Korean J Orthod.  2022 Jan;52(1):66-74. 10.4041/kjod.2022.52.1.66.

Comparison of one-jaw and two-jaw orthognathic surgery in patients with skeletal Class III malocclusion using data from 10 multi-centers in Korea: Part I. Demographic and skeletodental characteristics

• Lim SW
• Kim M
• Hong M
• Kang KH
• Kim M
• Kim SJ
• Kim YJ
• Kim YH
• Lim SH
• Sung SJ
• Baek SH
• Cho JH

• KMID: 2524903
• DOI: http://doi.org/10.4041/kjod.2022.52.1.66

Abstract

Objective
To investigate demographic and skeletodental characteristics of one-jaw (1J-OGS) and two-jaw orthognathic surgery (2J-OGS) in patients with skeletal Class III malocclusion.
Methods
750 skeletal Class III patients who underwent OGS at 10 university hospitals in Korea between 2015 and 2019 were investigated; after dividing them into the 1J-OGS (n = 186) and 2J-OGS groups (n = 564), demographic and skeletodental characteristics were statistically analyzed.
Results
2J-OGS was more frequently performed than 1J-OGS (75.2 vs. 24.8%), despite regional differences (capital area vs. provinces, 86.6 vs. 30.7%, p < 0.001). Males outnumbered females, and their mean operation age was older in both groups. Regarding dental patterns, the most frequent maxillary arch length discrepancy (ALD) was crowding in the 1J-OGS group (52.7%, p < 0.001) and spacing in the 2J-OGS group (40.4%, p < 0.001). However, the distribution of skeletal pattern was not significantly different between the two groups (all p > 0.05). The most prevalent skeletal patterns in both groups were hyper-divergent pattern (50.0 and 54.4%, respectively) and left-side chin point deviation (both 49.5%). Maxillary spacing (odds ratio [OR], 3.645; p < 0.001) increased the probability of 2J-OGS, while maxillary crowding (OR, 0.672; p < 0.05) and normo-divergent pattern (OR, 0.615; p < 0.05) decreased the probability of 2J-OGS.
Conclusions
In both groups, males outnumbered females, and their mean operation age was older. The most frequent ALD was crowding in the 1J-OGS group, and spacing in the 2J-OGS group, while skeletal characteristics were not significantly different between the two groups.

Keyword

Class III orthognathic surgery; Class III diagnosis; Class III treatment

Figure

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  Figure 1 Frequency of 1J-OGS and 2J-OGS in 10 University Hospitals. AMC, AUDH, EUMC, KHUDH, KUAH, and SNUDH were categorized as the capital region hospitals, while CNUDH, CSUDH, KNUDH, and WUDH were categorized as the provincial region hospitals. 1J-OGS, one-jaw orthognathic surgery; 2J-OGS, two-jaw orthognathic surgery; AMC, Asan Medical Center; AUDH, Ajou University Dental Hospital; EUMC, Ewha University Medical Center; KHUDH, Kyung Hee University Dental Hospital; KUAH, Korea University Anam Hospital; SNUDH, Seoul National University Dental Hospital; CNUDH, Chonnam National University Dental Hospital; CSUDH, Chosun University Dental Hospital; KNUDH, Kyungpook National University Dental Hospital; WUDH, Wonkwang University Dental Hospital.

Reference

1. Zamboni R, de Moura FRR, Brew MC, Rivaldo EG, Braz MA, Grossmann E, et al. 2019; Impacts of orthognathic surgery on patient satisfaction, overall quality of life, and oral health-related quality of life: a systematic literature review. Int J Dent. 2019:2864216. DOI: 10.1155/2019/2864216. PMID: 31316563. PMCID: PMC6604419.

2. Athanasiou AE, Melsen B, Eriksen J. 1989; Concerns, motivation, and experience of orthognathic surgery patients: a retrospective study of 152 patients. Int J Adult Orthodon Orthognath Surg. 4:47–55. PMID: 2600491.

3. Proffit WR, Jackson TH, Turvey TA. 2013; Changes in the pattern of patients receiving surgical-orthodontic treatment. Am J Orthod Dentofacial Orthop. 143:793–8. DOI: 10.1016/j.ajodo.2013.01.014. PMID: 23726329. PMCID: PMC4034071.

4. Proffit WR, Phillips C, Dann C 4th. 1990; Who seeks surgical-orthodontic treatment? Int J Adult Orthodon Orthognath Surg. 5:153–60. PMID: 2098450.

5. Boeck EM, Lunardi N, Pinto Ados S, Pizzol KE, Boeck Neto RJ. 2011; Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities. Braz Dent J. 22:340–5. DOI: 10.1590/S0103-64402011000400014. PMID: 21861036.

6. Castro V, do Prado CJ, Neto AI, Zanetta-Barbosa D. 2013; Assessment of the epidemiological profile of patients with dentofacial deformities who underwent orthognathic surgery. J Craniofac Surg. 24:e271–5. DOI: 10.1097/SCS.0b013e31828f28f3. PMID: 23714988.

7. Eslamipour F, Borzabadi-Farahani A, Le BT, Shahmoradi M. 2017; A retrospective analysis of dentofacial deformities and orthognathic surgeries. Ann Maxillofac Surg. 7:73–7. DOI: 10.4103/ams.ams_104_16. PMID: 28713739. PMCID: PMC5502519.

