Double Jaw Research Articles

Impact of the orofacial muscular rehabilitation exercise on facial expression recovery post-orthognathic surgery

ObjectiveThis study aimed to evaluate the impact of myofunctional rehabilitation of the orofacial muscles through specific exercises on the recovery of facial expression in patients following orthognathic surgery. Material and MethodsThe study included 62 patients who underwent Le Fort I and sagittal split ramus osteotomy (SSRO). Patients were divided into two groups: the first group started immediate post-operative myofunctional rehabilitation of the orofacial muscles through specific exercises. In contrast, patients in Group II did not undergo any myofunctional rehabilitation post-operative exercises. The recovery of facial expressions postoperatively was evaluated in both calm and smiling states by comparing the differences between 3D facial scanning data of chosen facial anatomical structures collected at five key time points: pre-surgery (D0), 2 days (D2), 14 days (D14), 1 month (D30), and 3 months (D90) postoperatively. ResultsThe analysis revealed that characteristic angles and lengths experienced significant changes post-surgery, with ∠chRnchL and ∠chRsnchL decreasing at D2 and normalizing by D30 in the experimental group, while the control group showed a slower recovery, normalizing by D90. The ChL-R length decreased at D2, returning to normal by D30 in the experimental group and D90 in the control group. The height Li-Ls increased at D2 and normalized by D30 in calm and smiling expressions across single and double jaw surgery patients. These findings underscore the more rapid recovery in the experimental group compared to the control group (P < 0.05; P < 0.005; P < 0.0001). ConclusionInitiating myofunctional rehabilitation immediately following orthognathic surgery enhances facial muscle function recovery, improves patient confidence, and expedites social reintegration. This approach is crucial for functional and psychological benefits.

Steiner cephalometric analysis in orthognathic surgery patients treated at Department of Oral and Maxillofacial Surgery, Hasan Sadikin General Hospital, Bandung

Objective: Orthognathic surgery is surgery on abnormalities of dentofacial that occur in the maxilla, mandible, or both. Determine measurement of the type of dentoskeletal abnormality in malocclusion using cephalometric analysis. Steiner analysis is used because it is considered that the Sela tursica-nasion-point A (SNA) angle, Sela tursica-nasion-point B (SNB) used to describe the relationship between the maxilla and the mandible. Material and Methods: The study involved 30 patients who underwent orthognathic surgery between April 2017 and April 2022 at Hasan Sadikin Hospital Bandung. Cephalometric radiography was utilized for assessment, employing the Steiner method to analyze various angles. Patient characteristics, including gender and age, were also observed. Parameters such as the average angle of SNA, SNB, and ANB were examined, alongside diagnoses, the number of corrected jaws, and the type of orthognathic surgery. Results: The findings indicated a predominance of male orthognathic surgery patients (63.3%), with the majority falling within the age range of 19 to 20 years (40%). Grade III malocclusion was the most prevalent diagnosis (96.7%), with double jaw correction being the most common procedure performed (90%). Bilateral sagittal split osteotomy was utilized in 93% of cases, followed by Le Fort I osteotomy in 96.7% of cases and chinplasty in 16.7% of patients. The average SNA, SNB and ANB was 83.8o, 90.6o, and -6.8o, respectively. Conclusion: The findings indicated a higher frequency of orthognathic surgery among patients diagnosed with class III malocclusion. Additionally, a notable proportion of patients underwent simultaneous orthognathic surgery on both the maxilla and mandible.

Steiner Analysis of Cephalometric in Orthognathic Surgery Patients of Department Oral and Maxillofacial Surgery Hasan Sadikin General Hospital Bandung of Period April 2017 – April 2022

Objective: Orthognathic surgery is surgery on abnormalities of dentofacial that occur in the maxilla, mandible, or both. Determine measurement of the type of dentoskeletal abnormality in malocclusion using cephalometric analysis. Steiner analysis is used because it is considered that the Sela tursica-nasion-point A (SNA) angle, Sela tursica-nasion-point B (SNB) used to describe the relationship between the maxilla and the mandible Material and Methods: The study involved 30 patients who underwent orthognathic surgery between April 2017 and April 2022 at Hasan Sadikin Hospital Bandung. Attention was carried out using cephalometric radiography and analyzed using the stainer method by observing angles also observing patient characteristics such as gender and age, average angle of SNA, SNB, ANB, diagnosis, number of corrected jaws and type of orthognathic surgery. Results: The results of this study showed that orthognathic surgery patients were more male (63.3%), most aged between 19 - 20 years (40%), diagnosis of grade III malocclusion (96.7%), double jaw correction action (90%), bilateral sagittal split osteotomy (93%), osteotomy le fort I (96.7%), chinplasty (16.7%), mean angle SNA (83.8), angle SNB (90.6), angle ANB (-6.8). Conclusion: The results showed that more patients underwent orthognathic surgery with class III malocclusion and underwent orthognathic surgery on the maxilla and mandible simultaneously Keywords: Orthognathic surgery, cephalometry, Steiner analysis, malocclusion

