Abstract
Objectives
Although several studies have reported the advantages of the surgery-first approach for orthognathic correction of Class III deformity, there are few reports of the success of this approach for patients with facial asymmetry. Therefore, the purpose of this study was to evaluate the outcome of bimaxillary surgery for asymmetric skeletal Class III deformity using a surgery-first approach.
Materials and methods
Sixty-five patients who consecutively underwent at least a combined Le Fort I and a bilateral sagittal split osteotomy for asymmetric skeletal Class III deformity were identified in the authors’ patient database. Standardized frontal photographs were used to measure the change in midface, intercommissural line, chin from midface, and chin deviation angles as well as upper, middle, and lower contour deviation angles. The facial midline symmetry index, facial contour symmetry index, and overall facial symmetry index were also calculated. Self-reported questionnaires regarding overall appearance and satisfaction with facial areas were administered at least 1 year post-surgery.
Results
Forty-six patients had genioplasty. There was a statistically significant improvement in the deviation angles measured and the facial midline, facial contour, and overall facial symmetry index. Self-reported questionnaires, completed at least 1 year post-surgery, showed that patient satisfaction was high.
Conclusions
These findings demonstrate that the surgical-orthodontic treatment with surgery-first approach can successfully maintain or improve facial symmetry.
Clinical relevance
The surgery-first approach for improving facial asymmetry using the guidelines described for setups of the models is a feasible alternative to the classic orthodontic-first approach for bimaxillary orthognathic surgery.
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Funding
The work was supported by the Chang Gung Memorial Hospital, Taiwan (CMRPG5C0113).
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All authors declare that they have no conflict of interest.
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The study protocol was approved by the Ethics Committee for Human Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Informed consent was not needed due to the retrospective design of the study.
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Liao, YF., Chen, YF., Yao, CF. et al. Long-term outcomes of bimaxillary surgery for treatment of asymmetric skeletal class III deformity using surgery-first approach. Clin Oral Invest 23, 1685–1693 (2019). https://doi.org/10.1007/s00784-018-2603-y
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DOI: https://doi.org/10.1007/s00784-018-2603-y