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Published in: Clinical Oral Investigations 7/2022

21-03-2022 | Original Article

Skeletal stability after bimaxillary surgery with surgery-first approach for class III asymmetry is not related to virtual surgical occlusal contact

Authors: Yu-Fang Liao, Piengkwan Atipatyakul, Yi-Hsuan Chen, Ying-An Chen, Chuan-Fong Yao, Yu-Ray Chen

Published in: Clinical Oral Investigations | Issue 7/2022

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Abstract

Objectives

Surgery-first orthognathic surgery is rarely used in class III asymmetry due to concerns of reduced skeletal stability from unstable surgical occlusion. This study aimed to evaluate if skeletal stability after surgery-first orthognathic surgery is related to virtual surgical occlusal contact or surgical change.

Materials and methods

We studied 58 adults with class III asymmetry, consecutively corrected by Le Fort I osteotomy and bilateral sagittal split osteotomy using a surgery-first approach. Dental casts were manually set to measure virtual surgical occlusal contact including contact distribution, contact number, and contact area. Cone-beam computed tomography taken before treatment, 1-week post-surgery, and after treatment was used to measure surgical change and post-surgical stability of the maxilla and mandible in translation (left/right, posterior/anterior, superior/inferior) and rotation (pitch, roll, yaw). The relationship between skeletal stability and surgical occlusal contact or surgical change was evaluated with correlation analysis.

Results

Significant instability was found in the mandible but not in the maxilla. No correlation was found between the maxillary or mandibular stability and surgical occlusal contact (all p > 0.01). However, a significant correlation was found between the maxillary (roll and yaw) or mandibular (shift, roll and pitch) stability and its surgical change (all p < 0.001).

Conclusions

In correction of class III asymmetry with surgery-first bimaxillary surgery, the skeletal stability is not related to the virtual surgical occlusal contact, but surgical skeletal change.

Clinical relevance

Planned over-correction is a reasonable option for correction of severe shift or roll mandibular asymmetry in bimaxillary surgery for class III deformity.
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Metadata
Title
Skeletal stability after bimaxillary surgery with surgery-first approach for class III asymmetry is not related to virtual surgical occlusal contact
Authors
Yu-Fang Liao
Piengkwan Atipatyakul
Yi-Hsuan Chen
Ying-An Chen
Chuan-Fong Yao
Yu-Ray Chen
Publication date
21-03-2022
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 7/2022
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-022-04462-5

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