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Skeletal stability after bimaxillary surgery with surgery-first approach for class III asymmetry is not related to virtual surgical occlusal contact

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Abstract

Objectives

Surgery-first orthognathic surgery is rarely used in class III asymmetry due to concerns of reduced skeletal stability from unstable surgical occlusion. This study aimed to evaluate if skeletal stability after surgery-first orthognathic surgery is related to virtual surgical occlusal contact or surgical change.

Materials and methods

We studied 58 adults with class III asymmetry, consecutively corrected by Le Fort I osteotomy and bilateral sagittal split osteotomy using a surgery-first approach. Dental casts were manually set to measure virtual surgical occlusal contact including contact distribution, contact number, and contact area. Cone-beam computed tomography taken before treatment, 1-week post-surgery, and after treatment was used to measure surgical change and post-surgical stability of the maxilla and mandible in translation (left/right, posterior/anterior, superior/inferior) and rotation (pitch, roll, yaw). The relationship between skeletal stability and surgical occlusal contact or surgical change was evaluated with correlation analysis.

Results

Significant instability was found in the mandible but not in the maxilla. No correlation was found between the maxillary or mandibular stability and surgical occlusal contact (all p > 0.01). However, a significant correlation was found between the maxillary (roll and yaw) or mandibular (shift, roll and pitch) stability and its surgical change (all p < 0.001).

Conclusions

In correction of class III asymmetry with surgery-first bimaxillary surgery, the skeletal stability is not related to the virtual surgical occlusal contact, but surgical skeletal change.

Clinical relevance

Planned over-correction is a reasonable option for correction of severe shift or roll mandibular asymmetry in bimaxillary surgery for class III deformity.

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Funding

The work was supported by the Chang Gung Memorial Hospital, Taiwan (CMRPG5K0181) and the Ministry of Science and Technology, Taiwan (MOST 108–2314-B-182–010).

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Authors and Affiliations

  1. Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Yu-Fang Liao, Piengkwan Atipatyakul & Yu-Ray Chen

  2. Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road, Guishan District, Taoyuan, 333, Taiwan

    Yu-Fang Liao & Yi-Hsuan Chen

  3. Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan

    Yu-Fang Liao, Yi-Hsuan Chen, Ying-An Chen, Chuan-Fong Yao & Yu-Ray Chen

  4. Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Yu-Fang Liao, Yi-Hsuan Chen, Ying-An Chen, Chuan-Fong Yao & Yu-Ray Chen

  5. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan

    Ying-An Chen, Chuan-Fong Yao & Yu-Ray Chen

Authors
  1. Yu-Fang Liao
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  2. Piengkwan Atipatyakul
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Correspondence to Yu-Fang Liao.

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All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Liao, YF., Atipatyakul, P., Chen, YH. et al. Skeletal stability after bimaxillary surgery with surgery-first approach for class III asymmetry is not related to virtual surgical occlusal contact. Clin Oral Invest 26, 4935–4945 (2022). https://doi.org/10.1007/s00784-022-04462-5

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  • DOI: https://doi.org/10.1007/s00784-022-04462-5

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