Factors Affecting Total Treatment Time in Patients Treated with Orthognathic Surgery Using the Surgery-First Approach: Multivariable Analysis Using 3D CT and Scanned Dental Casts

The aim of this study was to analyze factors affecting treatment times in patients treated with the surgery-first approach (SFA) for orthognathic surgery. Fifty skeletal class III patients who had undergone SFA bimaxillary orthognathic surgery were enrolled. Retrospective chart reviews and analysis of 3D CT and digitally scanned casts were conducted to assess the total treatment time. Statistical analysis was then performed with multiple study variables. Longer treatment times were required for patients with severe maxillary or mandibular teeth crowding (p = 0.009), a preoperative anterior open bite (p = 0.021), and those undergoing orthodontic extractions (p < 0.001). Longer treatment times were also observed when setting surgical occlusion in the postoperative anterior open bite (p = 0.007) and in patients with postoperative dental midline deviation (p < 0.001) and transverse maxillary deficiencies (p = 0.035). Treatment times were shorter when a class I molar key was formed in the surgical occlusion setup (p = 0.002) and in bilateral anterior and posterior occlusion with a minimum of four contact points (p < 0.001). The number of contact points, the number of extracted teeth, and postoperative midline deviation were identified as significant predictors. These results suggest that proper patient selection is important when considering SFA and that surgeons can reduce total treatment time with an appropriate surgical occlusion setup.

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Anterior Open Bite treated with Myofunctional Therapy and Palatal Crib

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1669 ◽

2015 ◽

Vol 16 (3) ◽

pp. 243-247

Author(s):

Moshabab A Asiry

Keyword(s):

Treatment Time ◽

Open Bite ◽

Anterior Open Bite ◽

Myofunctional Therapy ◽

Total Treatment Time ◽

Total Treatment ◽

Tongue Position ◽

Thumb Sucking ◽

The Stability ◽

Lower Incisors

ABSTRACT This case report demonstrates the treatment effects of palatal crib combined with the myofunctional therapy in a child with anterior open bite (AOB) due to thumb sucking and habitual anterior and low tongue position. The patient, an 11-year-old boy, had an anterior open bite and flared and spaced upper and lower incisors. Palatal cribs in conjunction with myofunctional therapy were used to discourage sucking habit and to adapt normal tongue position. Successful correction of the AOB with adequate overjet and overbite were achieved with total treatment time of 7 months. The importance of myofunctional therapy in adopting normal tongue position and in maintaining the stability of open bite correction is emphasized. How to cite this article Asiry MA. Anterior Open Bite treated with Myofunctional Therapy and Palatal Crib. J Contemp Dent Pract 2015;16(3):243-247.

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Surgery-first Approach

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1462 ◽

2017 ◽

Vol 8 (4) ◽

pp. 343-350

Author(s):

Yash A Shah ◽

Shailesh V Deshmukh ◽

Amol S Patil

Keyword(s):

Orthognathic Surgery ◽

Tooth Movement ◽

Treatment Time ◽

Orthodontic Tooth Movement ◽

Conventional Approach ◽

Treatment Protocols ◽

Orthodontic Therapy ◽

Total Treatment Time ◽

Total Treatment ◽

Surgery First

ABSTRACT Aim This article is intended to provide an overview of the Surgery First Approach (SFA) mainly including case selection, diagnosis, treatment protocols, success rate and the potential problems encountered. Background The most important indication of the need for orthognathic surgery is usually the psychosocial effect resulting from the unaesthetic appearance of a dentofacial deformity. The conventional approach in treatment of such deformities till today has been an orthodontics-first approach. Review Results Available evidence suggest that both the SFA and the conventional approach had similar outcomes in dentofacial relationships however the relapse tendency was greater with the SFA but the total treatment duration was substantially shorter. Conclusion SFA treats facial aesthetics (and the skeletal malrelation) first and then occlusion, i.e. orthognathic surgery antecedes the orthodontic therapy. The concept of this technique is to utilize orthognathic surgery to eliminate the displeasing pre-surgical facial profile and promptly accomplish facial aesthetic enhancement that is usually the patient's chief complaint at the beginning of the treatment. SFA also facilitates accelerated orthodontic tooth movement thus reducing the length of post-surgical orthodontic therapy. Clinical Significance The optimal esthetic and functional results, significant reduction in total treatment time and high patient satisfaction led us to the postulation that SFA may represent a reasonable, cost-effective method to manage skeletal malocclusions in selected cases and that it has the potential to become a standard approach to orthognathic surgery in the future. How to cite this article Shah YA, Deshmukh SV, Patil AS. Surgery-first Approach. World J Dent 2017;8(4):343-350.

