (T2), and 1 year after surgery (T3). The nasopharynx (Nph), oropharynx (Oph), hypopharynx (Hph) volume, and anteroposterior distance were measured through the InVivo Dental Application version 5.ResultsIn group 1, Oph AP, Oph volume, Hph volume, and whole pharynx volume were significantly decreased after the surgery (T1) and maintained. In group 2, Oph volume and whole pharynx volume were decreased (T2) and relapsed at 1 year postoperatively (T3).ConclusionIn class III malocclusion patients, mandibular setback surgery only showed a greater reduction in pharyngeal airway than bimaxillary surgery at 1 year postoperatively, and bimaxillary surgery was more stable in terms of airway. Therefore, it is important to evaluate the airway before surgery and include it in the surgical plan.
Highlights
This study evaluated the pharyngeal airway space changes up to 1 year after bilateral sagittal split osteotomy mandibular setback surgery and bimaxillary surgery with maxillary posterior impaction through threedimensional computed tomography analysis
In the case of Bilateral sagittal split ramus osteotomy (BSSRO) setback surgery with Le Fort I osteotomy, there are reports that the decrease in pharyngeal airway volume is less than in patients who underwent mandibular setback surgery only, and there are some studies that the anteroposterior (AP) dimension is rather increased in the upper pharyngeal airway after the surgery [13,14,15]
Patients were divided into two groups: (1) 1 jaw surgery patients (BSSRO setback surgery only), (2) 2 jaw surgery patients (Le Fort I osteotomy with posterior impaction and BSSRO setback surgery)
Summary
This study evaluated the pharyngeal airway space changes up to 1 year after bilateral sagittal split osteotomy mandibular setback surgery and bimaxillary surgery with maxillary posterior impaction through threedimensional computed tomography analysis. Many patients with skeletal class III malocclusion have esthetic and functional problems, and orthognathic surgery accompanying bilateral sagittal split osteotomy (BSSRO) setback surgery is administered to improve them. This surgery provides satisfactory results to patients by improving the mastication, pronunciation, Orthognathic surgery affects hard tissue and soft tissue and affects the stomatognathic system overall. In the case of BSSRO setback surgery with Le Fort I osteotomy, there are reports that the decrease in pharyngeal airway volume is less than in patients who underwent mandibular setback surgery only, and there are some studies that the anteroposterior (AP) dimension is rather increased in the upper pharyngeal airway after the surgery [13,14,15]
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