scholarly journals Analysis of Skeletal Malocclusion Patients Opting Only for Orthognathic Surgery Without Orthodontic Treatment

Author(s):  
S.P. Saravana Dinesh ◽  
2020 ◽  
pp. 27-31
Author(s):  
Ranjith Raveendran ◽  
Saju N S ◽  
Sameera G Nath

Background: The number of patients undergoing combined orthodontic treatment and orthognathic surgery is increasing. Hence, this study aimed to examine the impact of combined orthodontic and orthognathic treatment procedures on the life quality of patients with skeletal malocclusion. Materials and methods: 15 patients who had to undergo combined orthodontic and orthognathic treatment procedures were subjected to 22-item Orthognathic Quality of Life Questionnaire customised for the study. The questions were grouped into 4 domains – aesthethic, awareness, pschyological and social domains. They were assessed in three time lines - rst when they are explained and made aware of the treatment plan (T0), T1 when the orthodontic treatment is almost complete, and the patient is made ready for orthognathic surgery, then 6 months after the completion of the combined orthodontic-orthognathic surgery (T2). Results: Out of 15 patients, 9 were females and 6 were males between the age of 18-25 years. As the treatment progressed changes were noted in the patient's attitude. During T1 signicant change was observed in functional outcome – chewing. At T2 signicant changes were observe in esthetic, functional, social and psychological components (p<0.001). The treatment outcome did create a positive change in the patients by correcting their skeletal and dental abnormalities. Conclusion: The esthetic, functional, social and psychological outcomes of patients who have undergone combined orthodontic and orthognathic treatments are better post operatively.


2021 ◽  
Vol 32 (3) ◽  
pp. 164
Author(s):  
Endah Mardiati ◽  
Ida Ayu Astuti

Pendahuluan: Asimetri wajah akibat canting oklusal rahang atas seringkali menjadi keluhan  estetika wajah pasien. Perawatan canting oklusal parah memerlukan kombinasi perawatan ortodonti cekat dengan bedah ortognati. Tujuan laporan kasus ini adalah untuk menjelaskan perawatan ortodonti cekat kombinasi bedah Le Fort 1 pada kasus canting oklusal rahang atas pada maloklusi dentoskeletal kelas III disertai asimetri wajah. Laporan kasus: Seorang pasien perempuan umur 17 tahun 7 bulan datang ke praktek pribadi dengan keluhan gigi rahang atas miring, gigi belakang kanan tidak dapat mengunyah dengan nyaman. Pasien ingin dirawat gigi dan rahangnya. Pemeriksaan ekstra oral menunjukan wajah asimetri, profil cekung dan dagu sedikit menonjol. Pemeriksaan intra oral,  garis median rahang atas bergeser ke kiri, rahang bawah bergeser ke kanan, crossbite anterior, crossbite posterior unilateral, retrusi gigi anterior rahang atas dan rahang bawah. Analisis sefalometri lateral: maloklusi dentoskeletal kelas III. Diagnosis yang diberikan adalah maloklusi dentoskeletal kelas III disertai canting oklusal rahang atas, wajah asimetri, crossbite anterior, crossbite unilateral posterior. Rencana perawatan adalah perawatan ortodonti cekat kombinasi bedah ortognati Le Fort 1. Perawatan dilakukan dalam 4 tahap yaitu perawatan ortodonti dekompensasi, perawatan bedah ortognati rahang atas, perawatan ortodonti pasca bedah rahang, debonding dan pemasangan retainer. Simpulan: Maloklusi skeletal kelas III disertai canting oklusal rahang atas, asimetri wajah, crossbite anterior, dan crossbite posterior unilateral, yang dirawat menggunakan alat ortodonti cekat dan bedah ortognati Le Fort 1 dapat berhasil dengan baik. Relasi dental dan skeletal tercapai kelas I, interdigitasi gigi rahang atas dan rahang bawah mengunci, fungsi pengunyahan terkoreksi serta pasien merasa sangat puas dengan estetika wajahnya.Kata kunci: Maloklusi skeletal kelas III, asimetri wajah, canting maksila, crossbite anterior, crossbite posterior unilateral, bedah ortognati. ABSTRACTIntroduction: Facial asymmetry due to maxillary occlusal cant often becomes a facial aesthetics complaint. Treatment of severe occlusal cant requires a combination of fixed orthodontic treatment with orthognathic surgery. This case report was aimed to describe the combined fixed orthodontic treatment of Le Fort 1 in maxillary occlusal cant of class III dentoskeletal malocclusion with facial asymmetry. Case report: A female patient aged 17 years seven months came to the private clinic, complained of oblique maxillary teeth, and the right posterior was unable to masticate comfortably. The patient wants to be treated for her teeth and jaw. Extraoral examination revealed facial asymmetry, sunken profile and slightly protruding chin. The intraoral examination resulted in the maxillary median line that shifted to the left, mandible shifted to the right, anterior crossbite, unilateral posterior crossbite, and retrusion of maxillary and mandibular anterior teeth. The lateral cephalometric analysis resulted in class III dentoskeletal malocclusion. The diagnosis was class III dentoskeletal malocclusion with maxillary occlusal cant, facial asymmetry, anterior crossbite, and posterior unilateral crossbite. The treatment plan was fixed orthodontic treatment combined with Le Fort orthognathic surgery. The treatment was carried out in 4 stages: decompensated orthodontic treatment, maxillary orthodontic treatment, post-orthognathic surgery orthodontic treatment, debonding, and retainer placement. Conclusion: Class III skeletal malocclusion with maxillary occlusal cant, facial asymmetry, anterior crossbite, and the unilateral posterior crossbite was successfully treated with a fixed orthodontic appliance and Le Fort 1 orthognathic surgery. The dental and skeletal relations were achieved for class I, the interdigitation of the maxillary and mandibular teeth was locked, the masticatory function was corrected, and the patient was very satisfied with her facial aesthetics.Keywords: Class III skeletal malocclusion, facial asymmetry, maxillary cant, anterior crossbite, unilateral posterior crossbite, orthognathic surgery.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Farzad Rezaei ◽  
Hiwa Masalehi ◽  
Amin Golshah ◽  
Mohammad Moslem Imani

