Proffit WR, White RP, Sarver DM.St Louis, MO: Mosby; 2003
Cunningham SJ, Hunt NP, Feinmann C. Perceptions of outcome following orthognathic surgery. Br J Oral Maxillofac Surg. 1996; 34:210-213
Nurminen L, Pietilä T, Vinkka-Puhakka H. Motivation for and satisfaction with orthodontic-surgical treatment: a retrospective study of 28 patients. Eur J Orthod. 1999; 21:79-87
Luther F, Morris DO, Hart C. Orthodontic preparation for orthognathic surgery: how long does it take and why? A retrospective study. Br J Oral Maxillofac Surg. 2003; 41:401-406
Nagasaka H, Sugawara J, Kawamura H, Nanda R. “Surgery first” skeletal class III correction using the Skeletal Anchorage System. J Clin Orthod. 2009; 43:97-105
Dowling PA, Espeland L, Krogstad O, Stenvik A, Kelly A. Duration of orthodontic treatment involving orthognathic surgery. Int J Adult Orthod Orthognath Surg. 1999; 14:146-152
Diaz PM, Garcia RG, Gias LN Time used for orthodontic surgical treatment of dentofacial deformities in white patients. J Oral Maxillofac Surg. 2010; 68:88-92
Luther F, Morris DO, Karnezi K. Orthodontic treatment following orthognathic surgery: how long does it take and why? A retrospective study. J Oral Maxillofac Surg. 2007; 65:1969-1976
Robb SI, Sadowsky C, Schneider BJ, BeGole EA. Effectiveness and duration of orthodontic treatment in adults and adolescents. Am J Orthod Dentofacial Orthop. 1998; 114:383-386
Flanary CM, Alexander JM. Patients' response to the orthognathic surgery experience: factors leading to dissatisfaction. J Oral Maxillofac Surg. 1983; 41:770-774
Wilcko WM, Wilcko T, Bouquot JE, Ferguson DJ. Rapid orthodontics with alveolar reshaping: two case reports of decrowding. Int J Periodontics Restorative Dent. 2001; 21:9-19
Villegas C, Uribe F, Sugawara J, Nanda R. Expedited correction of significant dentofacial asymmetry using a “surgery first” approach. J Clin Orthod. 2010; 44:97-103
The combined treatment of orthognathic surgery with orthodontics for severe skeletal malocclusion can dramatically improve facial aesthetics. The traditional treatment plan for a skeletal malocclusion is orthognathic surgery, including a pre-orthodontic and post-orthodontic phase. Pre-orthodontic treatment increases the total treatment time and is sometimes considered the worst part of the treatment by the patient. Surgery followed by orthodontic treatment gives a good result and reduces the treatment duration for certain selected cases. The purpose of the present study was to report our experience with the ‘Surgery First’ approach for skeletal malocclusions.
CPD/Clinical Relevance: Skeletal malocclusions where the dental discrepancy is not severe can be treated first with orthognathic surgery followed by orthodontic treatment. This may reduce the overall treatment time.
Article
Traditional orthognathic treatment has consisted of a variable length of pre-operative orthodontic preparation, the surgery itself, and a relatively constant period of post-operative orthodontics.1 Patients have usually expressed high levels of satisfaction with the aesthetic and functional outcomes, especially if they have been accurately informed about all aspects of their treatment.2 However, a significant percentage of patients will rate the orthodontics as the worst part of their treatment due to the appliances’ visibility, the pain caused, and the duration.3 The estimated duration of orthodontic treatment has often tended to be too optimistic.4
Recently, the utilization of surgery without orthodontic preparation (ie ‘Surgery First’), followed by regular post-operative orthodontic alignment, was proposed by Nagasaka et al.5 The authors used this approach to correct skeletal Class III malocclusion with the aid of skeletal anchorage system orthodontics. The total treatment time was noticeably reduced. In addition, pre-operative profile worsening owing to incisor decompensation was avoided and the immediate profile improvement after the surgery was greatly appreciated by the patient.5
Register now to continue reading
Thank you for visiting Orthodontic Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
