Int J Stomatol

Int J Stomatol ›› 2022, Vol. 49 ›› Issue (2): 227-232.doi: 10.7518/gjkq.2022014

• Reviews • Previous Articles     Next Articles

Research advances on jaw stability and influencing factors in surgery-first approach

Yang Yunqi1,2(),Lin Yangyang1,2,Hou Min1,2()   

  1. 1. Dept. of Orthognathic Surgery, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China
    2. Tianjin Key Laboratory of Oral Function Reconstruction, Tianjin 300041, China
  • Received:2021-05-26 Revised:2021-09-11 Online:2022-03-01 Published:2022-03-15
  • Contact: Min Hou E-mail:waoyangyunqi@163.com;houmin8181@sina.com
  • Supported by:
    Tianjin Key Discipline of Clinical Medicine (Stomatology-Oral and Maxillofacial Surgery) Special Fund(HWZX007);Tianjin Stomatological Hospital Doctoral Master Program(2019BSQN04)

RichHTML

51

PDF (PC)

360

Abstract:

As the current mainstream mode, the traditional orthognathic surgical treatment model includes three perio-ds: presurgical orthodontic preparation, orthognathic surgery and postsurgical orthodontic procedure. However, this model has the problems of long treatment time, deterioration of the patient’s masticatory function and lateral appearance during the preoperative orthodontic period and so on. In recent years, many case studies have been reported at home and abroad, which shortens or omits presurgical orthodontic time. This new treatment is called surgery-first approach (SFA). Compared with the conventional treatment mode, SFA shortens the overall treatment time and improves facial aesthetics immediately after surgery. Therefore, SFA is more in line with the treatment needs of adult orthognathic patients. Meanwhile, the bone and teeth moved after surgery are more conducive to the movement of teeth. However, the jaw stability of patients after orthognathic surgery and the influencing factors are the main issues that need to be considered in clinical applications of surgery-first approach. This article reviews the jaw stability and its relationship to transitional occlusion, surgical design and orthodontic treatment under surgery-first approach.

Key words: surgery-first approach, jaw stability, combined orthodontic-orthognathic treatment, transitional occlusion

CLC Number: 

