Predicted versus executed surgical orthognathic treatment.

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.
• 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.