Assessment of mandibular bony healing, mandibular condyle and angulus after orthognathic surgery using fractal dimension method.

This study aims to compare the trabeculation changes in the bone structure observed at the mandibular osteotomy line and the mandibular condyle in patients after single and double-jaw orthognathic surgery. The study included 38 patients (23 female, 15 male) who underwent mandibular surgery with bilateral sagittal split ramus osteotomy technique. The patients were divided into two groups according to their surgical operation: single-jaw (bilateral sagittal split ramus osteotomy) or double-jaw (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) surgery. Trabecular changes seen in mandibular osteotomy lines, mandibular condyle and mandibular angulus were evaluated on panoramic radiographs of patients (preoperative, postoperative 2nd day, postoperative 3rd month and 12th month) using fractal analysis method. Fractal dimension analysis was calculated by box counting method. No statistically significant difference was found between the fractal analysis values in the mandibular condyle and angulus region preoperatively, postoperative 2nd day, postoperative 3rd month and postoperative 12th month in the single jaw group. There was no statistically significant difference between the fractal analysis values in the mandibular condyle and angulus region preoperatively, postoperative 2nd day, postoperative 3rd month and postoperative 12th month in the double jaw group. A significant difference was found in fractal analysis values in osteotomy lines in both groups. The lowest value was found on the 2nd postoperative day and reached the preoperative values in the 3rd and 12th months postoperatively. Fractal analysis values didn't show significant difference between the single, double-jaw groups in all periods. This result suggests that the fractal analysis method can be used to evaluate trabeculation in the bone healing process of the osteotomy lines and indirectly affected areas in the postoperative period after orthognathic surgery.

Maxillomandibular Advancement for Obstructive Sleep Apnea Syndrome: Long-Term Results of Respiratory Function and Reverse Face-Lift.

Scientific literature considers maxillomandibular advancement (MMA) as the most effective surgical treatment for the management of adult obstructive sleep apnea syndrome (OSAS). Maxillomandibular advancement enlarges the pharyngeal space by expanding the skeletal framework. Moreover, it projects the soft tissue of the cheeks, the mouth, and the nose in the aging face, which is characterized by multiple signs affecting the middle third and the lower third. The potential of orthognathic surgery (double jaw surgical advancement) of expanding the skeletal foundation to increase the facial drape support and to rejuvenate the face by a "reverse face-lift" is now recognized. The aim of this study was to review the surgical outcomes after MMA in terms of respiratory function and assessment of facial esthetics. We retrospectively reviewed the charts of all patients affected by OSAS who underwent maxillomandibular advancement between January 2010 and December 2015 in 2 tertiary hospitals (IRCCS Policlinico San Martino of Genoa and IRCCS Policlinico Ca' Granda of Milan). During the postoperative follow-up examination, all patients underwent polysomnographic examination and esthetic assessment to evaluate the respiratory function and facial rejuvenation after double jaw surgical advancement. The final study sample included 25 patients (5 females, 20 males). The overall success rate of the surgical treatment (apnea/hypopnea index, AHI <20) was 79%; the overall rate of surgical cure (AHI <5) was 47%. Twenty-three patients (92%) showed a degree of rejuvenation after MMA. Maxillomandibular advancement is currently the most effective surgical treatment for the management of OSAS in adult patients who are not responders to medical treatment. "Reverse face-lift" is the consequence of the double jaw surgical advancement.

