Our Summary

This research paper is about a study that compared two different surgical approaches for two types of jaw surgeries. The two surgical methods compared were the conventional surgical approach (CSA) and the surgery-first approach (SFA). The two types of jaw surgeries they looked at were traditional orthognathic osteotomies (where they cut and move parts of the upper and/or lower jaw to correct deformities) and anterior segmental osteotomies (where they cut and move the front part of the jaw).

The study was done by looking back at patients who had these surgeries at the Hanoi Plastic Surgery Center between 2000 and 2012. They looked at how long treatment took and whether there were any complications or relapses.

The study found that the surgery-first approach (SFA) was just as effective as the conventional approach (CSA). There were no significant differences in the rates of complications or relapses between the two methods for the traditional jaw surgery. For the anterior segmental osteotomy, there were no complications or relapses at all.

However, the really interesting finding was that the surgery-first approach significantly shortened the total treatment time for both types of surgeries. This suggests that the surgery-first approach could be a better option because it’s just as effective and takes less time.

FAQs

  1. What is the difference between the conventional surgical approach (CSA) and the surgery-first approach (SFA) in orthognathic surgery?
  2. Was there a significant difference in complication or relapse rates between CSA and SFA in the study?
  3. Does the surgery-first approach reduce the total treatment time for orthognathic osteotomies and anterior segmental osteotomies?

Doctor’s Tip

A helpful tip a doctor might tell a patient about orthognathic surgery is to consider the surgery-first approach (SFA) as it can result in a shorter treatment time compared to the conventional surgical approach (CSA). This approach has been shown to achieve similar clinical outcomes with lower rates of complication and relapse. It is important to discuss all options with your surgeon to determine the best approach for your individual case.

Suitable For

Orthognathic surgery is typically recommended for patients with skeletal discrepancies in their jaws, such as underbites, overbites, crossbites, and open bites. These discrepancies can lead to issues with chewing, speaking, and breathing, as well as facial aesthetic concerns. Patients with these conditions may also experience temporomandibular joint (TMJ) pain, headaches, and sleep apnea.

In addition, orthognathic surgery may be recommended for patients with facial asymmetry, congenital craniofacial anomalies, or orthodontic problems that cannot be corrected with braces alone. Patients who have completed their growth and have good oral hygiene are generally considered good candidates for orthognathic surgery.

It is important for patients considering orthognathic surgery to undergo a thorough evaluation by a team of oral and maxillofacial surgeons, orthodontists, and other specialists to determine if surgery is the best treatment option for their specific condition.

Timeline

Before orthognathic surgery:

  1. Patient undergoes a consultation with an orthodontist and oral surgeon to discuss the need for surgery and potential treatment options.
  2. Patient undergoes pre-surgical orthodontic treatment to align teeth and prepare for surgery.
  3. Patient undergoes pre-surgical testing and evaluation to ensure they are a good candidate for surgery.
  4. Patient undergoes orthognathic surgery to correct jaw deformities, which may include LeFort/BSSO or ASO procedures.
  5. Patient may experience pain, swelling, and discomfort following surgery.
  6. Patient follows post-operative instructions for recovery, including a soft diet and oral hygiene protocols.

After orthognathic surgery:

  1. Patient attends follow-up appointments with the orthodontist and oral surgeon to monitor healing and progress.
  2. Patient continues with post-surgical orthodontic treatment to fine-tune the bite and ensure long-term stability.
  3. Patient may experience changes in facial appearance as swelling decreases and the jaw settles into its new position.
  4. Patient may need to wear retainers or other orthodontic appliances to maintain the results of surgery.
  5. Patient may experience improved facial aesthetics, better bite function, and increased self-confidence as a result of orthognathic surgery.
  6. Patient may require additional procedures or adjustments in the future to maintain the results of surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with orthognathic surgery?
  2. How long is the recovery period after orthognathic surgery?
  3. What type of anesthesia will be used during the surgery?
  4. Will I need to follow a specific diet or take any medications after the surgery?
  5. How will orthognathic surgery improve my bite and facial appearance?
  6. Are there any alternative treatment options to orthognathic surgery?
  7. Will I need braces before or after the surgery?
  8. How many orthognathic surgeries have you performed, and what is your success rate?
  9. What is the expected outcome of the surgery in terms of facial aesthetics and function?
  10. How long will the results of the surgery last?

Reference

Authors: Hoang TA, Lee KC, Chuang SK. Journal: J Craniofac Surg. 2021 Mar-Apr 01;32(2):e153-e156. doi: 10.1097/SCS.0000000000006942. PMID: 33705057