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Can a surgery-first orthognathic approach reduce the total treatment time?

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2016.12.006 ◽

2017 ◽

Vol 46 (4) ◽

pp. 473-482 ◽

Cited By ~ 24

Author(s):

Woo Shik Jeong ◽

Jong Woo Choi ◽

Do Yeon Kim ◽

Jang Yeol Lee ◽

Soon Man Kwon

Keyword(s):

Treatment Time ◽

Total Treatment Time ◽

Total Treatment ◽

Surgery First

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Corrigendum to “Can a surgery-first orthognathic approach reduce the total treatment time?” [Int. J. Oral Maxillofac. Surg. 46 (2017) 473–482]

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2017.05.017 ◽

2017 ◽

Vol 46 (9) ◽

pp. 1203 ◽

Cited By ~ 1

Author(s):

W.S. Jeong ◽

J.W. Choi ◽

D.Y. Kim ◽

J.Y. Lee ◽

S.M. Kwon

Keyword(s):

Treatment Time ◽

Total Treatment Time ◽

Total Treatment ◽

Surgery First

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Total Treatment Time in the Surgery-First Orthognathic Approach

The Surgery-First Orthognathic Approach ◽

10.1007/978-981-15-7541-9_15 ◽

2021 ◽

pp. 321-344

Author(s):

Jong-Woo Choi ◽

Jang Yeol Lee

Keyword(s):

Treatment Time ◽

Total Treatment Time ◽

Total Treatment ◽

Surgery First

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Vital Tooth Whitening Techniques. A literature Review

Current Dentistry ◽

10.2174/2542579x02999200812130854 ◽

2020 ◽

Vol 02 ◽

Author(s):

Pia Chatterjee Kirk

Keyword(s):

Soft Tissues ◽

Treatment Time ◽

Tooth Bleaching ◽

Tooth Whitening ◽

Easy Method ◽

Tooth Structure ◽

Dental Esthetics ◽

Total Treatment Time ◽

Restorative Materials ◽

Total Treatment

Background: Vital tooth whitening has become an integral part of esthetic dentistry and remains one of the safest and most economic options today to improve dental esthetics without removing tooth structure. The tooth whitening materials have evolved into three categories: dentist-prescribed/dispensed (in office and patient home-use), and over-thecounter purchased and applied by patients. Objective: This review outlines the latest advances in dentist prescribed vital teeth whitening techniques, effects on tooth structure, soft tissues, and dental restoratives. Areas requiring additional research are also discussed. Methods: Electronic and manual literature search was conducted for key words such as tooth bleaching, and dental bleaching techniques using PubMed/MEDLINE, followed by manual selection of the studies that included whitening procedures in vital teeth. Results: The two main whitening agents are carbamide peroxide (CP) and hydrogen peroxide (HP or H2O2) whose concentration, duration of contact, and total treatment time can alter results. In addition, factors including the type of stain, and age of patient can affect results. Although whitening agents can affect tooth structure, restorative materials, and gingival tissues, the changes are temporary or can be treated using minimally invasive techniques. Conclusion: Areas requiring further research include the actual mechanism of whitening, its effect on tooth structure and restorative materials, and the development of an easy method to quantitate the degree of whitening in the dental office.

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Abordagem precoce da má oclusão de Classe II esquelética com atresia maxilar e mordida aberta anterior e o uso de alinhadores ClearCorrect – relato de caso

Orthodontic Science and Practice ◽

10.24077/2021;1453-97106 ◽

2021 ◽

Vol 14 (53) ◽

pp. 97-106

Author(s):

Roberto Hideo Shimizu ◽

Isabela Almeida Shimizu ◽

Ana Cláudia M. Melo Toyoffuku ◽

Rebecca Marquesini ◽

Tatiane Travizan Lima ◽

...

