Residents' journal review

Abstract

Traditionally, surgical treatment requires presurgical orthodontics to decompensate the malocclusion, orthognathic surgery to correct the skeletal discrepancy, and postsurgical orthodontics for finishing. This retrospective study examined the effect of presurgical orthodontics on treatment outcome regarding facial esthetics, occlusion, stability, and efficiency in skeletal Class III open-bite patients. Thirty-three patients were selected and divided into 2 groups: 13 received presurgical orthodontics, and 20 did not receive presurgical orthodontics. There were no significant differences between the groups in terms of the initial peer assessment rating (PAR) scores and cephalometric measurements. The results demonstrated no significant differences in facial convexity, facial height, upper or lower lip to E-plane, nasolabial angle, overbite, or PAR score at orthodontic debonding. The group with no presurgical orthodontics displayed a significantly larger overjets than did the presurgical orthodontics group (3.0 ± 1.2 vs 2.2 ±1.1 mm). Both values were within normal limits, and the difference was not clinically significant. No difference was found between the groups in maxillary stability in the vertical or horizontal plane. There was a statistically significant difference in mandibular stability vertically: in the group with no presurgical orthodontics, the mandible moved superiorly. However, this is a favorable direction in a patient with a Class III open bite, because it deepened the bite and is most likely due to the removal of dental interferences during the postsurgical orthodontics. The presurgical orthodontics group had a significantly longer treatment time (512 ± 103 vs 342 ± 127 days). Although further randomized and prospective trials are indicated, this study illustrates that reduced treatment time in the surgery-first approach might alleviate patient burnout without significant clinical differences in esthetics, occlusion, and stability.