The Journal of the Korean dental association (대한치과의사협회지)

The Korean Dental Association (대한치과의사협회)
권호 표지

Surgery-First Orthodontic Approach for the patients

환자를 위한 선수술 교정 접근 방법

  • Kook, Minsuk (Dept. of Oral and Maxillofacial Surgery Chonnam National University School of Dentistry)
  • 국민석 (전남대학교 치의학전문대학원 구강악안면외과학교실)
  • Received : 2017.02.28
  • Accepted : 2017.03.08
  • Published : 2017.04.01
Download PDF
⟨ Previous Next ⟩

Abstract

The traditional orthognathic surgery treatment consists of three steps: preoperative orthodontic treatment, orthognathic surgery, and postoperative orthodontic treatment, and the average treatment period is usually two years. Also, patients with Class III malocclusion should spend more time getting their facial features worse during the decompensation process. However, most of the patients who want orthognathic surgery visit the chief complaints of appearance improvement, and resolve this address as soon as possible. The concept of $^{\circ}{\AE}$Surgery - First 'does not cause a facial imbalance caused by decompensation for the pre - operative correction period, and the patient can obtain an improved facial profile immediately after the operation. In addition, the correction period is shortened by Regional Acceleratory Phenomenon (RAP) after surgery. However, it is not applicable to all patients. Patients with severe crowding, severe curve of spee or reverse curve of spee, severe transverse discrepancy of the maxilla and mandibular arch, and severe incisal angles are less likely to apply the technique. Although it is not yet possible to apply this technique to all patients, it has many advantages over the conventional method. Especially, the patients' preference is increasing due to the rapid appearance improvement and the shortening of the total treatment period.

Keywords

References

  1. Aziz SR. Simon P. Hullihen and the origin of orthognathic surgery. J Oral Maxillofac Surg. 2004 Oct;62(10):1303-7. https://doi.org/10.1016/j.joms.2003.08.044
  2. Zambito RF. Problem solving in orthodontic and orthognathic surgery. Int J Orthod. 1977 Mar;15(1):19-26.
  3. Luther F, Morris DO, Karnezi K. Orthodontic treatment following orthognathic surgery: how long does it take and why? A retrospective study. J Oral Maxillofac Surg. 2007 Oct;65(10):1969-76. https://doi.org/10.1016/j.joms.2007.05.026
  4. Brachvogel P, Berten JL, Hausamen JE. [Surgery before orthodontic treatment: a concept for timing the combined therapy of skeletal dysgnathias]. Dtsch Zahn Mund Kieferheilkd Zentralbl. 1991;79(7):557-63. German.
  5. Nagasaka H, Sugawara J, Kawamura H, Nanda R. "Surgery first" skeletal Class III correction using the Skeletal Anchorage System. J Clin Orthod. 2009 Feb;43(2):97-105.
  6. Frost HM. The regional acceleratory phenomenon: a review. Henry Ford Hosp Med J. 1983;31(1):3-9. Review.
  7. Hernandez-Alfaro F, Guijarro-Martinez R, Peiro-Guijarro MA. Surgery first in orthognathic surgery: what have we learned? A comprehensive workflow based on 45 consecutive cases. J Oral Maxillofac Surg. 2014 Feb;72(2):376-90 https://doi.org/10.1016/j.joms.2013.08.013
  8. Costa F, Robiony M, Politi M. Stability of sagittal split ramus osteotomy used to correct Class III malocclusion: review of the literature. Int J Adult Orthodon Orthognath Surg. 2001;16(2):121-9.
  9. Han JJ, Chong JH, Ryu SY, Oh HK, Park HJ, Jung S, Kook MS. Postoperative changes in mandibular position after mandibular setback surgery via the surgery-first approach in relation to the increase of vertical dimension and the amount of mandibular setback. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Dec;122(6):666-671 https://doi.org/10.1016/j.oooo.2016.07.016
  10. Liou EJ, Chen PH, Wang YC, Yu CC, Huang CS, Chen YR. Surgery-first accelerated orthognathic surgery: orthodontic guidelines and setup for model surgery. J Oral Maxillofac Surg. 2011 Mar;69(3):771-80. https://doi.org/10.1016/j.joms.2010.11.011