Dental and skeletal changes occurring after orthodontic-surgical treatment of mandibular prognathism

  • Tatjana Čutović Military Medical Academy, Clinic of Dental Medicine, Belgrade, Serbia
  • Jana Ilić Health Center Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Tijana Adamović University of Banja Luka, Faculty of Medicine, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Stevo Matijević University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Julija Radojičić University of Niš, Faculty of Medicine, Niš, Serbia
  • Srboljub Stošić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Keywords: cephalometry, malocclusion, angle class III, mandible, orthognathic surgical procedures, prognathism, treatment outcome

Abstract


Background/Aim. Mandibular prognathism (MPG) is a severe form of facial and jaw deformity. This kind of anomaly usually requires combined orthodontic-surgical treatment. The aim of this study was to determine the changes in the craniofacial complex after orthodontic-surgical treatment of patients with MPG by analyzing the cephalometric parameters on teleradiography images before and after treatment. Methods. The study included a sample of 40 subjects (mean age 24.1 ± 4.1 years) who underwent orthodontic-surgical treatment of MPG. Vertical and sagittal parameters which characterize MPG were measured on profile teleradiography images before and 12 months after treatment. Based on the analysis of cephalometric parameters on preoperative and postoperative teleradiography images, dental and skeletal changes that occurred after treatment were determined. Results. After the end of the treatment, most of the parameter values that characterize MPG were significantly reduced. A drop in values was noted in the following parameters: SNB, SNPg, NS/SpP, NS/MP, SpP/MP, NSAr, ArGoMe, Bjork polygon, NMe, NSna, SnaMe, SSnp, I/SpP. There was a statistically significant increase in the values of the following parameters SNA, ANB, GoArNS, SGo and i/MP. No significant changes in values were recorded on the OP/NS and SArGo parameters. Conclusion. Orthodontic-surgical treatment of MPG leads to changes in the bone and dental structures of the craniofacial system. As a result of such treatment, there is a functional improvement and an improvement in the appearance of the face.

References

1. Čutović T, Jović N, Stojanović Lj, Radojičić J, Mladenović I, Matijević S, et al. A cephalometric analysis of the cranial base and frontal part of the face in patients with mandibular prognathism. Vojnosanit Pregl 2014; 71(6): 534‒41.

2. Li Q, Zhang F, Li X, Chen F. Genome scan for locus involved in mandibular prognathism in pedigrees from China. Plos ONE 2010; 5(9): e12678.

3. Radalj Miličić Z, Kranjčević Bubuica A, Nikolov Borić D, Špalj S, Meštrović S. Linear predictors of facial rotation pattern in Croa-

tian Subjects with skeletal Class III maloclusion. Acta Stomatol Croat 2018; 52(3): 227‒37.

4. Milačić M. Orthodontics: the present for the future. Belgrade: Akademska misao; 2015. (Serbian)

5. Stojanović Lj, Mileusnić I, Mileusnić B, Čutović T. Orthodontic-surgical treatment of the skeletal class III malocclusion: a case report. Vojnosanit Pregl 2013; 70(2): 215‒20.

6. Downarowicz P, Matthews-Brzozowska T, Kawala B, Drohomyretska M. Dynamic changes in morphometric analysis in patients following Class III bimaxillary surgery. Adv Clin Exp Med 2012; 21(1): 93‒7.

7. Johnston CH, Burden D, Kennedy D, Harradine N, Stevenson M. Class III surgical-orthodontic treatment: A cephalometric study. Am J Orthod Dentofac Orthop 2006; 130(3): 300‒9.

8. Sinobad V, Strajnić Lj, Sinobad T. Skeletal changes in patients with mandibular prognathism after mandibular set back and bimaxillary surgery – A comparative cephalometric study. Vojnosanit Pregl 2020; 77(4): 395‒404.

9. Aydil B, Őzer N, Marşan G. Bimaxillary surgery in Class III malocclusion: Soft and hard tissue changes. J Craniomaxillofac Surg 2013; 41(3): 254‒7.

10. Marsan G, Cura N, Emekli U. Soft and hard tissue changes after bimaxillary surgery in Turkish female Class III patients. J Cra-niomaxillofac Surg 2009; 37(1): 8‒17.

11. Kaklamanos EG, Kolokitha OE. Relation between soft tissue and skeletal changes after mandibular setback surgery: A systematic review and meta-analysis. J Craniomaxillofac Surg 2016; 44(4): 427‒35.

12. Khadka A, Liu Y, Li J, Zhu S, Luo E, Feng G, et al. Changes in quality of life after orthognathic surgery: a comparison based on the involvement of the occlusion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112(6): 719‒25.

