Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Evaluation of Postoperative Accuracy and Relapse Extent in Orthognathic Surgery Patients: A Case Control Study
Ortognatik Cerrahi Hastalarında Postoperatif Doğruluğun ve Nüks Miktarının Değerlendirilmesi: Olgu Kontrol Araştırması
Tolgahan KARAa, Nihat AKBULUTa, Sibel AKBULUTb, Ahmet ALTANa
aDepartment of Oral and Maxillofacial Surgery, Tokat Gaziosmanpaşa University Faculty of Dentistry, Tokat, Türkiye
bDepartment of Orthodontics, Tokat Gaziosmanpaşa University Faculty of Dentistry, Tokat, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(3):481-9
doi: 10.5336/dentalsci.2021-86373
Article Language: EN
Full Text
ABSTRACT
 Objective: The success of orthognatic surgery depends on careful physical examination, correct diagnosis and good treatment planning. The aim of this study was to determine the accuracy of presurgical orthognatic planning and postoperative outcomes in single jaw or double jaw orthognathic surgery cases operated on in the Tokat Gaziosmanpaşa University Dentistry Faculty Department of Oral and Maxillofacial Surgery. Material and Methods: A total of 34 Class III patients were grouped in the form of bimaxillary osteotomy (Group 1), single jaw mandibular osteotomy with mandibular set-back (Group 2) and single jaw maxillary osteotomy with maxillary advancement (Group 3). Orthodontic analysis and measurements were performed on preoperative (T0), immediate postoperative (T1), 6 months (T2) and 12 months (T3) lateral cephalometric radiographs. Results: Based on multivariate analyses, there was no statistically significant difference in any of the groups between our T1-T0 values (p>0.05), with the exception of the distance of the ANS point from the vertical reference point (p=0.004). To evaluate the recurrence rates, the values between the T2- T1 and the T3-T1 periods were examined, and were not found to be statistically significant. However in Group 1, T3-T1 differences with regard to VR-ANS (p=0.003) and VR-L1 (p=0.033) showed a statistically significant recurrence. Conclusion: This study showed that the orthognathic surgical plan resulting from the methods we used were transferred to the surgery correctly. In addition, besides the postoperative orthodontic treatment, our techniques for fixation and osteotomy were effective in reducing the potential for relapse.

Keywords: Orthognathic surgery; recurrence; orthodontics
ÖZET
 Amaç: Ortognatik cerrahinin başarısı dikkatli fizik muayene, doğru teşhis ve iyi bir tedavi planlamasına bağlıdır. Bu çalışmanın amacı, Tokat Gaziosmanpaşa Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi Anabilim Dalında opere edilen tek çene veya çift çene ortognatik cerrahi olgularında ameliyat öncesi ortognatik planlamanın ve ameliyat sonrası sonuçların doğruluğunu belirlemektir. Gereç ve Yöntemler: Toplam 34 Sınıf III hasta, çift çene osteotomi yapılanlar (Grup 1), tek çene mandibular geriletme yapılanlar (Grup 2) ve tek çene maksiller ilerletme yapılanlar (Grup 3) olarak gruplandırılmıştır. Operasyon öncesinde (T0), operasyonun hemen sonrasında (T1), 6. ay (T2) ve 12. aylarda ortodontik analiz ve ölçümler yapılmıştır. Bulgular: Çoklu değişken analizlerine göre ANS noktasının dikey referans noktasına olan mesafesi (p=0,004) dışında, T1-T0 değerlerimiz arasında (p>0,05) grupların hiçbirinde istatistiksel olarak anlamlı bir fark yoktu. Nüks oranlarını değerlendirmek için T2-T1 ve T3-T1 dönemleri arasındaki değerlere bakılmış ve istatistiksel olarak anlamlı bulunmamıştır. Ancak Grup 1'de VR-ANS (p=0,003) ve VRL1 (p=0,033) açısından T3-T1 farklılıkları istatistiksel olarak anlamlı bir nüks görülmüştür. Sonuç: Bu çalışma, kullandığımız yöntemlerle oluşturulan ortognatik cerrahi planın operasyona başarıyla aktarıldığını göstermektedir. Ayrıca postoperatif ortodontik tedavinin yanı sıra osteotomi ve fiksasyon yöntemlerimizin de nüksü önlemede etkili olduğu görülmektedir.

Anahtar Kelimeler: Ortognatik cerrahi; nüks; ortodonti
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