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Are We Correctly Measuring Mandibular Stability After Surgery-First Approach? A Comparative Study Based on Novel
Nabil Mokhter Mansour1, Mohamed Elsaid Abdelshaheed1, Ahmed Hassan El-Sabbagh1
1Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
The Journal of Craniofacial Surgery
|February 13, 2023
Summary
Mandibular stability after surgery-first approach (SFA) is accurately assessed by measuring segments across the osteotomy line, not traditional methods. This approach confirms SFA is as stable as the orthodontic-first approach (OFA).
Area of Science:
- Orthognathic surgery
- Maxillofacial reconstruction
- Skeletal stability assessment
Background:
- Traditional methods for assessing mandibular stability after surgery-first approach (SFA) may be inaccurate.
- Post-surgical dental movements in SFA can be mistaken for relapse.
- Conventional orthodontic-first approach (OFA) involves different timing of dental movements.
Purpose of the Study:
- To evaluate mandibular skeletal stability after SFA using a novel method.
- To differentiate planned dental movements from actual surgical instability.
- To compare the skeletal stability of SFA with OFA.
Main Methods:
- Utilized 3D reconstructions from computed tomography/cone-beam computed tomography.
- Measured relationships between proximal and distal mandibular segments across the osteotomy line.
- Compared two matched groups (SFA and OFA) at three time points: pre-surgery, immediately post-surgery, and 1 year post-surgery.
Main Results:
- Skeletal stability in the SFA group showed minimal changes (under 0.5 mm) one year after surgery.
- SFA demonstrated comparable skeletal stability to OFA.
- Observed mandibular counterclockwise rotation was linked to planned dental movements, not surgical instability.
Conclusions:
- A new method measuring segment relationships across the osteotomy line accurately assesses SFA stability.
- SFA is a skeletally stable orthognathic procedure.
- Planned post-surgical dental movements should not be misinterpreted as relapse when evaluating SFA stability.
