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Ann Maxillofac Surg. 2018 Jul-Dec;8(2):270-275. doi: 10.4103/ams.ams_152_18.

Esthetic Outcome and Airway Evaluation following Bi-Jaw Surgery V/S Mandibular Setback Surgery in Skeletal Class III Malocclusion Using Surgery First Approach.

Author information

1
Department of Orthodontics and Dentofacial Orthopedics, D.A.P.M.R.V Dental College, Bangalore, Karnataka, India.
2
Department of Oral and Maxillofacial Surgery, Mar Baselios Dental College, Kothamangalam, Kerala, India.

Abstract

Background:

Class III skeletal deformity is the result of mandibular prognathism, maxillary deficiency, or a combination. Treatment frequently requires a combination of orthodontics and orthognathic surgical procedures to improve facial esthetics and harmonize facial profile.

Objectives:

The objective of the study is to assess and quantify, by means of cephalometric analysis, the pre- and postoperative soft-tissue and airway changes following bi-jaw surgery and mandibular setback surgery after the correction of skeletal Class III deformities using surgery-first approach.

Materials and Methods:

Patients with skeletal Class III malocclusion were classified based on the A point-nasion-B point, beta angle, and Witt's appraisal. The cases were divided based on the type of surgery-first orthognathic approach they received. Group A (20 patients) comprised patients who underwent bi-jaw surgery (Le Fort I + bilateral sagittal split osteotomy [BSSO]) and Group B (20 patients) who underwent BSSO alone. After the lateral cephalograms were digitized, the cephalograms were evaluated for soft-tissue changes and airway changes.

Results:

The soft-tissue response to simultaneous two-jaw surgery was superior to those seen in mandibular setback procedures with the exception of the changes seen in the facial contour angle and soft-tissue facial angle. There was a significant decrease in lower airway in cases treated with mandibular setback alone.

Conclusion:

Cases treated with bi-jaw surgeries had a significant soft-tissue improvement in the long term compared to mandibular setback surgeries. Since there was a significant reduction in the lower airway in cases treated with isolated mandibular surgeries, bi-jaw surgeries maybe preferred over mandibular setback surgeries.

KEYWORDS:

Airway changes; Class III skeletal deformity; bi-jaw surgery; mandibular setback surgery; soft tissue; surgery-first approach

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