The impact of orthognathic surgery on quality of life for class III dentofacial deformities

In this study, we aim to evaluate the quality of life in patients with Class III deformities after orthognathic surgery. A total of the 40 patients (26 female and 14 male) were included. The mean age of the patients was 24.85. Patients' ages ranged from 20 to 36 years. All patients received orthodontic treatment before surgery. Sagittal split ramus osteotomy was performed for single jaw patients. Le Fort I osteotomy and sagittal split ramus osteotomy was performed for double jaw patients. Patients completed the Oral Health Impact Profile 14 (OHIP-14) and Orthognathic Quality of Life Questionnaire (OQLQ) three times. [Preoperatively (T0), 1st week after orthognathic surgery (T1) and in the 6th - 12th months after orthognathic surgery (T2)]. There was a statistically significant difference in the dimensions of OHIP-14 when the preoperative (T0) score, postoperative 1st week (T1) score and postoperative 6th - 12th month (T3) score are compared among themselves except for psychological discomfort, physical disability, and handicap. OQLQ total score and preoperative (T0) score was greater than the postoperative 1st week (T1) score and the postoperative 1st week(T1) score was greater than the postoperative 6th - 12th month (T2) scores except oral function. When single jaw and double jaw surgeries were compared, no statistically significant difference was found between OHIP-14 and OQLQ total scores for preoperative, postoperative 1st week, and postoperative 6th - 12th months. When both OHIP-14 and OQLQ scores were examined after orthognathic surgery, the OHRQOL of patients with Class III dentofacial deformity improved significantly.

Early Outcomes and Risk Factors in Orthognathic Surgery for Mandibular and Maxillary Hypo- and Hyperplasia: A 13-Year Analysis of a Multi-Institutional Database

Orthognathic surgery (OS) is a frequently performed procedure for the correction of dentofacial deformities and malocclusion. Research on OS is mostly limited to single-surgeon experience or single-institutional reports. We, therefore, retrospectively analyzed a multi-institutional database to investigate outcomes of OS and identify risk factors for peri- and postoperative complications. We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2008-2020) to identify patients who underwent OS for mandibular and maxillary hypo- and hyperplasia. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. We also evaluated risk factors for complications. The study population included 674 patients, 48% of whom underwent single jaw surgery, 40% double jaw surgery, and 5.5% triple jaw surgery. The average age was 29 ± 11 years, with an equal gender distribution (females: n = 336; 50%, males: n = 338; 50%). Adverse events were relatively rare, with a total of 29 (4.3%) complications reported. The most common surgical complication was superficial incisional infection (n = 14; 2.1%). While the multivariable analysis revealed isolated single lower jaw surgery (p = 0.03) to be independently associated with surgical complication occurrence, it also identified an association between the outpatient setting and the frequency of surgical complications (p = 0.03) and readmissions (p = 0.02). In addition, Asian ethnicity was identified as a risk factor for bleeding (p = 0.003) and readmission (p = 0.0009). Based on the information recorded by the ACS-NSQIP database, our analysis underscored the positive (short-term) safety profile of OS. We found OS of the mandible to be associated with higher complication rates. The calculated risk role of OS in the outpatient setting warrants further investigation. A significant correlation between Asian OS patients and postoperative adverse events was found. Implementation of these novel risk factors into the surgical workflow may help facial surgeons refine their patient selection and improve patient outcomes. Future studies are needed to investigate the causal relationships of the observed statistical correlations.

Does preventive single dose of intravenous dexketoprofen reduce pain and swelling after orthognathic surgery? A prospective, randomized, double blind clinical trial.

The purpose of this study was to evaluate the effect of a single-dose intravenous dexketoprofen administration for preventive analgesia on postoperative pain and reducing swelling in double jaw surgery. The authors designed a prospective, randomized, and double-blind cohort study. Patients who have Class III malocclusion were randomly divided in two groups. 50 mg intravenous dexketoprofen trometamol were administrated 30 minutes before incision in treatment group, while intravenous sterile saline was administrated 30 minutes before incision in placebo group. The primary predictor variable was treatment group. Primary outcomes were pain, swelling and 24-hour opioid intake. Patient- controlled analgesia with tramadol was given for management of postoperative pain. Other variables were demographic and operation related parameters. Visual analogue scale was used to evaluate postoperative pain. 3dMD Face System (3dMD, USA) was used to measure postoperative swelling. Data were analysed using two independent samples t test and Mann Whitney U test. The study sample was composed of 30 patients with a mean age of 20,63 years and 21 were female. Preemptive dexketoprofen administration decreased postoperative tramadol consumption by 25.9% compared to placebo group, and there was a statistically significant decrease in VAS scores (p<0,05). There was no statistically significant difference between the groups in terms of swelling (p>0,05). Preventive administration of intravenous dexketoprofen provides adequate analgesic effect in the postoperative 24-hour period and reduces opioid consumption in orthognathic surgery.

