The Effect of Bimaxillary Orthognathic Surgery on Nasalance, Articulation Errors, and Speech Intelligibility in Skeletal Class III Deformity Patients

Background: Technological progress has led to the transition to digital methods to perform surgical planning and to obtain surgical splints with CAD/CAM technologies. The present study aimed to compare the accuracy of jaw repositioning in bimaxillary orthognathic surgery using traditional and digital surgical planning in skeletal class III patients. Methods: This study included 60 skeletal class III patients divided into two groups based on the method used to perform surgical planning: traditional (T, n = 30) and digital (D, n = 30). For each patient, a 2D presurgical Visual Treatment Objective (VTO) was prepared and the outcome of the surgery was compared with that planned by using determined cephalometric measurements (ANB, SNA, SNB, Ar-Go-Me, S-Ar-Go). Statistical analysis showed that the measurements planned and those obtained after surgery were equivalent in Group D. For Group T, the analysis showed equivalence only for one of the considered measurements (ANB). By comparing the results of the two groups, Group D presented a lower level of error than Group T. Conclusions: Digital surgical planning performed significantly better in terms of accuracy of jaw repositioning than the traditional protocol.

Download Full-text

Effect of Mandibular Set-Back surgery versus Bimaxillary Orthognathic Surgery on pharyngeal airway space and consequent daytime sleepiness in Dento-skeletal class III malocclusion patients.

Egyptian Dental Journal ◽

10.21608/edj.2021.69271.1562 ◽

2021 ◽

Vol 67 (3) ◽

pp. 1943-1952

Author(s):

Hussein Hatem ◽

Sameh Seif ◽

Walaa Ahmed ◽

Shaimaa Refahee

Keyword(s):

Daytime Sleepiness ◽

Orthognathic Surgery ◽

Class Iii ◽

Class Iii Malocclusion ◽

Skeletal Class ◽

Pharyngeal Airway ◽

Back Surgery ◽

Bimaxillary Orthognathic Surgery

Download Full-text

A New Approach to Set the Absolute Midsagittal Plane of the Mandible Using a Similarity Index in Skeletal Class III Patients with Facial Asymmetry

Applied Sciences ◽

10.3390/app10238550 ◽

2020 ◽

Vol 10 (23) ◽

pp. 8550

Author(s):

Woo-Jin Han ◽

Jae Joon Hwang ◽

Yun-Hoa Jung ◽

Bong-Hae Cho ◽

Kee-Joon Lee ◽

...

Keyword(s):

Orthognathic Surgery ◽

Similarity Index ◽

Facial Asymmetry ◽

Class Iii ◽

Midsagittal Plane ◽

New Approach ◽

Skeletal Class ◽

Computed Tomography Images ◽

Bimaxillary Orthognathic Surgery ◽

Anterior Segments

This study sought to test the feasibility of a newly developed plane called computed modified absolute mandibular midsagittal plane (cmAMP) based on the similarity index (SI) for evaluating the stereoscopical symmetry of the mandible by comparison with other proposed midsagittal planes. This study involved 29 adult patients (15 men, 14 women; average age, 23.1 ± 6.9 years) with skeletal Class III facial asymmetry who underwent bimaxillary orthognathic surgery. Using cone-beam computed tomography images taken before and 1 year after surgery, cmAMP with the highest SI value between the two anterior segments of the hemi-mandible was set by a computer algorithm. Results show that the SI using cmAMP had the highest value (0.83 ± 0.04) before surgery compared to the other midsagittal planes, and was not significantly different from the SI (0.80 ± 0.05) using a facial midsagittal plane (MSP) after surgery. The distance (1.15 ± 0.74 mm) and angle (2.02 ± 0.82°) between MSP and cmAMP after surgery were significantly smaller than those between MSP and other midsagittal planes. In conclusion, the cmAMP plane best matches the two anterior segments of hemi-mandible symmetrically and is the closest to MSP after orthognathic surgery in skeletal Class III patients with facial asymmetry.

