Surgery-first accelerated orthognathic surgery: orthodontic guidelines and setup for model surgery.
The surgery-first approach indicates that the orthognathic surgery precedes the orthodontic treatment, whereas the orthodontics-first approach indicates that the orthodontic treatment precedes the orthognathic surgery. The conventional approach is an orthodontics-first approach. The purposes of this article are to introduce the concept of the surgery-first approach and to report the guidelines for orthodontic management and model surgery without presurgical orthodontic decompensation. The surgery-first approach treats facial esthetics first and then occlusion, whereas the conventional approach treats occlusion first and then facial esthetics. The surgery-first approach uses osteotomy to solve both skeletal problems and dental compensation, and a "transitional" occlusion is set up postoperatively. Orthodontics in the surgery-first approach is a postoperatively adjunctive treatment to transfigure the transitional occlusion into the solid final occlusion. The advantages of the surgery-first approach are that 1) the patient's chief complaint, dental function, and facial esthetics are achieved and improved in the beginning of the treatment; 2) the entire treatment period is shortened to 1 to 1.5 years or fewer depending on the complexity of orthodontic treatment; and 3) the phenomenon of postoperatively accelerated orthodontic tooth movement reduces the difficulty and treatment time of orthodontic management in the surgery-first approach.
Department of Orthodontics and Craniofacial Dentistry, Chang Gung Memorial Hospital, and Graduate Institute of Oral and Craniofacial Medicine, Chang Gung University, Taoyaun, Taiwan. lioueric@ms19.hinet.net
Eric J W
EJ
Liou
Po-Hsung
PH
Chen
Yu-Chih
YC
Wang
Chung-Chih
CC
Yu
C S
CS
Huang
Yu-Ray
YR
Chen
D004955:Esthetics, Dental; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D008313:Malocclusion, Angle Class III / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D008953:Models, Anatomic; D009971:Orthodontics, Corrective / Q000379:methods*; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019340:Osteotomy, Le Fort; D011182:Postoperative Care; D017410:Practice Guidelines as Topic; D013997:Time Factors