13. Rezaei F, Masalehi H, Golshah A, Imani MM. Oral health related quality of life of patients with class III skeletal malocclusion before and after orthognathic surgery. BMC Oral Health 2019; 19(1): 289.

14. Zamboni R, de Moura FRR, Brew MC, Rivaldo EG, Braz MA, Grossmann E, et al. Impacts of orthognathic surgery on patient satisfaction, overall quality of life, and oral health-related quali-ty of life: a systematic literature review. Int J Dent 2019; 2019: 2864216.

15. Belusic-Gobic M, Kralj M, Harmicar D, Cerovic R, Mady Maricic B, Spalj S. Dentofacial deformity and orthognathic surgery: Influ-ence on self-esteem and aspects of quality of life. J Cranio-maxillofac Surg 2021; 49(4): 277‒81.

16. Trovik TA, Wisth PJ, Tornes K, Boe OE, Moen K. Patients' per-ceptions of improvements after bilateral sagittal split osteoto-my advancement surgery: 10 to 14 years of follow-up. Am J Orthod Dentofacial Orthop 2012; 141(2): 204‒12.

17. Martino F, Pena M, Joubert R. Surgical-orthodontic retreatment of a severe skeletal Class III malocclusion following an ortho-dontic camouflage. Dental Press J Orthod 2021; 26(4): e2119247.

18. Duarte V, Zaror C, Villanueva J, Werlinger F, Vidal C, Solé P, et al. Changes in health-related quality of life after orthognathic surgery: a multicenter study. Clin Oral Investig 2022; 26(4): 3467‒76.

19. Martinez P, Bellot-Arcis C, Llamas JM, Cibrian R, Gandia JL, Paredes-Gallardo V. Orthodontic camouflage versus orthog-

nathic surgery for Class III deformity: a comparative cephalo-metric analysis. Int J Oral Maxillofac Surg 2017; 46(4): 490‒5.

20. Silva M, Francisco I, Sanz D, Palmeira L, Vale F. Negative social comparisons and social discomfort in dentofacial deformity: a cross-sectional study. Minerva Dent Oral Sci 2021; 70(2): 88‒94.

21. Meger MN, Fatturi AL, Gerber JT, Weiss SG, Rocha JS, Scariot R, et al. Impact of orthognathic surgery on quality of life of pa-tients with dentofacial deformity: a systematic review and me-ta-analysis. Br J Oral Maxillofac Surg 2021; 59(3): 265‒71.

22. Zere E, Chaudhari PK, Sharan J, Dhingra K, Tiwari N. Developing Class III malocclusions: challenges and solutions. Clin Cosmet Investig Dent 2018; 10: 99‒116.

23. Lee JY, Lee SM, Kim SH, Kim Y II. Long-term follow-up of in-tersegmental displacement after orthognathic surgery using cone-beam computed tomographic superimposition. Angle Orthod 2020; 90(4): 548‒55.

24. Čutović T. Mandibular prognathism. Belgrade: Zadužbina An-drejević; 2014. (Serbian)

25. Rustemeyer J, Martin A. Soft tissue response in orthognathic surgery patients treated by bimaxillary osteotomy: cephalome-try compared with 2-D photogrammetry. Oral Maxillofac Surg 2013; 17(1): 33‒41.

26. Rustemeyer J, Martin A. Assessment of soft tissue changes by cephalometry and two-dimensional photogrammetry in bilat-eral sagittal split ramus osteotomy cases. J Oral Maxillofac Res 2011; 2(3): e2.

27. Jacobsone G, Stenvik A, Espeland L. Soft tissue response after Class III bimaxillary surgery. Impact of surgical change in face height and long-term skeletal relapse. Angle Orthod 2013; 83(3): 533‒9.

28. Becker OE, Avelar RL, Dolzan Ado N, Haas OL Jr, Scolari N, Oliveira RB. Soft and hard tissue changes in skeletal Class III patients treated with double-jaw orthognathic surgery-maxillary advancement and mandibular setback. Int J Oral Maxillofac Surg 2014; 43(2): 204‒12.

29. Raschke GR, Rieger UM, Peisker A, Djedovic G, Gomez-Dammeier M, Guentsch A, et al. Morphologic outcome of bimaxillary sur-gery- An anthropometric appraisal. Med Oral Patol Oral Cir Bucal 2015; 20 (1): e103–10.

30. Baherimoghaddam T, Oshagh M, Naseri N, Nasrbadi I, Torkan S. Changes in cephalometric variables after orthognathic surgery and their relationship to patients' Quality of life and satisfac-tion. J Oral Maxillofac Res 2014; 5(4): e6.

31. Chew MT. Soft and hard tissue changes after bimaxillary sur-gery in Chinese Class III patients. Angle Orthod 2005; 75(6): 959‒63.

Published
2023/04/30
Section
Original Paper