  • R783.5

TrendMD: 
[1] Huang CS, Hsu SS, Chen YR. Systematic review of the surgery-first approach in orthognathic surgery[J]. Biomed J, 2014, 37(4): 184-190.
doi: 10.4103/2319-4170.126863
[2] Sharma VK, Yadav K, Tandon P. An overview of surgery-first approach: recent advances in orthognathic surgery[J]. J Orthod Sci, 2015, 4(1): 9-12.
doi: 10.4103/2278-0203.149609 pmid: 25657986
[3] Huang XQ, Cen X, Sun WT, et al. The impact of surgery-first approach on the oral health-related quality of life: a systematic review and Meta-analysis[J]. BMC Oral Health, 2019, 19(1): 136.
doi: 10.1186/s12903-019-0842-1
[4] Choi JW, Lee JY, Yang SJ, et al. The reliability of a surgery-first orthognathic approach without presurgical orthodontic treatment for skeletal class Ⅲ dentofacial deformity[J]. Ann Plast Surg, 2015, 74(3): 333-341.
doi: 10.1097/SAP.0b013e318295dcce
[5] Nagasaka H, Sugawara J, Kawamura H, et al. “Surgery first” skeletal classⅢcorrection using the ske-letal anchorage system[J]. J Clin Orthod, 2009, 43(2): 97-105.
[6] Park JK, Choi JY, Yang IH, et al. Patient’s satisfaction in skeletal classⅢcases treated with two-jaw surgery using orthognathic quality of life questionnaire: conventional three-stage method versus surgery-first approach[J]. J Craniofac Surg, 2015, 26(7): 2086-2093.
doi: 10.1097/SCS.0000000000001972
[7] Park KH, Sandor GK, Kim YD. Skeletal stability of surgery-first bimaxillary orthognathic surgery for ske-letal classⅢmalocclusion, using standardized criteria[J]. Int J Oral Maxillofac Surg, 2016, 45(1): 35-40.
doi: 10.1016/j.ijom.2015.09.015
[8] 杨斌, 王怀良, 丁榆德, 等. 手术优先模式治疗Angle Ⅲ类牙颌畸形185例临床回顾分析[J]. 中华整形外科杂志, 2018, 34(6): 422-431.
Yang B, Wang HL, Ding YD, et al. Surgery-first approach for Angle classⅢmalocclusion: clinical retrospective analysis of 185 cases[J]. Chin J Plast Surg, 2018, 34(6): 422-431.
[9] Kim JY, Park JH, Jung HD, et al. 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[J]. J Clin Med, 2020, 9(3): E641.
[10] Liou EJ, Chen PH, Wang YC, et al. Surgery-first accelerated orthognathic surgery: orthodontic guidelin-es and setup for model surgery[J]. J Oral Maxillofac Surg, 2011, 69(3): 771-780.
doi: 10.1016/j.joms.2010.11.011
[11] Alencar DS, Cunha Almeida RC, Maues Casagrande CP, et al. Orthodontic-surgical treatment for a patient with classⅡmalocclusion and inadequate maxillary incisor inclination[J]. Am J Orthod Dentofacial Orthop, 2020, 157(5): 690-703.
doi: 10.1016/j.ajodo.2019.01.030
[12] Ince-Bingol S, Arman-Ozcirpici A. Treatment of an adult skeletal classⅡpatient with a modified surge-ry-first approach[J]. Int Orthod, 2020, 18(3): 569-575.
doi: 10.1016/j.ortho.2020.03.004
[13] Hwang DS, Seo JS, Choi HS. Skeletal stability after 2-jaw surgery via surgery-first approach in facial asy-mmetry patients using CBCT[J]. Maxillofac Pla-st Reconstr Surg, 2020, 42(1): 11.
[14] Song JY, Yang H, He X, et al. Surgery-first for a patient with mild hemifacial microsomia: a case report and review of literature[J]. World J Clin Cases, 2021, 9(1): 148-162.
doi: 10.12998/wjcc.v9.i1.148
[15] Behrman SJ, Behrman DA. Oral surgeons’ conside-rations in surgical orthodontic treatment[J]. Dent C-lin North Am, 1988, 32(3): 481-507.
[16] Ko EW, Hsu SS, Hsieh HY, et al. Comparison of progressive cephalometric changes and postsurgical stability of skeletal classⅢcorrection with and without presurgical orthodontic treatment[J]. J Oral Maxillofac Surg, 2011, 69(5): 1469-1477.
doi: 10.1016/j.joms.2010.07.022
[17] Peiró-Guijarro MA, Guijarro-Martínez R, Hernán-dez-Alfaro F. Surgery first in orthognathic surgery: a systematic review of the literature[J]. Am J Orthod Dentofacial Orthop, 2016, 149(4): 448-462.
doi: 10.1016/j.ajodo.2015.09.022
[18] Hoang TA, Lee KC, Chuang SK. The surgery-first approach to orthognathic surgery[J]. J Craniofac Surg, 2021, 32(2): e153-e156.
doi: 10.1097/SCS.0000000000006942
[19] Jeong WS, Lee JY, Choi JW. Large-scale study of long-term vertical skeletal stability in a surgery-first orthognathic approach without presurgical orthodontic treatment: part Ⅱ[J]. J Craniofac Surg, 2018, 29(4): 953-958.
