Open AccessThree-Dimensional Changes in the Mandibular Proximal Segment After Using a Surgery-First Approach in Patients With Class III Malocclusion and Facial Asymmetry
Author(s) -
MyungSu Kim,
Nayansi Jha,
JaeHong Choi,
Inah Kim,
UiLyong Lee,
Lucía Cevidanes,
Jin-Young Choi,
SeungHak Baek
Publication year - 2022
Publication title -
the journal of craniofacial surgery/the journal of craniofacial surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.515
H-Index - 73
eISSN - 1536-3732
pISSN - 1049-2275
DOI - 10.1097/scs.0000000000008520
Subject(s) - medicine , condyle , orthognathic surgery , facial symmetry , malocclusion , osteotomy , orthodontics , cone beam computed tomography , sagittal plane , cephalometric analysis , dentistry , computed tomography , anatomy , surgery
This study was performed to evaluate condylar position and angulation after asymmetric mandibular setback between a conventional (CA) and surgery-first approach (SFA) using three-dimensional analysis. The condylar positions of 30 patients with skeletal Class III malocclusion and facial asymmetry who underwent 1-jaw (sagittal split ramus osteotomy) or 2-jaw orthognathic surgery (Le Fort I osteotomy and sagittal split ramus osteotomy) with CA (n = 18) or SFA (n = 12) from 2 university hospitals were studied. The three-dimensional assessment of condylar changes was performed using computed tomography images at the initial time point (T0) and at least 6 months after surgery (T1). Segmentation of condyles and cranial base assessment from cone-beam computed tomography images were performed using ITK-SNAP software (version 3.4.0). Condylar position and angulation changes were calculated using 3D Slicer software (version 4.10.2), and statistical analysis was performed. No significant translational or rotational condylar changes were observed between the deviated and non-deviated sides in each group or between the CA and SFA groups except yaw ( p = 0.014). Linear mixed-model analysis and multi-variate analysis showed no significant difference between the CA and SFA groups. Surgery-first approach might not be associated with more harmful effects on the condylar position and angulation changes as compared with CA.