Stability of single-jaw vs two-jaw surgery following the correction of skeletal class III malocclusion: A systematic review and meta-analysis.

Abstract

This review aims to compare the stability of sagittal skeletal and overjet anteroposterior correction of skeletal class III malocclusion in single-jaw and two-jaw orthognathic procedures. An unrestricted comprehensive electronic search was undertaken on Embase, Cochrane's CENTRAL, Web of Science, Medline, Scopus and LILACs databases up to October 2020. The bibliographies of relevant studies, ongoing, unpublished and grey literature were screened. Two independent reviewers performed study selection, bias assessment and data extraction; a third reviewer mediated inconsistencies. Randomized clinical trials, prospective cohort, retrospective cohort and series with a minimum of 1year follow-up were eligible for inclusion. Additional subgroup analyses were undertaken. The generated effects were scored using the GRADE approach. Nine articles met the inclusion criteria and eight studies were subsequently analysed quantitatively. No significant difference in sagittal stability at the ANB angle, A-point or B-point on a short-term was detected. However, a statistically significant difference, indicating a greater short-term relapse in overjet with mandibular setbacks alone, was found (MD: -0.40mm; 95% CI -0.77 to -0.04; I2 : 0%; P=.03). Long-term follow-up (≥5years) revealed a statistically non-significant difference in stability of sagittal skeletal and overjet corrections. Within the limitations of this review, both procedures seem to offer comparable skeletal and overjet stability outcomes; however, further high-quality research is required to confirm these findings.