Pediatric Orthognathic Surgery: A NSQIP-P Comparison of Peri-Operative Factors and Outcome Differences Between Cleft and Noncleft Patients.

The present study aimed to investigate the risk factors, complication profiles, and clinical outcomes of cleft and noncleft patients undergoing single jaw (mandibular or LeFort 1) and bimaxillary (BSSO + LeFort 1). Retrospective Cross-sectional Study Setting: National Surgical Quality Improvement Program database 2018-2019. Pediatric patients. Outcomes for mandibular, LeFort 1, and bimaxillary osteotomy were retrospectively evaluated for cleft and noncleft patients. Multivariate logistic regression was used to determine the odds of complications and length of stay for cleft and noncleft patients undergoing single jaw and double jaw surgery. 669 pediatric patient underwent orthognathic surgery in the study period; the majority received LF1 only (n = 385; 58.3%), followed by mandible only (n = 179; 27.1%), and bimaxillary (n = 105; 15.9%%). Cleft differences were present in 56% of LFI patients, 32% of mandibular patients, and 22% of bimaxillary patients. After multivariate adjustment, ASA class III was associated with nearly 400% increased odds of any complication including readmission and reoperation (OR = 5.99; CI [[1.54-23.32]], p < 0.01, and 65% increased LOS (β-coefficient = 1.65, CI [1.37-1.99], p < 0.01). Presence of cleft was not significantly associated with odds of any complication (p = 0.69) nor increased LOS (p = 0.46) in this population. Complications remained low between surgery types among cleft and noncleft patients. The most significant risk factor in pediatric orthognathic surgery was not the presence of cleft but rather increased ASA class. Though common in patients seeking orthognathic surgery, cleft differences did not cause additional risk after adjustment for other variables.

Utilization of Function Generation Synthesis on Biomimetics: A Case Study on Moray Eel Double Jaw Design.

Throughout history, humans have observed living or non-living things in nature and then imitated them in relation to these observations. This is due to the fact that the energy found in nature is generally consumed at an optimal level in order for it to endure. Biomimetic inspiration in many designs and applications is widely displayed, including within the field of engineering. In this paper, we were inspired by the double set of jaws found in the moray eel, which gives this fish a huge advantage while hunting, with a mobile pharyngeal jaw that works together with its oral jaw in order to overcome ineffective suction capabilities. A procedure that mimics the hunting motion of the moray eel was utilized by considering the overall movement as a single degree of freedom with multiple outputs on account of the repeating motion that is required during hunting. This procedure includes structural and dimensioning synthesis, wherein the latter was utilized with analytic kinematic synthesis for each linkage transfer. The flexibilities in parameters were taken into account with a novel multiple iterative kinematic synthesis algorithm that resulted in various mechanisms with the same purpose. Among the excessive number of resultant mechanisms, the optimization was carried out by considering the highest torque transmission ratio at critical timings that were specified as bio-constraints. In the end, the kinematic movement validation was utilized.

Evaluation of patient satisfaction with pharyngeal airway changes after orthognathic surgery in patients with Class III skeletal anomalies.

The aims of our study were to determine the changes in the pharyngeal airway after treating patients with Class III malocclusion who received double jaw surgery, to determine the hard tissue and soft tissue parameters and the hyoid bone and tongue positions after surgery, to determine the changes to compare the pretreatment and post-treatment measurements of the patients in the double jaw group with the measurements of the control group patients, and to evaluate postoperative patient satisfaction. The study included thirty-two Class III adult patients that received double jaw surgery and twenty-five Class I patients. Cephalometric records were taken before treatment (T1) and after treatment (T2). After double jaw orthognathic surgery, there were statistically significant changes in all pharyngeal airway linear and areal parameters (p<0.001). There were significant superior and posterior movements of the tongue and hyoid bone post-surgery. The post-treatment analysis of the double jaw surgery group and control group were compared, with statistically significant differences in the mandibular dental parameters and pharyngeal airway measurements in patients in the double jaw surgery group. Despite the narrowings detected, high satisfaction scores were observed in the patient satisfaction questionnaire and the patients did not experience respiratory problems.

Bilateral Mucous Retention Cyst of the Submandibular Salivary Gland: A Rare Unusual Presentation and Review of the Literature.

