Comparison of treatment duration and complications between surgery-first and conventional orthognathic approaches: a...

This study compares the surgery-first approach (SFA) and the conventional orthognathic approach (COA) in terms of total treatment duration and complications in patients with skeletal malocclusions.

A retrospective analysis was conducted on 34 patients treated at Helsinki University Hospital, with 17 patients in each treatment group. The groups were matched by age, sex, and type of surgery. Treatment duration was assessed using statistical comparisons, and perioperative and postoperative complications were analyzed using logistic and Poisson regression models adjusted for age, sex, and surgery type.

SFA significantly reduced the total treatment duration compared to COA by eliminating the presurgical orthodontic phase (13.0 months vs. 27.67 months, P = 1.66×10-10). The groups were similar in terms of their difficulty scores according to the ICON scale (P > 0.05). However, the postsurgical orthodontic phase was significantly longer in the SFA group (11.72 months vs. 8.22 months, P = 6.18×10-13). Maxillary retrognathia was independently associated with a shorter total treatment duration, while open bite prolonged postsurgical orthodontic treatment, regardless of the surgical approach. Age was the only significant predictor of complications (P = 0.042), with older patients being at a greater risk.

SFA is an effective alternative to COA, offering a shorter overall treatment duration while requiring longer postsurgical orthodontic management. While complication rates do not significantly differ between the approaches, older patients are at a higher risk of complications.