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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie

Published in:

01-08-2011 | Original article

Influence of orthognathic surgery on periodontal tissues

Short-term results

Authors: K. Weinspach, I. Staufenbiel, H. Günay, W. Geurtsen, R. Schwestka-Polly, A.P. Demling

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Issue 4/2011

Abstract

Objective

The present prospective study aimed at evaluating the influence of orthognathic surgery on mucogingival tissues and the subgingival microflora.

Patients and methods

Fifteen consecutively-treated patients with a mean age of 24.9±7.7 years were included in this study. The surgical interventions comprised the Le Fort I osteotomy of the maxilla and/or sagittal split osteotomy of the mandible. The following periodontal and microbial parameters were measured preoperatively (T₀) as well as 1 week (T₁) and 6 weeks (T₂) postoperatively: pocket probing depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI), and changes in the subgingival microflora. Periodontal parameters were calculated for all sites as well as for buccal and oral sites separately. For statistical analysis, the general linear model and paired t test were applied (level of significance: p<0.05).

Results

PPD readings increased significantly on oral tooth sites when T₀ values were compared to T₁ (p=0.009) and T₂values (p=0.042). GR increased significantly on buccal sites from 0.10±0.16 mm at baseline to 0.21±0.23 mm at T₁ (p=0.013) and 0.31±0.31 mm at T₂ (p=0.001). Furthermore, we noted significant changes in the CAL (oral sites) and PI (buccal and oral sites). We observed no significant differences in BOP and periodontopathogenetic bacteria.

Conclusion

Orthognathic surgery has a statistically significant effect on the development of gingival recessions. However, this effect may not necessarily clinically impair the esthetic appearance.

Altug-Atac AT, Bolatoglu H, Memikoglu UT (2008) Facial soft tissue profile following bimaxillary orthognathic surgery. Angle Orthod 78:50–57PubMedCrossRef

Arx T von, Salvi GE, Janner S et al (2009) Gingival recession following apical surgery in the esthetic zone: a clinical study with 70 cases. Eur J Esthet Dent 4:28–45

Arx T von, Vinzens-Majaniemi T, Burgin W et al (2007) Changes of periodontal parameters following apical surgery: a prospective clinical study of three incision techniques. Int Endod J 40:959–969CrossRef

Bell WH (1975) Le Forte I osteotomy for correction of maxillary deformities. J Oral Surg 33:412–426PubMed

Dal Pont G (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 19:42–47

Demling A, Demling C, Schwestka-Polly R et al (2010) Short-term influence of lingual orthodontic therapy on microbial parameters and periodontal status. Angle Orthod 80:480–484PubMedCrossRef

Epker BN, Wolford LM (1975) Middle-third facial osteotomies: their use in the correction of acquired and developmental dentofacial and craniofacial deformities. J Oral Surg 33:491–514PubMed

Foushee DG, Moriarty JD, Simpson DM (1985) Effects of mandibular orthognathic treatment on mucogingival tissues. J Periodontol 56:727–733PubMed

Gardner N (2007) Gingival recession: rare but significant complication of the Le Fort I osteotomy. Br J Oral Maxillofac Surg 45:174–175PubMedCrossRef

10.

Gastel J van, Quirynen M, Teughels W et al (2008) Longitudinal changes in microbiology and clinical periodontal variables after placement of fixed orthodontic appliances. J Periodontol 79:2078–2086PubMedCrossRef

11.

Gibbs CH, Hirschfeld JW, Lee JG et al (1988) Description and clinical evaluation of a new computerized periodontal probe – the Florida probe. J Clin Periodontol 15:137–144PubMedCrossRef

12.

Islam R, Kitahara T, Naher L et al (2010) Lip morphology changes following orthognathic surgery for class III malocclusion. Angle Orthod 80:344–353PubMedCrossRef

13.

