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The effect of tongue reduction for preventing adverse effects in patients undergoing class III orthognathic surgery: a three-dimensional comparative analysis

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Abstract

Objectives

This study aims to evaluate the potential benefits of combining tongue reduction with mandibular setback surgery in patients undergoing class III orthognathic surgery. Specifically, we investigated whether this combined approach reduced the risk of surgical relapse, condylar resorption, and airway space reduction by mitigating tongue pressure on the mandible.

Material and methods

The study retrospectively enrolled patients who had undergone bilateral sagittal split ramus osteotomy (BSSRO) with at least 5 mm of setback and met the criteria of a body mass index > 20 kg/m2 and tongue volume > 100 mm3. The study included 20 patients with 10 in the tongue reduction group (TR, n = 10) and 10 in the BSSRO only group (SO, n = 10).

Results

The volumetric changes of the total airway space were significantly different between the TR and SO groups (p = 0.028). However, no significant differences were observed in the condylar resorption and postoperative relapse between the groups (p = 0.927 and 0.913, respectively). The difference between the resorption of the anterior and posterior segments of the condyle was also statistically insignificant (p = 0.826). Postoperative counterclockwise rotation of the proximal segment only demonstrated a significant correlation with postoperative relapse (p = 0.048).

Conclusions

The reduction in tongue volume demonstrated a preventive effect on the reduction of the airway space after mandibular setback, although it did not yield statistical significance concerning surgical relapse and condylar volume. The counterclockwise rotation of the proximal segment might be responsible for the forward displacement of the distal segment and postoperative relapse. However, the clinical implications of this finding should be interpreted with caution owing to the limited sample size

Clinical relevance

Tongue reduction could potentially serve as a preventive measure in preserving the airway space and might be beneficial in mitigating the risk of obstructive sleep apnea in patients with class III deformity.

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Funding

This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2021R1G1A1093360)

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Author notes

  1. Bong-Jin Jeong and Joo-Young Ohe contributed equally to this work. 

Authors and Affiliations

  1. Department of Oral & Maxillofacial Surgery, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, 02447, Seoul, Republic of Korea

    Bong-Jin Jeong, Joo-Young Ohe, Byung-Joon Choi & Junho Jung

  2. Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea

    Bong-Jin Jeong

  3. Department of Preventive and Social Dentistry, College of Dentistry, Kyung Hee University, Seoul, Republic of Korea

    Jae-In Ryu

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  1. Bong-Jin Jeong
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  4. Byung-Joon Choi
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Contributions

Conceptualization: JJ; methodology: JJ, CBJ, OJY; investigation: BJJ, JJ; formal analysis: BJJ, JIR, JJ; writing—original draft: BJJ, JJ, OJY; writing—review and editing: OJY, JJ; supervision: JJ, CBJ.

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Correspondence to Junho Jung.

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Ethical approval

The present study was approved by the Ethics Committee of the Kyung Hee University Dental Hospital (KH-DT20013).

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The authors declare no competing interest.

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Jeong, BJ., Ohe, JY., Ryu, JI. et al. The effect of tongue reduction for preventing adverse effects in patients undergoing class III orthognathic surgery: a three-dimensional comparative analysis. Clin Oral Invest 28, 162 (2024). https://doi.org/10.1007/s00784-024-05554-0

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