Download Full-text

Maxillary stability in patients with skeletal class III malocclusion treated by bimaxillary orthognathic surgery: comparison of mandible-first and maxilla-first approaches in a randomized controlled study

British Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.bjoms.2021.10.001 ◽

2021 ◽

Author(s):

Mohamed Hamdy Mahmoud ◽

Tarek Ismail Elfaramawi ◽

Kareem Samir El-Tabarany ◽

Niveen Abdellatif Askar

Keyword(s):

Orthognathic Surgery ◽

Randomized Controlled Study ◽

Controlled Study ◽

Class Iii ◽

Class Iii Malocclusion ◽

Skeletal Class ◽

Randomized Controlled ◽

Bimaxillary Orthognathic Surgery

Download Full-text

Relapse and temporomandibular joint dysfunction (TMD) as postoperative complication in skeletal class III patients undergoing bimaxillary orthognathic surgery: A systematic review

Journal of Oral Biology and Craniofacial Research ◽

10.1016/j.jobcr.2021.06.003 ◽

2021 ◽

Author(s):

Neeraj ◽

Srinivas Gosla Reddy ◽

Ashutosh Dixit ◽

Padmanidhi Agarwal ◽

Rebecca Chowdhry ◽

...

Keyword(s):

Systematic Review ◽

Postoperative Complication ◽

Temporomandibular Joint ◽

Orthognathic Surgery ◽

Class Iii ◽

Temporomandibular Joint Dysfunction ◽

Skeletal Class ◽

Bimaxillary Orthognathic Surgery

Download Full-text

Postsurgical Stability of Temporomandibular Joint of Skeletal Class III Patients Treated with 2-Jaw Orthognathic Surgery via Computer-Aided Three-Dimensional Simulation and Navigation in Orthognathic Surgery (CASNOS)

BioMed Research International ◽

10.1155/2021/1563551 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Ling-Chun Wang ◽

Yi-Hao Lee ◽

Chi-Yu Tsai ◽

Te-Ju Wu ◽

Ya-Ying Teng ◽

...

Keyword(s):

Orthognathic Surgery ◽

Three Dimensional ◽

Class Iii ◽

Skeletal Class ◽

Computer Aided ◽

Before And After ◽

Bimaxillary Orthognathic Surgery ◽

The Mean ◽

Dimensional Simulation ◽

The Right

Objective. The aim of this study is to clarify the postsurgical stability of temporomandibular joints in skeletal class III patients treated with 2-jaw orthognathic surgery which was performed utilizing computer-aided three-dimensional simulation and navigation in orthognathic surgery (CASNOS) protocol. Materials and Methods. 23 consecutive nongrowing skeletal class III patients with mandibular prognathism associated with maxillary retrognathism treated with 2-jaw orthognathic surgery between 2018 and 2019 were enrolled in this study. The surgery was planned according to the standardized protocol of CASNOS (computer-aided three-dimensional simulation and navigation in orthognathic surgery). Computed tomography (CT) scans were performed in all patients 3 weeks presurgically and 6 months postsurgically. ITKSNAP and 3D Slicer software were used to reconstruct three-dimensional facial skeletal images, to carry out image segmentation, and to superimpose and quantify the TMJ position changes before and after surgery. Amount of displacement of the most medial and lateral points of the condyles and the change of intercondylar angles were measured to evaluate the postsurgical stability of TMJ. Results. A total amount of 23 skeletal class III patients female : male = 12 : 11 with age ranged from 20.3 to 33.5 years (mean: 24.39 ± 4.8 years old ) underwent Le Fort I maxillary advancement and BSSO setback of the mandible. The surgical outcome revealed the satisfactory correction of their skeletal deformities. The mean displacement of the right most lateral condylar point (RL-RL ′ ) was 1.04 ± 0.42 mm and the mean displacement of the left most lateral condylar point (LL-LL ′ ) was 1.19 ± 0.41 mm . The mean displacement of the right most medial condylar point (RM-RM ′ ) was 1.03 ± 0.39 mm and the left most medial condylar point (LM-LM ′ ) was 0.96 ± 0.39 mm . The mean intercondylar angle was 161.61 ± 5.08 ° presurgically and 159.28 ± 4.92 ° postsurgically. Conclusion. The postsurgical position of TM joint condyles in our study only presented a mild change with all the landmark displacement within a range of 1.2 mm. This indicates the bimaxillary orthognathic surgery via 3D CASNOS protocol can achieve a desired and stable result of TMJ position in treating skeletal class III adult patients with retrognathic maxilla and prognathic mandible.

Download Full-text