doi: 10.1097/SCS.0000000000004433 pmid: 29521747
[20] Yang L, Xiao YD, Liang YJ, et al. Does the surgery-first approach produce better outcomes in orthognathic surgery? A systematic review and Meta-analysis[J]. J Oral Maxillofac Surg, 2017, 75(11): 2422-2429.
doi: 10.1016/j.joms.2017.06.002
[21] Kim CS, Lee SC, Kyung HM, et al. Stability of mandibular setback surgery with and without presurgical orthodontics[J]. J Oral Maxillofac Surg, 2014, 72(4): 779-787.
doi: 10.1016/j.joms.2013.09.033
[22] Wei HP, Liu ZX, Zang JJ, et al. Surgery-first/early-orthognathic approach may yield poorer postoperative stability than conventional orthodontics-first approach: a systematic review and Meta-analysis[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2018, 126(2): 107-116.
doi: 10.1016/j.oooo.2018.02.018
[23] Pelo S, Saponaro G, Patini R, et al. Risks in surgery-first orthognathic approach: complications of segmental osteotomies of the jaws. A systematic review[J]. Eur Rev Med Pharmacol Sci, 2017, 21(1): 4-12.
[24] Liao YF, Lo SH. Surgical occlusion setup in correction of skeletal classⅢdeformity using surgery-first approach: guidelines, characteristics and accuracy[J]. Sci Rep, 2018, 8(1): 11673.
doi: 10.1038/s41598-018-30124-2
[25] Baek SH, Ahn HW, Kwon YH, et al. Surgery-first approach in skeletal classⅢmalocclusion treated wi-th 2-jaw surgery: evaluation of surgical movement and postoperative orthodontic treatment[J]. J Craniofac Surg, 2010, 21(2): 332-338.
doi: 10.1097/SCS.0b013e3181cf5fd4
[26] Ko EW, Lin SC, Chen YR, et al. Skeletal and dental variables related to the stability of orthognathic surgery in skeletal classⅢmalocclusion with a surgery-first approach[J]. J Oral Maxillofac Surg, 2013, 71(5): e215-e223.
doi: 10.1016/j.joms.2012.12.025
[27] Liao YF, Chiu YT, Huang CS, et al. Presurgical orthodontics versus no presurgical orthodontics: treatment outcome of surgical-orthodontic correction for skeletal classⅢopen bite[J]. Plast Reconstr Surg, 2010, 126(6): 2074-2083.
doi: 10.1097/PRS.0b013e3181f52710
[28] Gandedkar NH, Chng CK, Tan W. Surgery-first orthognathic approach case series: salient features and guidelines[J]. J Orthod Sci, 2016, 5(1): 35-42.
doi: 10.4103/2278-0203.176657 pmid: 26998476
[29] López DF, Aristizábal JF, Martínez-Smit R. Condylectomy and “surgery first” approach: an expedited treatment for condylar hyperplasia in a patient with facial asymmetry[J]. Dental Press J Orthod, 2017, 22(4): 86-96.
[30] Janakiraman N, Feinberg M, Vishwanath M, et al. Integration of 3-dimensional surgical and orthodontic technologies with orthognathic “surgery-first” approach in the management of unilateral condylar hyperplasia[J]. Am J Orthod Dentofacial Orthop, 2015, 148(6): 1054-1066.
doi: 10.1016/j.ajodo.2015.08.012
[31] Badiali G, Costabile E, Lovero E, et al. Virtual orthodontic surgical planning to improve the accuracy of the surgery-first approach: a prospective evaluation[J]. J Oral Maxillofac Surg, 2019, 77(10): 2104-2115.
doi: 10.1016/j.joms.2019.04.017
[32] 商洪涛, 史雨林, 白石柱, 等. 骨性Ⅲ类面形患者数字化正颌外科治疗[J]. 中国美容整形外科杂志, 2016, 27(12): 713-716.
Shang HT, Shi YL, Bai SZ, et al. Digital orthognathic surgery in the treatment of skeletal class Ⅲ type patients[J]. Chin J Aesthet Plast Surg, 2016, 27(12): 713-716.
[33] 范娟, 林阳阳. 双颌手术中数字化导板辅助定位技术的研究进展[J]. 中国美容整形外科杂志, 2019, 30(12): 725-727.
Fan J, Lin YY. Research progress of digital guide assisted localization technology in bimaxillary surgery[J]. Chin J Aesthet Plast Surg, 2019, 30(12): 725-727.
[34] Zhou Y, Zhou YH, Wang XX, et al. Minimal presurgical orthodontics for a skeletal class Ⅲ patient with mandibular asymmetry[J]. Am J Orthod Dentofacial Orthop, 2016, 149(1): 99-113.
doi: 10.1016/j.ajodo.2014.10.039
[35] Liao YF, Chen YF, Yao CF, et al. Long-term outcomes of bimaxillary surgery for treatment of asymmetric skeletal class Ⅲ deformity using surgery-first approach[J]. Clin Oral Investig, 2019, 23(4): 1685-1693.
