Orthognathic surgery-first approach with lingual appliances: a case report

Pamukçu, Hande; Özsoy, Serhat; Tüz, Hakan H.; Polat-Özsoy, Ömur

doi:10.21307/aoj-2022.001

Abstract

Background

A surgery-first approach has many advantages related to a shortened treatment time and an immediate facial aesthetic improvement compared to a three-stage conventional orthognathic surgery protocol.

Objective

The aim of this case report was to describe the treatment of a 21-year-old, female, patient who presented with a skeletal Class III malocclusion, maxillary retrusion, a negative overjet, an anterior and bilateral posterior cross-bite, and a vertical facial pattern highlighted by a high mandibular plane angle.

Methods

Orthodontic treatment was performed using self-ligating lingual appliances and a surgery-first approach. The active treatment time was 16 months.

Results and conclusion

Successful treatment results were achieved using a combination of an orthognathic surgery-first approach and lingual appliances in a patient with high aesthetic expectations.

References

Baek SH, Ahn HW, Kwon YH, Choi JY. Surgery-first approach in skeletal class III malocclusion treated with 2-jaw surgery: Evaluation of surgical movement and postoperative orthodontic treatment. J Craniofac Surg 2010;21:332–8.
Search in Google Scholar Back to article
Uribe F, Adabi S, Janakiraman N, Allareddy V, Steinbacher D, Shafer D, et al. Treatment duration and factors associated with the surgery-first approach: a two-center study. Prog Orthod 2015;16:29.
Search in Google Scholar Back to article
Bourzgui F. Orthodontics: Basic aspects and clinical considerations. Rijeka, Croatia: InTech; 2012265–300.
Search in Google Scholar Back to article
Brugnami F, Caiazzo A, Dibart S. Lingual orthodontics: accelerated realignment of the social six with piezocision. Compend Contin Educ Dent 2013;34:608–10.
Search in Google Scholar Back to article
Gu Y, McNamara JA, Sigler LM, Baccetti T. Comparison of craniofacial characteristics of typical Chinese and Caucasian young adults. Eur J Orthod 2011;33:205–11.
Search in Google Scholar Back to article
Ricketts RM. Perspectives in the clinical application of cephalometrics the first fifty years. Angle Orthod 1981;51:115–50.
Search in Google Scholar Back to article
Peiró-Guijarro MA, Guijarro-Martínez R, Hernández-Alfaro F. Surgery first in orthognathic surgery: A systematic review of the literature. Am J Orthod Dentofac Orthop 2016;149:448–62.
Search in Google Scholar Back to article
Dingman RO. Surgical correction of mandibular prognathism, an improved method. Am J Orthod Oral Surg 1944;30:683–92.
Search in Google Scholar Back to article
Hernández-Alfaro F, Guijarro-Martínez R, Peiró-Guijarro MA. Surgery first in orthognathic surgery: What have we learned ? A comprehensive workflow based on 45 consecutive cases. J Oral Maxillofac Surg 2014;72:376–90.
Search in Google Scholar Back to article
Choi JW, Lee JY, Yang SJ, Koh KS. The reliability of a surgery-first orthognathic approach without presurgical orthodontic treatment for skeletal Class III dentofacial deformity. Ann Plast Surg 2015;74:333–41.
Search in Google Scholar Back to article
Naini FB, Gill DS. Orthognathic surgery: principles, planning and practice Oxford: Wiley-Blackwell; 2017663–74.
Search in Google Scholar Back to article
Hernández-Alfaro F, Guijarro-Martínez R, Molina-Coral A, Badía-Escriche C. “Surgery first” in bimaxillary orthognathic surgery. J Oral Maxillofac Surg 2011;69:e201–e207.
Search in Google Scholar Back to article
Park H-M, Lee Y-K, Choi J-Y, Baek S-H. Maxillary incisor inclination of skeletal Class III patients treated with extraction of the upper first premolars and two-jaw surgery: Conventional orthognathic surgery vs surgery-first approach. Angle Orthod 2014;84:720–9.
Search in Google Scholar Back to article
Ko EWC, Hsu SSP, Hsieh HY, Wang YC, Huang CS, Chen YR. Comparison of progressive cephalometric changes and postsurgical stability of skeletal Class III correction with and without presurgical orthodontic treatment. J Oral Maxillofac Surg 2011;69:1469–77.
Search in Google Scholar Back to article
Kim C-S, Lee S-C, Kyung H-M, Park H-S, Kwon T-G. Stability of mandibular setback surgery with and without presurgical orthodontics. J Oral Maxillofac Surg 2014;72:779–87.
Search in Google Scholar Back to article
Vanarsdall RL. Transverse dimension and long-term stability. Semin Orthod 1999;5:171–80.
Search in Google Scholar Back to article
Liou EJW, Chen P-H, Wang Y-C, Yu C-C, Huang CS, Chen Y-R. Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement. J Oral Maxillofac Surg 2011;69:781–5.
Search in Google Scholar Back to article
Nagasaka H, Sugawara J, Kawamura H, Nanda R. Surgery first skeletal Class III correction using the skeletal anchorage system. J Clin Orthod 2009;43:97–105.
Search in Google Scholar Back to article
Johnston C, Hunt O, Burden D, Stevenson M, Hepper P. Self-perception of dentofacial attractiveness among patients requiring orthognathic surgery. Angle Orthod 2010;80:361–6.
Search in Google Scholar Back to article
Pelo S, Gasparini G, Garagiola U, Cordaro M, Di Nardo F, Staderini E, et al. Surgery-first orthognathic approach vs traditional orthognathic approach: Oral health-related quality of life assessed with 2 questionnaires. Am J Orthod Dentofac Orthop 2017;152:250–4.
Search in Google Scholar Back to article
Yaffe A, Fine N, Binderman I. Regional accelerated phenomenon in the mandible following mucoperiosteal flap surgery. J Periodontol 1994;65:79–83.
Search in Google Scholar Back to article
Dibart S, Yee C, Surmenian J, Sebaoun JD, Baloul S, Goguet-Surmenian E, et al. Tissue response during Piezocision-assisted tooth movement: A histological study in rats. Eur J Orthod 2014;36:457–64.
Search in Google Scholar Back to article
Martos Diaz P, Gonzalez Garcia R, Naval Gias L, Aguirre-Jaime A, Sastre Pérez J, Mancha de la Plata M, et al. Time used for orthodontic surgical treatment of dentofacial deformities in white patients. J Oral Maxillofac Surg 2010;68:88–92.
Search in Google Scholar Back to article
Jeong WS, Choi JW, Kim DY, Lee JY, Kwon SM. Can a surgery-first orthognathic approach reduce the total treatment time?. Int J Oral Maxillofac Surg 2017;46:473–82.
Search in Google Scholar Back to article
Pelo S, Saponaro G, Patini R, Staderini E, Giordano A, Gasparini G, et al. Risks in surgery-first orthognathic approach. Eur Rev Med Pharmacol Sci 2017;21:4–12.
Search in Google Scholar Back to article
Villegas C, Uribe F, Sugawara J, Nanda R. Expedited correction of significant dentofacial asymmetry using a “surgery first” approach. J Clin Orthod 2010;44:97–103.
Search in Google Scholar Back to article
Yu CC, Chen PH, Liou EJW, Huang CS, Chen YR. A surgery-first approach in surgical-orthodontic treatment of mandibular prognathism—a case report. Chang Gung Med J 2010;33:699–705.
Search in Google Scholar Back to article
Echarri P. Lingual orthodontics: patient selection and diagnostic considerations. Semin Orthod 2006;12:160–6.
Search in Google Scholar Back to article
Liao Y-F, Chiu Y-T, Huang C-S, Ko EW-C, Chen Y-R. Presurgical orthodontics versus no presurgical orthodontics: treatment outcome of surgical-orthodontic correction for skeletal Class III open bite. Plast Reconstr Surg 2010;126:2074–83.
Search in Google Scholar Back to article
Ko EW-C, Lin SC, Chen YR, Huang CS. Skeletal and dental variables related to the stability of orthognathic surgery in skeletal Class III malocclusion with a surgery-first approach. J Oral Maxillofac Surg 2013;71:e215–e223.
Search in Google Scholar Back to article
Creekmore T. Lingual orthodontics—its renaissance. Am J Orthod Dentofac Orthop 1989;96:120–37.
Search in Google Scholar Back to article
Geron S, Wasserstein A, Geron Z. Stability of anterior open bite correction of adults treated with lingual appliances. Eur J Orthod 2013;35:599–603.
Search in Google Scholar Back to article