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Published on: February 23, 2024
Five-year stability of occlusal function in orthognathic patients with sagittal malocclusions : Digital quantitative
Lisa-Marie Mai1, Jeremy Mouchoux2, Philipp Meyer-Marcotty2
1Department of Orthodontics, University Medical Center Göttingen, Göttingen, Germany. lisa-marie.mai@med.uni-goettingen.de.
Objectives:
Successful orthognathic therapies are characterised by a physiologically configured occlusion whose long-term clinical stability is mainly assessed through occlusal parameters. In the present study, long-term treatment outcomes were assessed based on occlusal changes after 5 years using digital occlusion and masticatory efficiency analysis.
Methods:
This study examined 33 adult patients after treatment of skeletal class II (n = 18; 12 women, median age 28.15 years; interquartile range [IQR] = 15.10) and class III malformations (n = 15; 7 women, median age 23.90 years; IQR = 4.80) 9 months (T1) and 5 years (T2) postorthognathic therapy. A total of 20 patients with neutral skeletal relation (10 women; median age 30.50 years; IQR = 7.50) served as a control group. Skeletal classification was based on sagittal jaw configuration (Wits) and habitual intercuspation was recorded using the T‑Scan Novus® (Tekscan Inc., South Boston, MA, USA) for digital occlusion analysis with the following variables: total tooth contact (TTC), occlusion time (TOC), occlusion asymmetry (OAS), anterior and posterior antagonism (ATC and PTC). In addition, masticatory performance was assessed using a standardized two-colour chewing gum bolus analysis.
Results:
Five years after surgery (T2), none of the occlusal parameters differed significantly between the groups, indicating functional approximation to the control group. Longitudinal analysis revealed significant improvements within both surgical groups (T1 to T2). In class II patients, TTC, ATC and PTC increased, while TOC decreased significantly. Class III patients also showed significant increases in TTC, ATC and PTC with TOC and OAS remaining unchanged. Overall, both treatment groups demonstrated substantial recovery and long-term stabilization of occlusal function. Bolus homogeneity analysis showed no significant difference between control and treatment patients 5 years after surgery.
Conclusion:
The 5‑year observation of orthognathic treatment for sagittal jaw malformations showed significant improvements in occlusal parameters. Both masticatory efficiency and occlusal parameters measured at 5 years postoperatively did not differ significantly from the control group, indicating that the functional improvements achieved by the therapy were stable in the long term.
