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Benington, Philip and Anwar, M. and Mohan, A. and Gillgrass, T. and Ayoub, A. (2024) Outcome measures of the surgery first approach for orthognathic correction of dentofacial deformities. British Journal of Oral and Maxillofacial Surgery, 62 (1). pp. 71-75. ISSN 0266-4356

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The study aimed to assess the treatment durations and occlusal outcomes for patients with dentofacial deformities who underwent orthognathic surgery-first approach. The results showed that the SFA can be effective at correcting both Class 2 and Class 3 malocclusion types with reduced treatment times.

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Abstract

Background: In the surgery-first approach (SFA) the orthognathic surgery is performed without the need for presurgical orthodontic treatment. Aim: This study was aimed at assessing the treatment durations and occlusal outcomes for a consecutive cohort of patients, with a range of dentofacial deformities, who have completed orthognathic treatment using the SFA. Methodology: The duration of orthognathic treatment was measured. The overall change in occlusion, and the quality of the final occlusion, were evaluated using the patients’ study casts. A single independent, calibrated, operator carried out the occlusal scores, using the validated Peer Assessment Rating (PAR) index. This was repeated to test intra-operator reliability. Results: A total of 51 patients completed surgery-first treatment during the study period. The mean age at surgery was 23.3 years. The pre-treatment skeletal jaw relationship was Class III in 39 cases, and Class II in 12 cases. The mean overall treatment duration was 11.7 months (SD = 5.7). The intra-examiner reliability of assessing the occlusion was high. The PAR scores confirmed a significant improvement in the quality of occlusion at the completion of treatment, which compares favourably with previous studies on the conventional orthodontics-first approach. Conclusion: The SFA can be effective at correcting both Class 2 and Class 3 malocclusion types with reduced treatment times.

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