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Predicted versus executed surgical orthognathic treatment.

B Falter1, S Schepers, L Vrielinck

  • 1Oral and Maxillofacial Surgery, St. John's Hospital, Genk, Belgium.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|December 27, 2012
PubMed
Summary

Surgical-orthodontic treatment plans changed for 13.5% of patients, particularly Class III cases. Factors like longer treatment intervals and specific malocclusions influenced these changes in orthognathic surgery.

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Area of Science:

  • Orthodontics and Oral Surgery
  • Craniofacial Surgery
  • Dental Research

Background:

  • Orthognathic surgery is a complex procedure often requiring combined surgical-orthodontic treatment.
  • Treatment plan modifications can occur during the pre-surgical orthodontic phase.
  • Understanding factors influencing plan changes is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To analyze combined surgical-orthodontic treatment plans.
  • To compare planned orthognathic surgery with the actual procedure performed.
  • To identify factors leading to treatment plan alterations during pre-surgical orthodontics.

Main Methods:

  • Retrospective review of 312 orthognathic surgery patient files (2008-2010).
  • Analysis of patient demographics, malocclusion type (Angle Class), and pre-operative records.
Keywords:
BSSOBimaxillary operationLe FortOrthognathic surgeryTreatment

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  • Investigation of factors influencing treatment plan changes, including Surgical Assisted Rapid Palatal Expansion (SARPE).

    • Main Results:

    • 13.5% of patients (42/312) had their original treatment plan changed.
    • Changes were more frequent with longer intervals between initial planning and surgery (22.4 vs. 16.4 months).
    • Class III malocclusions (27.3%) showed significantly higher alteration rates compared to Class II (7.6%).

    Conclusions:

    • Approximately one in seven orthognathic surgery patients undergo a modified procedure.
    • Class III patients with specific overjet and overbite may require conversion from planned monomaxillary to bimaxillary surgery.
    • Treatment plan adjustments are influenced by malocclusion severity and treatment duration.