The surgery-first approach for orthognathic correction of maxillary deficiency—is it stable? Three-dimensional assessment of CBCT scans and digital dental models

Saghafi, H. , Benington, P., Ju, X. and Ayoub, A. (2024) The surgery-first approach for orthognathic correction of maxillary deficiency—is it stable? Three-dimensional assessment of CBCT scans and digital dental models. International Journal of Oral and Maxillofacial Surgery, (doi: 10.1016/j.ijom.2024.02.006) (Early Online Publication)

Abstract

The aim of this study was to determine the skeletal stability of Le Fort I maxillary advancement following the surgery-first approach, by three-dimensional (3D) assessment of cone beam computed tomography (CBCT) scans and digital dental models. CBCT scans of 25 class III patients obtained 1 week preoperatively (T0) and 1 week (T1) and 6 months (T2) postoperatively were superimposed to measure surgical movements (T0–T1) and skeletal relapse (T1–T2). The distorted dentition of the CBCT scans at T1 was replaced with 3D images of the dental models to assess the postoperative occlusion. Surgical movements of the maxilla (mean ± standard deviation values) were 6.79 ± 2.30 mm advancement, 1.28 ± 1.09 mm vertically, and 0.71 ± 0.79 mm mediolaterally. Horizontal rotation (yaw) was 1.56° ± 1.21°, vertical rotation (pitch) 1.86° ± 1.88°, and tilting (roll) 1.63° ± 1.54°. At T2, the posterior relapse was 0.72 ± 0.43 mm (P = 0.001) and relapse in pitch was 1.56° ± 1.42° (P = 0.007). There was no correlation between the size of the surgical movements and the amount of relapse. A weak correlation was noted between the number of teeth in occlusal contact immediately following surgery and relapse of maxillary roll (r = − 0.434, P = 0.030). The stability of maxillary advancement with the surgery-first approach was satisfactory and was not correlated with the quality of the immediate postoperative occlusion.

• Item Type: Articles
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ju, Dr Xiangyang and Saghafi, Hamideh and Ayoub, Professor Ashraf and Benington, Mr Philip
• Authors: Saghafi, H., Benington, P., Ju, X., and Ayoub, A.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: International Journal of Oral and Maxillofacial Surgery
• Publisher: Elsevier
• ISSN: 0901-5027
• ISSN (Online): 1399-0020
• Published Online: 05 March 2024
• Copyright Holders: Copyright © 2024 The Author(s)
• First Published: First published in International Journal of Oral and Maxillofacial Surgery 2024
• Publisher Policy: Reproduced under a Creative Commons licence