World Journal of Dentistry

Register      Login

VOLUME 8 , ISSUE 4 ( July-August, 2017 ) > List of Articles

REVIEW ARTICLE

Surgery-first Approach

Yash A Shah, Shailesh V Deshmukh, Amol S Patil

Citation Information : Shah YA, Deshmukh SV, Patil AS. Surgery-first Approach. World J Dent 2017; 8 (4):343-350.

DOI: 10.5005/jp-journals-10015-1462

Published Online: 01-10-2017

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Aim

This article is intended to provide an overview of the Surgery First Approach (SFA) mainly including case selection, diagnosis, treatment protocols, success rate and the potential problems encountered.

Background

The most important indication of the need for orthognathic surgery is usually the psychosocial effect resulting from the unaesthetic appearance of a dentofacial deformity. The conventional approach in treatment of such deformities till today has been an orthodontics-first approach.

Review Results

Available evidence suggest that both the SFA and the conventional approach had similar outcomes in dentofacial relationships however the relapse tendency was greater with the SFA but the total treatment duration was substantially shorter.

Conclusion

SFA treats facial aesthetics (and the skeletal malrelation) first and then occlusion, i.e. orthognathic surgery antecedes the orthodontic therapy. The concept of this technique is to utilize orthognathic surgery to eliminate the displeasing pre-surgical facial profile and promptly accomplish facial aesthetic enhancement that is usually the patient's chief complaint at the beginning of the treatment. SFA also facilitates accelerated orthodontic tooth movement thus reducing the length of post-surgical orthodontic therapy.

Clinical Significance

The optimal esthetic and functional results, significant reduction in total treatment time and high patient satisfaction led us to the postulation that SFA may represent a reasonable, cost-effective method to manage skeletal malocclusions in selected cases and that it has the potential to become a standard approach to orthognathic surgery in the future.

How to cite this article

Shah YA, Deshmukh SV, Patil AS. Surgery-first Approach. World J Dent 2017;8(4):343-350.


PDF Share
  1. Surgery first orthognathic approach for skeletal Class III malocclusion corrections—a literature review. J Med Assoc Thai 2012 Nov;95(Suppl 11):S172-S180.
  2. Surgery-first orthognathic surgery: beyond patients’ satisfaction. J Korean Assoc Oral Maxillofac Surg 2012;38:319-320.
  3. A surgery-first approach in surgical-orthodontic treatment of mandibular prognathism—a case report. Chang Gung Med J 2010 Nov-Dec;33(6):699-705.
  4. Surgery-first accelerated orthognathic surgery: orthodontic guidelines and setup for model surgery. J Oral Maxillofac Surg 2011 Mar;69(3):771-780.
  5. “Surgery first” in bimaxillary orthognathic surgery. J Oral Maxillofac Surg 2011 Jun;69(6):e201-e207.
  6. ; Mahdavie, NN.; Evans, CA. Guidelines for ‘surgery first’ orthodontic treatment. In: Bourzgui F, editor. Orthodontics-basic aspects and clinical considerations. Rijeka: In Tech; 2012. Available from: http://www.intechopen.com/books/orthodontics-basicaspects-and-clinical-considerations/orthodontic-guidelines-for-the-surgery-first-treatment-ofseveremalocclusions. [Last accessed 12/10/2016]
  7. Surgery first in orthognathic surgery: What have we learned? A comprehensive workflow based on 45 consecutive cases. J Oral Maxillofac Surg 2014 Feb;72(2):376-390.
  8. Surgery-first approach on patients with temporomandibular joint disease by intraoral vertical ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol 2013 Dec;116(6):e429-e436.
  9. The surgeryfirst approach in orthognathic surgery: a retrospective study of 50 cases. Int J Oral Maxillofac Surg 2015 Dec;44(12):1463-1467.
  10. Skeleton first in surgical treatment of facial disharmony. J Craniofac Surg 2015 Mar;26(2):336-339.
  11. Surgery-first approach in skeletal class III malocclusion treated with 2-jaw surgery: evaluation of surgical movement and postoperative orthodontic treatment. J Craniofac Surg 2010 Mar;21(2):332-338.
  12. Anticipated benefit: a new protocol for orthognathic surgery treatment that eliminates the need for conventional orthodontic preparation. Dent Press J Orthod 2010 Jan-Feb;15(1):144-157.
  13. Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement. J Oral Maxillofac Surg 2011 Mar;69(3):781-785.
  14. Evaluation of post-surgical relapse after mandibular setback surgery with minimal orthodontic preparation. J Craniomaxillofac Surg 2013 Jul;41(1):47-51.
  15. Skeletal and dental variables related to the stability of orthognathic surgery in skeletal Class III malocclusion with a surgery-first approach. J Oral Maxillofac Surg 2013 May;71(5):e215-e223.
  16. Expedited correction of significant dentofacial asymmetry using a “surgery first” approach. J Clin Orthod 2010 Feb;44(2):97-103.
  17. Surgery first in orthognathic surgery: a systematic review of the literature. Am J Orthod Dentofac Orthop 2016 Apr;149(4):448-462.
  18. New clinical protocol to evaluate craniomaxillofacial deformity and plan surgical correction. J Oral Maxillofac Surg 2009 Oct;67(10):2093-2106.
  19. Planning the surgery-first approach in surgical-orthodontic treatment with a computer aided surgical simulation (CASS) planning protocol. J Taiwan Assoc Orthod 2012;24(2):24-37.
  20. Comparison of progressive cephalometric changes and postsurgical stability of skeletal Class III correction with and without presurgical orthodontic treatment. J Oral Maxillofac Surg 2011 May;69(5):1469-1477.
  21. On a definition of the appropriate timing for surgical intervention in orthognathic surgery. Int J Oral Maxillofac Surg 2014 Jul;43(7):846-855.
  22. Systematic review of the surgery-first approach in orthognathic surgery. Biomed J 2014 Jul-Aug;37(4):184-190.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.