Background: Mucous Retention Cyst (MRC) are non-neoplastic, developmental salivary gland lesion. Although more common in the minor salivary gland, few cases have been reported in the major salivary gland.&#x0D; Objective: To draw the attention of clinicians to a rare occurrence of MRC in the submandibular gland bilaterally.&#x0D; &#x0D; Case Report: The index case presents as a slowly progressive painless lesion of 10 years duration associated with aesthetics concerns. The lesion appeared as a double jaw with extension into the neck. Though lobulated and fluctuant, aspirate yielded yellow coloured, non-viscous and non-foul smelling fluid. Ultrasonography revealed a multilobulated mass with mobile heterogeneous fluid-like content in the submental and submandibular regions bilaterally. The massive size of the lesion limited the ultrasonic visualization of the submandibular salivary glands. The patient could not afford advanced imaging. During surgery, the lesion had involved the submandibular gland bilaterally with attachment to the hyoid bone and in close relation to the recurrent laryngeal nerve. Although the nerve was preserved, the patient experienced temporary hoarseness, which resolved with medication. Histopathologic examination of the excised lesion revealed the lesion as Mucous Retention Cyst.&#x0D; Conclusion: The massive size of the lesion, delayed presentation and financial constraints in obtaining advanced imaging could have contributed to the diagnostic dilemma. This rare case will help the clinicians include MRC as a differential diagnosis of lesions involving submandibular salivary gland bilaterally. It also draws the attention of the maxillofacial surgeons to the unexpected injury to the recurrent laryngeal nerve and its management in a low-income setting environment.&#x0D; &#x0D;

Correlation between levels of patient satisfaction and the value of cephalometric skeletal analysis in post-orthognatic surgery patients

Objective: The purpose of this study was to analyze the level of patient satisfaction after orthognathic surgery and the correlation between the patient satisfaction level after orthognathic surgery and the results of the cephalometric skeletal analysis. &#x0D; Material and Methods: This study were patients who had orthognathic surgery either BSSO, Osteotomy Le Fort 1, or Double Jaw Surgery. First, the subjects filled out a questionnaire about patient satisfaction after orthognathic surgery, the second was taking cephalometric radiographs which were then analyzed by the Steiner method by measuring the angles of SNA, SNB, ANB, and GoGN-SN.&#x0D; Results: The results of the study on 10 research subjects showed that all questionnaire scores were in the "satisfied" category. Cephalometric skeletal analysis of all cephalograms showed 50% normal SNA angle, 10% normal SNB angle, 80% normal ANB angle, and 90% normal GoGN-SN angle. The Concordal Kendall test results show the correlation coefficient value of 0.534 or 53.4%.&#x0D; Conclusion: On average, patients are very satisfied with the orthognathic surgery they have undergone. There is a correlation between the level of patient satisfaction after orthognathic surgery and the results of the cephalometric skeletal analysis.

A Permian fish reveals widespread distribution of neopterygian-like jaw suspension

The actinopterygian crown group (comprising all living ray-finned fishes) originated by the end of the Carboniferous. However, most late Paleozoic taxa are stem actinopterygians, and broadly resemble stratigraphically older taxa. The early Permian †Brachydegma caelatum is notable for its three-dimensional preservation and past phylogenetic interpretations as a nested member of the neopterygian crown. Here, we use computed microtomography to redescribe †Brachydegma, uncovering an unanticipated combination of primitive (e.g., aortic canal; immobile maxilla) and derived (e.g., differentiated occipital ossifications; posterior stem of parasphenoid; two accessory hyoidean ossifications; double jaw joint) dermal and endoskeletal traits relative to most other Paleozoic actinopterygians. Some of these features were previously thought to be restricted to the neopterygian crown. The precise phylogenetic position of †Brachydegma is unclear, with placements either on the polypterid stem or as an early-diverging stem neopterygian. However, our analyses decisively reject previous placements of †Brachydegma in the neopterygian crown. Critically, we demonstrate that key endoskeletal components of the hyoid portion of the suspensorium of crown neopterygians appeared deeper in the tree than previously thought.