doi: 10.1007/s00784-018-2603-y
[36] 王怀良, 杨斌. “手术优先”模式治疗成人安氏Ⅲ类𬌗畸形的研究进展[J]. 中国美容整形外科杂志, 2017, 28(4): 235-237.
Wang HL, Yang B. Research progress of “surgery-first” model in the treatment of adult Angle classⅢmalocclusion[J]. Chin J Aesthet Plast Surg, 2017, 28(4): 235-237.
[37] Min BK, Choi JY, Baek SH. Comparison of treatment duration between conventional three-stage me-thod and surgery-first approach in patients with skeletal class Ⅲ malocclusion[J]. J Craniofac Surg, 2014, 25(5): 1752-1756.
doi: 10.1097/SCS.0000000000001002
[38] Frost HM. The regional acceleratory phenomenon: a review[J]. Henry Ford Hosp Med J, 1983, 31(1): 3-9.
pmid: 6345475
[39] Liou EJ, Chen PH, Wang YC, et al. Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement[J]. J Oral Maxillofac Surg, 2011, 69(3): 781-785.
doi: 10.1016/j.joms.2010.10.035
[40] Salazar AG, Waite PD, Kau CH. Enhancing the orthognathic surgery experience: treatment in 10 weeks “surgery first” approach[J]. Ann Maxillofac Surg, 2020, 10(1): 227-231.
doi: 10.4103/ams.ams_203_19
[41] Lee NK, Kim YK, Yun PY, et al. Evaluation of post-surgical relapse after mandibular setback surgery with minimal orthodontic preparation[J]. J Craniomaxillofac Surg, 2013, 41(1): 47-51.
doi: 10.1016/j.jcms.2012.05.010
[42] Hu J, Jiang Y, Wang D, et al. Comparison of cost-effectiveness and benefits of surgery-first versus orthodontics-first orthognathic correction of skeletal class Ⅲ malocclusion[J]. Int J Oral Maxillofac Surg, 2021, 50(3): 367-372.
[43] Pelo S, Gasparini G, Garagiola U, et al. Surgery-first orthognathic approach vs traditional orthognathic approach: oral health-related quality of life assessed with 2 questionnaires[J]. Am J Orthod Dentofacial Orthop, 2017, 152(2): 250-254.
doi: 10.1016/j.ajodo.2016.12.022
[44] Saghafi H, Benington P, Ayoub A. Impact of orthognathic surgery on quality of life: a comparison between orthodontics-first and surgery-first approaches[J]. Br J Oral Maxillofac Surg, 2020, 58(3): 341-347.
doi: S0266-4356(20)30007-3 pmid: 31992457
[45] Feu D, de Oliveira BH, Palomares NB, et al. Oral health-related quality of life changes in patients wi-th severe classⅢmalocclusion treated with the 2-jaw surgery-first approach[J]. Am J Orthod Dentofacial Orthop, 2017, 151(6): 1048-1057.
doi: 10.1016/j.ajodo.2016.10.034
[46] 王涛. 外科优先序列治疗——正颌外科的发展热点之一及其误区[J]. 国际口腔医学杂志, 2020, 47(5): 497-505.
Wang T. Surgery first approach: one of the hotspots in orthognathic surgery and common problems[J]. Int J Stomatol, 2020, 47(5): 497-505.
[47] Oh MH, Hwang HS, Lee KM, et al. Cone-beam computed tomography evaluation on the condylar displacement following sagittal split ramus osteotomy in asymmetric setback patients: comparison between conventional approach and surgery-first approach[J]. Angle Orthod, 2017, 87(5): 733-738.
doi: 10.2319/122316-925.1
[48] He XT, He JY, Yuan H, et al. Surgery-first and orthodontic-first approaches produce similar patterns of condylar displacement and remodeling in patients with skeletal class Ⅲ malocclusion[J]. J Oral Maxillofac Surg, 2019, 77(7): 1446-1456.
doi: 10.1016/j.joms.2019.01.061
[1] Guo Peizhu, Feng Yunxia, Ren Juan. Research progress on the surgery-first approach to treat skeletal malocclusion [J]. Inter J Stomatol, 2016, 43(1): 43-.
[2] Tan Jianqin, Tang Zhenglong. Advancement on the surgery-first approach for the correction of dento-maxillofacial deformities [J]. Inter J Stomatol, 2016, 43(1): 99-.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[2] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[3] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[4] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[5] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[6] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[7] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[8] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[9] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .
[10] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .