畸形,Ⅲ类错 畸形," /> 畸形,Ⅲ类错 畸形,"/> Application and research progress of the surgery-first approach in the treatment of dento-maxillofacial deformities

Journal of Prevention and Treatment for Stomatological Diseases ›› 2019, Vol. 27 ›› Issue (11): 733-738.doi: 10.12016/j.issn.2096-1456.2019.11.009

• Review Articles • Previous Articles     Next Articles

Application and research progress of the surgery-first approach in the treatment of dento-maxillofacial deformities

LIU Jiaqi,CAO Zhiwei,BI Ruiye()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2019-05-25 Revised:2019-08-02 Online:2019-11-20 Published:2019-12-03
  • Contact: Ruiye BI E-mail:david-bry@foxmail.com

Abstract:

For patients with dento-maxillofacial deformities who receive orthodontic-orthognathic combined treatment, the conventional treatment approach is preoperative orthodontic-orthognathic surgery-postoperative orthodontics. However, with the development of techniques used in orthodontic and orthognathic treatment, the surgery-first approach (SFA), namely, orthodontic surgery-postoperative orthodontics, has been widely used currently and displays several advantages, such as improving the treatment efficiency and providing patients with more satisfaction. This review provides a brief discussion and review of SFA concerning its development, indications, advantages and disadvantages, outcomes and stability, and the application and research progress of SFA in orthodontic-orthognathic combined treatment for patients with maxillofacial deformity. The literature review results showed that compared with the conventional treatment approach, SFA has relatively strict indications, which usually include patients with skeletal class Ⅱ/Ⅲ malocclusion, skeletal open bite, and bimaxillary protrusion or patients with facial asymmetry but who require little preoperative orthodontic treatment or removal of the compensation of the dental arch, specifically as follows: ①well-aligned to mildly crowded anterior teeth, ②flat to mild curve of Spee, ③normal to mildly proclined/retroclined incisor inclination, ④acceptable arch coordination, ⑤extensive occlusal contact between the upper and lower dentition requiring at least 3 occlusal contacts. Any occlusion that may affect the outcome of surgery or final result of the overall treatment, as well as any disease that may jeopardize the healing process after surgery, is regarded as a contraindication. Furthermore, SFA has potential disadvantages, such as a possible higher incidence of complications, including unstable occlusion and malunion of bones, which still require further research to be confirmed. Most researchers believe that no significant difference occurs between the outcome and stability of the two approaches. However, currently, we still need a sufficient sample size of prospective studies to provide accurate evidence.

Key words: State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases;, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

CLC Number: 

  • R783.5

Table 1

Summary of SFA stability in different literature evaluations"

作者,年份 研究类型 纳入评价文献数量 样本量 结论
Kim等,2014[29] 回顾性
队列研究

61(传统治疗模式38例,
SFA 23例)
对于下颌前突并行下颌支矢状骨劈开术的患者,SFA的稳定性较传统治疗模式差
Huang等,2014[11] 系统评价 14 在横向、垂直向和矢状向上,SFA能取得相同或更好的稳定性
Peiro-Guijarro等,2016[17] 系统评价 11 SFA稳定且可预测的,但其稳定性不如传统治疗模式
Jeong等,2017[4] 回顾性
队列研究
155(传统治疗模式51例,
SFA 104例)
SFA与传统治疗模式中颌骨在前后向的长期稳定性无明显差异
Jeong等,2018[25] 回顾性
队列研究
155(传统治疗模式51例,
SFA 104例)
SFA与传统治疗模式中颌骨在垂直向的长期稳定性无明显差异
Seifi等,2018[21] 系统评价 7 对于骨性Ⅲ类错 畸形的患者两种治疗模式的稳定性无明显差异
Soverina等,2019[26] 系统评价 14 两种治疗模式中正颌手术的治疗效果是一样稳定的
[1] Mahmood HT, Ahmed M, Fida M , et al. Concepts, protocol,variations and current trends in surgery first orthognathic approach: a literature review[J]. Dental Press J Orthod, 2018,23(3):36.
doi: 10.1590/2177-6709.23.3.36.e1-6.onl pmid: 30088563
[2] Liou EJ, Chen PH, Wang YC , et al. Surgery-first accelerated orthognathic surgery: orthodontic guidelines and setup for model surgery[J]. J Oral Maxillofac Surg, 2011,69(3):771-780.
doi: 10.1016/j.joms.2010.11.011 pmid: 21257249
[3] Uribe F, Agarwal S, Shafer D , et al. Increasing orthodontic and orthognathic surgery treatment efficiency with a modified surgery-first approach[J]. Am J Orthod Dentofacial Orthop, 2015,148(5):838-848.
doi: 10.1016/j.ajodo.2014.10.038 pmid: 26522045
[4] Jeong WS, Lee JY, Choi JW . Large-scale study of long-term anteroposterior stability in a surgery-first orthognathic approach without presurgical orthodontic treatment[J]. J Craniofac Surg, 2017,28(8):2016-2020.
doi: 10.1097/SCS.0000000000003853 pmid: 28891895
[5] Nagasaka H, Sugawara J, Kawamura H , et al. "Surgery first" skeletal Class Ⅲ correction using the skeletal anchorage system[J]. J Clin Orthod, 2009,43(2):97-105.
pmid: 19276579
[6] Hernández-Alfaro F, Guijarro-Martinez R . On a definition of the appropriate timing for surgical intervention in orthognathic surgery[J]. Int J Oral Maxillofac Surg, 2014,43(7):846-855.
doi: 10.1016/j.ijom.2014.02.007 pmid: 24631424
[7] Yu HB, Mao LX, Wang XD , et al. The surgery-first approach in orthognathic surgery: a retrospective study of 50 cases[J]. Int J Oral Maxillofac Surg, 2015,44(12):1463-1467.
[8] 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.2017.01.020 pmid: 28232010
[9] Junji S, Zaher A, Dorth Hiroshi N , et al. "Surgery first" orthognathics to correct a skeletal class Ⅱ malocclusion with an impinging bite[J]. J Clin Orthod, 2010,44(7):429-438.
pmid: 21038796
[10] Kochar GD, Chakranarayan A, Londhe SM , et al. Management of skeletal Class Ⅱ malocclusion by surgery-first approach[J]. J Craniofac Surg, 2017,28(1):e40-e43.
doi: 10.1097/SCS.0000000000003257 pmid: 28060199
[11] 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 pmid: 25116713
[12] 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 pmid: 23838836
[13] Choi JW, Bradley JP . Surgery first orthognathic approach without presurgical orthodontic treatment: questions and answers[J]. J Craniofac Surg, 2017,28(5):1330-1333.
doi: 10.1097/SCS.0000000000003733 pmid: 28582307
[14] Kim YK . Complications associated with orthognathic surgery[J]. J Korean Assoc Oral Maxillofac Surg, 2017,43(1):3-15.
doi: 10.5125/jkaoms.2017.43.1.3 pmid: 28280704
[15] Park HM, Lee YK, Choi JY , et al. 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[J]. Angle Orthod, 2014,84(4):720-729.
doi: 10.2319/072113-529.1 pmid: 24274956
[16] Kim JY, Jung HD, Kim SY , et al. Postoperative stability for surgery-first approach using intraoral vertical ramus osteotomy: 12 month follow-up[J]. Br J Oral Maxillofac Surg, 2014,52(6):539-544.
doi: 10.1016/j.bjoms.2014.03.011 pmid: 24746355
[17] Peiro-Guijarro MA, Guijarro-Martinez R, Hernandez-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 pmid: 27021449
[18] Hernández-Alfaro F, Nieto MJ, Ruiz-Magaz V , et al. Inferior subapical osteotomy for dentoalveolar decompensation of class Ⅲ malocclusion in ′surgery-first′ and ′surgery-early′ orthognathic treatment[J]. Int J Oral Maxillofac Surg, 2017,46(1):80-85.
doi: 10.1016/j.ijom.2016.09.026 pmid: 27780642
[19] 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]. J Oral Maxillofac Surg, 2014,72(2):376-390.
doi: 10.1016/j.joms.2013.08.013 pmid: 24139292
[20] Yu CC, Chen PH, Liou EJ , et al. A surgery-first approach in surgical-orthodontic treatment of mandibular prognathism--a case report[J]. Biomed J, 2010,33(6):699-705.
doi: 10.1097/SCS.0000000000005491 pmid: 30939558
[21] Seifi M, Matini NS, Motabar AR , et al. Dentoskeletal stability in conventional orthognathic surgery, presurgical orthodontic treatment and surgery-first approach in Class-Ⅲ patients[J]. World J Plast Surg, 2018,7(3):283-293.
doi: 10.29252/wjps.7.3.283. pmid: 30560066
[22] Frost HM . The biology of fracture healing. An overview for clinicians. Part I[J]. ClinOrthop RelatRes, 1989,248:283-293.
pmid: 2680202
[23] Frost HM . The biology of fracture healing. An overview for clinicians. Part Ⅱ[J]. Clin Orthop Related Res, 1989,248:294-309.
pmid: 2680203
[24] 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 pmid: 21353934
[25] 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[J]. J Craniofac Surg, 2018,29(4):953-958.
doi: 10.1097/SCS.0000000000004433 pmid: 29521747
[26] Soverina D, Gasparini G, Pelo S , et al. Skeletal stability in orthognathic surgery with the surgery first approach: a systematic review[J]. Int J Oral Maxillofac Surg, 2019,48(7):930-940.
doi: 10.1016/j.ijom.2019.01.002 pmid: 30685226
[27] Huang CS, Chen YR . Orthodontic principles and guidelines for the surgery-first approach to orthognathic surgery[J]. Int J Oral Maxillofac Surg, 2015,44(12):1457-1462.
doi: 10.1016/j.ijom.2015.05.023 pmid: 26573565
[28] Huang S, Chen W, Ni Z , et al. The changes of oral health-related quality of life and satisfaction after surgery-first orthognathic approach: a longitudinal prospective study[J]. Head Face Med, 2016,12(1):1-7.
doi: 10.1186/s13005-015-0098-1 pmid: 26729274
[29] 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.
pmid: 28121363
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