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The Surgery-first Approach to Orthognathic Surgery.

Tuan-Anh Hoang1, Kevin C Lee2, Sung-Kiang Chuang3

  • 1Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam.

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|March 11, 2021
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Summary

The surgery-first approach (SFA) offers similar outcomes to the conventional surgical approach (CSA) for orthognathic osteotomies and anterior segmental osteotomies, significantly reducing overall treatment time.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthodontics
  • Plastic Surgery

Background:

  • Orthognathic surgery corrects jaw discrepancies.
  • Conventional surgical approach (CSA) involves orthodontics before surgery.
  • Surgery-first approach (SFA) prioritizes surgery before orthodontic alignment.

Purpose of the Study:

  • To compare outcomes between CSA and SFA for LeFort/BSSO and anterior segmental osteotomies (ASO).
  • To evaluate treatment time, complication rates, and relapse rates for both approaches.

Main Methods:

  • Retrospective cohort study of 146 patients (2000-2012).
  • Classified patients by osteotomy type (LeFort/BSSO or ASO) and surgical timing (CSA or SFA).
  • Analyzed total treatment duration, complication incidence, and relapse rates.

Main Results:

  • No significant differences in complication or relapse rates between CSA and SFA for traditional osteotomies.
  • Zero complications or relapses observed in the ASO group.
  • SFA significantly reduced total treatment time by 3.9 months for traditional osteotomies and 3.3 months for ASO.

Conclusions:

  • SFA achieves comparable clinical outcomes to CSA with a shorter treatment duration.
  • SFA is an effective approach for both traditional orthognathic osteotomies and anterior segmental osteotomies.