Relapse in class II orthognathic surgery: a systematic review

Area of Science:

• Orthodontics and Maxillofacial Surgery
• Dental Research
• Skeletal Class II Malocclusion

Background:

• Post-orthognathic surgery relapse is influenced by multiple factors.
• A proposed "hierarchy of stability" lacks systematic evidence.
• Investigating relapse extent based on surgical procedure in Angle class II patients is crucial.

Approach:

• Systematic review of randomized and controlled clinical trials.
• Searched seven databases for relevant studies.
• Assessed risk of bias (ROBINS-I) and evidence quality (GRADE).

Key Points:

• Four non-randomized cohort studies (132 patients) were included.
• Bimaxillary and mandibular advancement procedures demonstrated high stability.
• Maxillary single-jaw procedures showed sagittal stability but vertical instability.

Conclusions:

• Low-quality evidence partially supports the "hierarchy of stability" theory.
• Bimaxillary procedures and mandibular advancement appear highly stable for class II correction.
• More research is needed to fully understand relapse in relation to orthognathic interventions.