Abstract Background Orthognathic surgery includes improvement of morphology and function of occlusion as well as psychological perception and oral health-related quality of life (OHRQoL) of patients. The aim of this study was to determine the OHRQoL of patients with class III skeletal malocclusion before and after orthognathic surgery. Materials and methods A total of 112 skeletal class III patients including 39 (34.8%) males and 73 (65.2%) females participated in this descriptive quasi-experimental study in three groups: “prior to orthodontic treatment” (n = 25); “under orthodontic treatment and prior to surgery” (n = 65), and “after surgery” (n = 25). All patients filled out a demographic information questionnaire, the oral health impact profile-14 (OHIP-14), and the orthognathic quality of life questionnaire (OQLQ) under the supervision of the examiner. Data were analyzed using ANOVA, independent samples t-test, Mann Whitney test, and Kruskal-Wallis test. Results OHRQoL summary score changed from 14.5 prior to orthodontic treatment to 23.4 prior to surgery and during orthodontic treatment to 5.4 after surgery. These OHRQoL changes were statistically significant (P < 0.001). Conclusions Orthognathic surgery matters to patients with class III skeletal malocclusion and significantly improves their OHRQoL.


2021 ◽  
Vol 11 (14) ◽  
pp. 6439
Author(s):  
Ewa Zawiślak ◽  
Szymon Przywitowski ◽  
Anna Olejnik ◽  
Hanna Gerber ◽  
Paweł Golusiński ◽  
...  

The analysis aims at assessing the current trends in orthognathic surgery. The retrospective study covered a group of 124 patients with skeletal malocclusion treated by one team of maxillofacial surgeons at the University Hospital in Zielona Góra, Poland. Various variables were analysed, including demographic characteristics of the group, type of deformity, type of osteotomy used, order in which osteotomy was performed and duration of types of surgery. The mean age of the patients was 28 (ranging from 17 to 48, SD = 7). The group included a slightly bigger number of females (59.7%), with the dominant skeletal Class III (64.5%), and asymmetries were found in 21.8% of cases. Types of osteotomy performed during surgeries were divided as follows: LeFort I, segmental LeFort I, BSSO, BSSO with genioplasty, LeFort I with BSSO, LeFort I with BSSO and genioplasty, segmental LeFort I with BSSO, isolated genioplasty. Bimaxillary surgeries with and without genioplasty constituted the largest group of orthognathic surgeries (49.1%), and a slightly smaller percentage were one jaw surgeries (46.7%). A statistically significant correlation was found between the type of surgery and the skeletal class. In patients with skeletal Class III, bimaxillary surgeries were performed significantly more often than in patients with skeletal Class II (57.5% vs. 20.0%; p = 0.0002). The most common type of osteotomy in all surgeries was bilateral osteotomy of the mandible modo Obwegeser–Epker in combination with Le Fort I maxillary osteotomy (42.7%). The order of osteotomies in bimaxillary surgeries was mandible first in 61.3% of cases. The longest surgery was bimaxillary osteotomy with genioplasty (mean = 265 min), and the shortest surgery was isolated genioplasty (mean = 96 min). The results of the analysis show a significant differentiation between the needs of orthognathic surgery and the types of corrective osteotomy applied to the facial skeleton.


