Esthetic Outcome and Airway Evaluation following Bi-Jaw Surgery V/S Mandibular Setback Surgery in Skeletal Class III Malocclusion Using Surgery First Approach.

Abstract

BACKGROUND:

Class III skeletal deformity is the result of mandibular prognathism, maxillary deficiency, or a combination. Treatment frequently requires a combination of orthodontics and orthognathic surgical procedures to improve facial esthetics and harmonize facial profile.

OBJECTIVES:

The objective of the study is to assess and quantify, by means of cephalometric analysis, the pre- and postoperative soft-tissue and airway changes following bi-jaw surgery and mandibular setback surgery after the correction of skeletal Class III deformities using surgery-first approach.

MATERIALS AND METHODS:

Patients with skeletal Class III malocclusion were classified based on the A point-nasion-B point, beta angle, and Witt's appraisal. The cases were divided based on the type of surgery-first orthognathic approach they received. Group A (20 patients) comprised patients who underwent bi-jaw surgery (Le Fort I + bilateral sagittal split osteotomy [BSSO]) and Group B (20 patients) who underwent BSSO alone. After the lateral cephalograms were digitized, the cephalograms were evaluated for soft-tissue changes and airway changes.

RESULTS:

The soft-tissue response to simultaneous two-jaw surgery was superior to those seen in mandibular setback procedures with the exception of the changes seen in the facial contour angle and soft-tissue facial angle. There was a significant decrease in lower airway in cases treated with mandibular setback alone.

CONCLUSION:

Cases treated with bi-jaw surgeries had a significant soft-tissue improvement in the long term compared to mandibular setback surgeries. Since there was a significant reduction in the lower airway in cases treated with isolated mandibular surgeries, bi-jaw surgeries maybe preferred over mandibular setback surgeries.

• Authors: Bushra Kanwal, Akshai Shetty, Varghese Mani, C S Prashanth, K M Pramod, Sharmila Arjunan
• Journal: Annals of maxillofacial surgery (Ann Maxillofac Surg) 2018 Jul-Dec Vol. 8 Issue 2 Pg. 270-275 ISSN: 2231-0746 [Print] India
• PMID: 30693244 (Publication Type: Journal Article)