title: Evaluation of relapse after orthodontic therapy combined with orthognathic surgery in the treatment of skeletal class III.
abstract: BACKGROUND
  Multidisciplinary treatment of skeletal malocclusion by orthognathic surgery in addition to orthodontics is a routine strategy believed to offer good functional and esthetic outcomes. Postoperative relapse is, however, a problem. The present study was conducted to analyze the stability of outcomes achieved by surgical treatment of skeletal class III patients in terms of the rate and extent of relapses.
  
  
  METHODS
  A total of 30 patients who had undergone orthodontic treatment combined with orthognathic surgery were included. The primary inclusion criterion was a skeletal class III treated by mandibular setback (Obwegeser/Dal Pont) surgery alone or combined with maxillary advancement (Le Fort I) surgery. Analysis was based on one preoperative and two postoperative cephalograms per patient.
  
  
  RESULTS
  We observed relapse (defined, in accordance with Proffit, as changes >2 mm or 2°) at a rate of 24% after bimaxillary procedures, compared to a lower rate of 21% after mandibular setback procedures only. The relapse rate was 21% among patients who had undergone upper-jaw surgery versus 27% among those who had undergone lower-jaw surgery, which was statistically significant.
  
  
  CONCLUSIONS
  The majority of patients exhibited stable treatment outcomes. Maxillary advancement procedures were found to be less susceptible to relapse-resulting in more stable outcomes-and mandibular setback distances correlated positively with the degree of the relapse. No statistically significant differences were observed between the procedures conducted in both jaws versus in the lower jaw only, or in the extent of upper-jaw repositioning.
authors: Department of Orthodontics, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany.
authors: Inken Friederike
authors: IF
authors: de Haan
authors: Robert
authors: R
authors: Ciesielski
authors: Tobias
authors: T
authors: Nitsche
authors: Bernd
authors: B
authors: Koos
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000000981:diagnostic imaging* / Q000628:therapy*; D019186:Mandibular Advancement / Q000379:methods*; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012008:Recurrence; D014087:Tooth Movement Techniques / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
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