2020 ◽  
pp. 194338752095008
Author(s):  
Gaurav Singh ◽  
Utsav Singh Gurung ◽  
Madan Mishra ◽  
Amit Gaur

Study Design: Retrospective cohort study. Objective: The purpose of this study was to evaluate and share our experience with the surgery first approach (SFA) for correction of skeletal malocclusion. Methods: After consultation with the department of orthodontics, 45 patients with skeletal malocclusions suitable to undergo SFA were enrolled in this study (14 bimaxillary protrusion and 31 skeletal class III malocclusion). Le Fort I maxillary osteotomy, bilateral sagittal split ramus osteotomy, subapical osteotomy, and genioplasty were performed as required. After a healing period of 2 weeks, postoperative orthodontic treatment was started to achieve the final occlusion. Results: The mean duration of postoperative orthodontic treatment was 15.2 months, which is much shorter than the conventional orthodontic first approach (OFA) where presurgical orthodontic duration alone takes 12-24 months according to an individual. In the bimaxillary protrusion group, it was 18 months, which was significantly longer than for the other group ( P < .05). Conclusions: SFA offers an efficient alternative to conventional OFA with shorter total treatment duration, immediate marked improvement in facial profile, reduced biological costs, and similar operative stability. However, it comes at the cost of heightened challenges regarding case selection, accurate prediction, and surgical precision. With a joint venture between skilled and experienced surgeons and orthodontists, the outcome can be very promising.


1988 ◽  
Vol 15 (1) ◽  
pp. 27-32 ◽  
Author(s):  
C. D. Stephens ◽  
N. W. Harradine

The records of 200 orthodontic patients accepted for treatment by the Orthodontic Department of the Bristol Dental Hospital in 1977 were compared with 200 taken on in 1985 in order to determine whether there had been any change in the proportion of referred cases requiring more complex procedures. Within each sample, cases were categorized as follows: (a) suitable for removable appliance treatment by an undergraduate or general practitioner; (b) requiring simple one arch fixed appliance treatment such as might he attempted by a general practitioner after a period of further training; (c) needing specialist treatment such as full multibracketed fixed appliances or orthognathic surgery. It was found that there had been no change in the proportions of simple and complex cases referred during the 8-year period although the proportion of patients now receiving complex treatment had increased greatly. Possible explanations and implications are discussed.


2021 ◽  
Vol 8 ◽  
Author(s):  
Laila Elhajoubi ◽  
Intissar Elidrissi ◽  
Asmae Bahoum ◽  
Fatima Zaoui ◽  
Mohammed Faouzi Azaroual

Introduction: This case report describes compensatory orthodontic treatment in a young patient aged 13 years. She presented with a class III skeletal malocclusion associated with mandibular laterognathy. The patient's main reason for consultation was the anterior cross bite and the aesthetics of her smile.Materials and Methods: The chosen treatment was therefore an orthodontic camouflage with the extraction of the first mandibular premolars and the second maxillary premolars, in order to catch a correct anterior articular and restore a good occlusal relationship, however, the mandibular laterognathy was camouflaged by means of dental compensations and also by correcting the deviation of the incisors medians through a class III mechanics with good anchorage management.Results: After 24 months of treatment, an ideal overjet and overbite associated with a Class I canine and molar relationship, was obtained, associated with a perfect coincidence of the interincisor medians.Conclusion: Class III skeletal cases can often be treated either by orthodontic camouflage or surgery. In our case study, the treatment adopted was orthodontic camouflage with extractions. The results of the treatment were satisfactory and the occlusal objectives were achieved. The final harmonious smile pleased the patient and improved her self-esteem and quality of life.


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