Comparison of Different Decompensation Approaches on Facial Profile in Orthodontic-Orthognathic Treatment for Skeletal Class III Patients

Linan Liu; Yan Liu; Lichi Han; Chunjie Zhang; Peiyu Hou

doi:10.1007/s00266-023-03546-1

Comparison of Different Decompensation Approaches on Facial Profile in Orthodontic-Orthognathic Treatment for Skeletal Class III Patients

Aesthetic Plast Surg. 2023 Oct;47(5):1957-1966. doi: 10.1007/s00266-023-03546-1. Epub 2023 Aug 14.

Authors

Linan Liu^#^{1

2}, Yan Liu^#^{1

3}, Lichi Han⁴, Chunjie Zhang¹, Peiyu Hou¹

Affiliations

¹ Department of Stomatology of Medical College of Dalian University, No.10 Xuefu Avenue, Development District, Dalian, Liaoning, 116622, China.
² State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
³ Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, Hubei, 430015, China.
⁴ Department of Stomatology of Medical College of Dalian University, No.10 Xuefu Avenue, Development District, Dalian, Liaoning, 116622, China. hanlichi@dlu.edu.cn.

^# Contributed equally.

PMID: 37580561
DOI: 10.1007/s00266-023-03546-1

Abstract

Background: The objective of the present study was to assess the hard and soft tissue differences of skeletal Class III malocclusion patients treated with orthodontic-orthognathic surgery treatment between two decompensation approaches including extraction of maxillary premolars in preoperative orthodontics and clockwise rotation of the maxilla in orthognathic surgery.

Methods: 22 skeletal Class III patients with the crowding of maxillary dental arch less than 3mm were included in this study. These patients were divided into two groups: extraction group and non-extraction group. Lateral cephalograms taken before preoperative orthodontic treatment and after postoperative orthodontic treatment were used to analyze the differences of hard and soft tissues between two groups. Independent t test was used to evaluate the differences of variables between extraction group and non-extraction group.

Results: After treatment, there was significant difference of Wits between extraction group and non-extraction group (- 4.34 mm vs - 2.82 mm, respectively, P <0.05). Co-Gn was significantly greater in non-extraction group than in extraction group (77.18 mm vs 71.58 mm, P <0.05). U1-SN and L1-MP in extraction group were significantly closer to the normal values than non-extraction group (P <0.05). Regarding the change of variables before and after orthodontic-orthognathic treatment, NLA (7.25° vs 1.46°, P <0.01) and G-Sn-Pog' (8.06° vs 4.62°, P <0.05) were significantly greater in extraction group than in non-extraction group.

Conclusion: For patients with skeletal Class III malocclusion, extraction of maxillary premolars in preoperative orthodontic treatment can more effectively eliminate the dental compensation and achieve a more harmonious facial profile compared to clockwise rotation of the maxilla in orthognathic surgery.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Decompensation approach; Orthodontic–orthognathic surgery treatment; Skeletal Class III malocclusion.

MeSH terms

Cephalometry
Humans
Malocclusion, Angle Class III* / surgery
Mandible / surgery
Maxilla / surgery
Orthognathic Surgical Procedures*