The Effects of Orthognathic Surgery on Periodontal Status

Background: The aim of this study was to investigate the effects of orthognathic surgery on periodontium in the 3rd and 6th months after the operation. Methods: In a total of 10 orthognathic surgery patients (7 females, 3 males, mean age 23.2 ± 4.83), full mouth clinical periodontal measurements as plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing (BOP), clinical attachment level (CAL), and mobility (M) were performed before the surgical procedure (T0) at 6 sites (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, and disto-lingual) of all teeth except the third molars. Six of these patients underwent double jaw orthognathic surgery, 2 patients sagittal split osteotomy, and 2 patients Lefort 1 surgery. The same full mouth clinical periodontal measurements were repeated in the 3rd (T1) and 6th (T2) months after surgery. Results: There was no statistically significant difference between the T0 and T1 and T2 values in any of the parameters (PI, GI, PD, BOP, CAL, and M) at any of the regions measured (maxillary teeth, mandibular teeth, or full mouth). Conclusion: Within the limits of this study, it has been observed that orthognathic surgical treatments do not have a significant effect on periodontal status.

4th industrial revolution in Orthognahtic surgery

Historically, the emergence of new technologies has had a major impact on industries as a whole. The field of orthodontic surgery was no different, especially with the advent of computers in the 20th century, oral andmaxillofacial surgeons and orthodontists were able to make more accurate and precise diagnoses, resulting inimproved results of double jaw surgery. In this manuscript, I will introduce some studies on how robots and artificial intelligence, which are said to be two new technologies in the era of the 4th industrial revolution, are being applied to the field of orthognathic surgery.

Kinematic motion analysis of the members of a double jaw crusher

Computational technology makes it possible to accelerate and simplify the processes of kinematic and dynamic analysis. The paper deals with the problem of kinematic analysis of a planar six-joint mechanism of a jaw double-spring crusher. Computational techniques and software support have been used in the kinematic analysis. The obtained results are compared with the results of the graphical solution. The graphical solution has been carried out by using CAD software. MSC.Adams/View program was used to create a model and simulate the jaw crusher motion. In both cases there was agreement of the obtained results.

Evaluation of Nasal Tip Projection and Rotation of Nasal Tip after Orthognathic Surgery by Using Goode's Method.

The aim of this study was to evaluate the projection and rotational tipping(upturning) changes in the nose after orthognathic surgery by using the Goode Method. In this retrospective study, 21 adult patients (12 males, 9 females) who had double jaw surgery (Lefort I Maxillary Advancement and Impaction + Mandibular Setback) were evaluated by using Goode's method(nasal projection) and by evaluation of NLA(Nasolabial Angle)(Nasal rotation) on pre-op and post-op standardized photographs. There was no statistically significant difference between NLA baseline and outcome mean values (p: 0.519), while there was a statistically significant difference between Goode ratios baseline and outcome values (p: 0.025). There was no statistically significant relationship between NLA values and Goode ratios changes and, age, Maxillary Advancement, Impaction and Setback. Gender did not have an effect on the changes of NLA values and Goode ratios. The results of this study presented significant sagittal direction nasal changes in the form of nasal tip protrusion after double jaw surgery, while no statistical effect was found on nasal tip rotation in the vertical direction.

Vertical bony step between proximal and distal segments after mandibular setback is related with relapse: A cone-beam computed tomographic study

Vertical bony step (VBS) occurs between proximal and distal segments of the mandible during mandibular setback surgery with bilateral sagittal split ramus osteotomy. The purpose of this study was to investigate whether VBS is correlated with the relapse of mandibular setback using 3-dimensional models constructed from cone-beam computed tomography. The subjects consisted of 30 patients who underwent bilateral sagittal split ramus osteotomy for a mandibular setback. Double jaw surgery was performed in 18 patients, and isolated mandibular setback surgery was performed in 12 patients. Cone-beam computed tomography scans were taken at pretreatment (T0), postsurgery (T1), and posttreatment (T2). Treatment changes and the correlations between measurements were evaluated. The mean mandibular setback was -11.9 mm, and the mean VBS was -5.6 mm. Correlations with the relapse of mandibular setback were found in the amount of mandibular setback (T1 - T0), development of VBS (T1 - T0), posterior movement of the proximal segment (T1 - T0), counterclockwise rotation of symphysis (T2 - T1), and the resolution of VBS (T2 - T1). The development and resolution of VBS were correlated with the relapse of mandibular setback. Minimizing VBS is recommended to reduce the relapse of mandibular setback.

Skeletal Class III Treated with Double Jaw Surgery: A Case Report

Skeletal Class III Treated with Double Jaw Surgery: A Case Report