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Year : 2018  |  Volume : 8  |  Issue : 2  |  Page : 270-275

Esthetic outcome and airway evaluation following Bi-Jaw surgery V/S mandibular setback surgery in skeletal class III malocclusion using surgery first approach

1 Department of Orthodontics and Dentofacial Orthopedics, D.A.P.M.R.V Dental College, Bangalore, Karnataka, India
2 Department of Oral and Maxillofacial Surgery, Mar Baselios Dental College, Kothamangalam, Kerala, India

Correspondence Address:
Dr. Bushra Kanwal
Department of Orthodontics and Dentofacial Orthopedics, D.A.P.M.R.V Dental College, 24th Main, JP Nagar 1st Phase, Bengaluru - 560 078, Karnataka
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DOI: 10.4103/ams.ams_152_18

PMID: 30693244

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Background: Class III skeletal deformity is the result of mandibular prognathism, maxillary deficiency, or a combination. Treatment frequently requires a combination of orthodontics and orthognathic surgical procedures to improve facial esthetics and harmonize facial profile. Objectives: The objective of the study is to assess and quantify, by means of cephalometric analysis, the pre- and postoperative soft-tissue and airway changes following bi-jaw surgery and mandibular setback surgery after the correction of skeletal Class III deformities using surgery- first approach. Materials and Methods: Patients with skeletal Class III malocclusion were classified based on the A point–nasion–B point, beta angle, and Witt's appraisal. The cases were divided based on the type of surgery- first orthognathic approach they received. Group A (20 patients) comprised patients who underwent bi-jaw surgery (Le Fort I + bilateral sagittal split osteotomy [BSSO]) and Group B (20 patients) who underwent BSSO alone. After the lateral cephalograms were digitized, the cephalograms were evaluated for soft-tissue changes and airway changes. Results: The soft-tissue response to simultaneous two-jaw surgery was superior to those seen in mandibular setback procedures with the exception of the changes seen in the facial contour angle and soft-tissue facial angle. There was a significant decrease in lower airway in cases treated with mandibular setback alone. Conclusion: Cases treated with bi-jaw surgeries had a significant soft-tissue improvement in the long term compared to mandibular setback surgeries. Since there was a significant reduction in the lower airway in cases treated with isolated mandibular surgeries, bi-jaw surgeries maybe preferred over mandibular setback surgeries.

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