Kramer FJ, Baethge C, Swennen G et al (2004) Intra- and perioperative complications of the LeFort I osteotomy: a prospective evaluation of 1000 patients. J Craniofac Surg 15:971–977; 978–979PubMedCrossRef

14.

Kreisler M, Gockel R, Schmidt I et al (2009) Clinical evaluation of a modified marginal sulcular incision technique in endodontic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:22–28CrossRef

15.

Magnusson T, Ahlborg G, Finne K et al (1986) Changes in temporomandibular joint pain-dysfunction after surgical correction of dentofacial anomalies. Int J Oral Maxillofac Surg 15:707–714PubMedCrossRef

16.

Mordenfeld A, Andersson L (1999) Periodontal and pulpal condition of the central incisors after midline osteotomy of the maxilla. J Oral Maxillofac Surg 57:523–529; 529–530PubMedCrossRef

17.

Morgan TA, Fridrich KL (2001) Effects of the multiple-piece maxillary osteotomy on the periodontium. Int J Adult Orthod Orthognath Surg 16:255–265

18.

Obwegeser H (1965) Surgery of the maxilla for the correction of prognathism. SSO Schweiz Monatsschr Zahnheilkd 75:365–374PubMed

19.

Omnell ML, Tong DC, Thomas T (1994) Periodontal complications following orthognathic surgery and genioplasty in a 19-year-old: a case report. Int J Adult Orthod Orthognath Surg 9:133–139

20.

Ramfjord SP (1959) Indices for prevalence and incidence of periodontal disease. J Periodontol 30:51–59

21.

Schendel SA, Jacobson R (2009) Three-dimensional imaging and computer simulation for office-based surgery. J Oral Maxillofac Surg 67:2107–2114PubMedCrossRef

22.

Schultes G, Gaggl A, Karcher H (1998) Periodontal disease associated with interdental osteotomies after orthognathic surgery. J Oral Maxillofac Surg 56:414–419PubMedCrossRef

23.

Schwestka-Polly R, Kubein-Meesenburg D, Luhr HG (1999) Results of the application of the Goettingen concept for three-dimensional repositioning of the maxilla in orthognathic surgery. Mund Kiefer Gesichtschir 3:123–130PubMedCrossRef

24.

Silness J, Loe H (1964) Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135PubMedCrossRef

25.

Teltzrow T, Kramer FJ, Schulze A et al (2005) Perioperative complications following sagittal split osteotomy of the mandible. J Craniomaxillofac Surg 33:307–313PubMed

26.

Trauner R, Obwegeser H (1957) The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 10:677–689; contd

27.

Tugnait A, Clerehugh V (2001) Gingival recession – its significance and management. J Dent 29:381–394PubMedCrossRef

28.

Ueki K, Marukawa K, Shimada M et al (2006) The prevention of periodontal bone loss at the osteotomy site after anterior segmental and dento-osseous osteotomy. J Oral Maxillofac Surg 64:1526–1531PubMedCrossRef

29.

Velvart P, Peters CI (2005) Soft tissue management in endodontic surgery. J Endod 31:4–16PubMedCrossRef

30.

Yeo JF, Loh FC, Egyedi P et al (1989) Serious circulatory disturbance after Le Fort I osteotomy. A case report. J Craniomaxillofac Surg 17:222–225PubMed

31.

Zarrinkelk HM, Throckmorton GS, Ellis E 3rd et al (1996) Functional and morphologic changes after combined maxillary intrusion and mandibular advancement surgery. J Oral Maxillofac Surg 54:828–837PubMedCrossRef

Title: Influence of orthognathic surgery on periodontal tissues
Short-term results
Authors: K. Weinspach
I. Staufenbiel
H. Günay
W. Geurtsen
R. Schwestka-Polly
A.P. Demling
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Issue 4/2011
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI: https://doi.org/10.1007/s00056-011-0033-4

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Influence of orthognathic surgery on periodontal tissues

Short-term results

Abstract

Objective

Patients and methods

Results

Conclusion

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Results

Conclusion

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