Keyword(s):

Treatment Time ◽

Low Complexity ◽

Class Ii ◽

Open Bite ◽

Class Ii Malocclusion ◽

Anterior Open Bite ◽

Skeletal Class ◽

Posterior Crossbite ◽

Skeletal Class Ii ◽

High Predictability

Adequate planning and early treatment of Angle Class II malocclusion with maxillary atresia and anterior open bite provides harmonization of maxillomandibular bone bases in the three planes of space. Orthodontic aligners have emerged as an alternative treatment having the following advantages: being more aesthetic and more comfortable for the patient, less treatment time when they are correctly indicated, less chairside time, less complications, possibility of remote monitoring, easier feeding, and dental hygiene. On the other hand, they offer difficulties to treat adults with severe skeletal Class II malocclusions, posterior crossbite and anterior open bite. Therefore, the objective of this clinical case report is to early correct skeletal Class II malocclusion with maxillary atresia through the use of mechanical orthopedics and devices that help eliminate habits and close the anterior open bite, and later the use of orthodontic aligners to finish the treatment. It was concluded that the early interceptive treatment of malocclusion was efficient to harmonize the bone bases in the anteroposterior, vertical, and transversal directions, changing this malocclusion from high to low complexity and, consequently, highly predictable and with an excellent prognosis for treatment with orthodontic aligners. The treatment with ClearCorrect aligners corrected the occlusion in a shorter period of time when compared to corrective orthodontics and with a high predictability in relation to the virtual setup.

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Idiopathic condylar resorption in orthodontics

Orthodontic Update ◽

10.12968/ortu.2021.14.2.82 ◽

2021 ◽

Vol 14 (2) ◽

pp. 82-88

Author(s):

Salwa El-Habbash ◽

Timothy McSwiney

Keyword(s):

Risk Factors ◽

Orthognathic Surgery ◽

Mechanical Load ◽

Systemic Disease ◽

Treatment Options ◽

Open Bite ◽

Mandibular Movement ◽

Anterior Open Bite ◽

Surgical Risk ◽

Multiple Treatment

Condylar resorption (CR) can be categorized into functional and dysfunctional remodelling of the temporomandibular joint (TMJ). The literature describes dysfunctional remodelling of the TMJ as idiopathic condylar resorption (ICR). Idiopathic condylar resorption (ICR) is a well-documented but poorly understood pathological entity that can occur spontaneously or post-orthognathic surgery. It predominantly affects young women, with other risk factors including Class 2 malocclusion with steep mandibular plane angles. It is distinguished by a decreased condylar head volume and ramus height, progressive mandibular retrusion and an anterior open bite. Its aetiology can be categorized into surgical and non-surgical risk factors. These include hormones, systemic disease, trauma, mechanical load and surgical risk factors, such as magnitude and direction of mandibular movement, type of surgical fixation and length of post-operative maxilla-mandibular fixation. ICR is a diagnosis of exclusion, and identified by a combination of clinical, radiographic and haematological findings. Multiple treatment options have been described in the literature, including medical management, orthodontics, orthognathic surgery, TMJ surgery, TMJ and orthognathic surgery combined, and total joint prosthesis reconstruction. Further research is required to better understand the aetiology of ICR and more long-term, controlled, multicentre clinical studies are needed to evaluate the outcomes of surgical and non-surgical management of CR patients. CPD/Clinical Relevance: Idiopathic condylar resorption has many presentations and potential causes that can greatly impact the decisions and outcomes for orthodontic/orthognathic treatment.

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Bimaxillary Protrusion - A Case Report

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v7i1.24697 ◽

2019 ◽

Vol 7 (1) ◽

pp. 70-73

Author(s):

Hemant Kumar Halwa ◽

Sumit Kumar Yadav ◽

Kishor Dutta ◽

Sandeep Kumar Gupta ◽

Raju Shrestha ◽

...

Keyword(s):

Case Report ◽

Orthodontic Treatment ◽

Treatment Time ◽

Facial Appearance ◽

Total Treatment Time ◽

Total Treatment ◽

Bimaxillary Protrusion ◽

Maximum Anchorage

Correction of a severe bimaxillary protrusion with maximum anchorage can be challenging. This case report describes the treatment of a girl with a bimaxillary protrusion. Orthodontic treatment included extraction of her 4 first premolars. The total treatment time was 18 months. Her dental proclination and facial appearance was significantly improved.

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