8. Olkun HK, Borzabadi-Farahani A, Uçkan S. 2019; Orthognathic surgery treatment need in a Turkish adult population: a retrospective study. Int J Environ Res Public Health. 16:1881. DOI: 10.3390/ijerph16111881. PMID: 31141986. PMCID: PMC6603578.

9. Baik HS, Kim KH, Park Y. 1995; The distributions and trends in malocclusion patients- a 10 year study of 2155 patients from YDSH. Korean J Orthod. 25:87–100.

10. Hwang MS, Yoon YJ, Kim KW. 2001; An epidemiologic study on the orthodontic patients who visited Department of Orthodontics, Chosun University Dental Hospital last 10 years (1990-1999). Korean J Orthod. 31:283–300.

11. Im DH, Kim TW, Nahm DS, Chang YI. 2003; Current trends in orthodontic patients in Seoul National University Dental Hospital. Korean J Orthod. 33:63–72.

12. Lee CH, Park HH, Seo BM, Lee SJ. 2017; Modern trends in Class III orthognathic treatment: a time series analysis. Angle Orthod. 87:269–78. DOI: 10.2319/043016-349.1. PMID: 27513030. PMCID: PMC8384372.

13. Lee HY, Ahn Y, Park LY, Soh BS, Jo SK, Ko SO, et al. 2004; A clinicostastical study of inpatients of orthognathic surgery between 1993-2002. J Korean Assoc Maxillofac Plast Reconstr Surg. 26:477–83.

14. Lee SH, Park IS, Lee CH, Kwon TG, Yun M, Deng F. 2005; Clinicostatistical study on orthognathic surgery in our department. J Korean Assoc Oral Maxillofac Surg. 31:255–9.

15. Piao Y, Kim SJ, Yu HS, Cha JY, Baik HS. 2016; Five-year investigation of a large orthodontic patient population at a dental hospital in South Korea. Korean J Orthod. 46:137–45. DOI: 10.4041/kjod.2016.46.3.137. PMID: 27226959. PMCID: PMC4879316.

16. Jung MH. 2012; Age, extraction rate and jaw surgery rate in Korean orthodontic clinics and small dental hospitals. Korean J Orthod. 42:80–6. DOI: 10.4041/kjod.2012.42.2.80. PMID: 23112936. PMCID: PMC3481968.

17. Lee SJ, Suhr CH. 1994; Recognition of malocclusion and orthodontic treatment need of 7-18 year-old Korean adolescent. Korean J Orthod. 24:367–94.

18. Sato FR, Mannarino FS, Asprino L, de Moraes M. 2014; Prevalence and treatment of dentofacial deformities on a multiethnic population: a retrospective study. Oral Maxillofac Surg. 18:173–9. DOI: 10.1007/s10006-013-0396-3. PMID: 23408297.

19. Sato S. 1994; Case report: developmental characterization of skeletal Class III malocclusion. Angle Orthod. 64:105–11. discussion 111–2. DOI: 10.1043/0003-3219(1994)064<0105:CRDCOS>2.0.CO;2. PMID: 8010518.

20. Haraguchi S, Takada K, Yasuda Y. 2002; Facial asymmetry in subjects with skeletal Class III deformity. Angle Orthod. 72:28–35. DOI: 10.1043/0003-3219(2002)072<0028:FAISWS>2.0.CO;2. PMID: 11843270.

21. Arad I, Jandu J, Bassett P, Fleming PS. 2011; Influence of single-jaw surgery vs bimaxillary surgery on the outcome and duration of combined orthodontic-surgical treatment. Angle Orthod. 81:983–7. DOI: 10.2319/030211-150.1. PMID: 21615211.

22. Bailey LJ, Duong HL, Proffit WR. 1998; Surgical Class III treatment: long-term stability and patient perceptions of treatment outcome. Int J Adult Orthodon Orthognath Surg. 13:35–44. PMID: 9558534.

23. Bailey LT, Proffit WR, White RP Jr. 1995; Trends in surgical treatment of Class III skeletal relationships. Int J Adult Orthodon Orthognath Surg. 10:108–18. PMID: 9081996.

24. Wolford LM. 2000; The sagittal split ramus osteotomy as the preferred treatment for mandibular prognathism. J Oral Maxillofac Surg. 58:310–2. DOI: 10.1016/S0278-2391(00)90062-4. PMID: 10716114.

25. Kim DK, Baek SH. 2013; Change in maxillary incisor inclination during surgical-orthodontic treatment of skeletal Class III malocclusion: comparison of extraction and nonextraction of the maxillary first premolars. Am J Orthod Dentofacial Orthop. 143:324–35. DOI: 10.1016/j.ajodo.2012.10.014. PMID: 23452966.

26. Xu B, Qin K. 2012; The effect of extraction and non-extraction decompensation to bimaxillary orthognathic surgery in skeletal class III malocclusion. Hua Xi Kou Qiang Yi Xue Za Zhi. 30:143–7. Chinese. PMID: 22594229.

27. Bang SM, Kwon YD, Kim SJ, Lee BS, Choi BJ, Ohe JY, et al. 2012; Postoperative stability of 2-jaw surgery with clockwise rotation of the occlusal plane. J Craniofac Surg. 23:486–90. DOI: 10.1097/SCS.0b013e3182413f6b. PMID: 22421845.

28. Lee UL, Nam JH, Choi WC, Kim HW, Kim HJ, Choi YJ. 2019; Comparison of lip line cant change after 1-jaw and 2-jaw surgery. J Craniofac Surg. 30:1820–4. DOI: 10.1097/SCS.0000000000005556. PMID: 31033678.

29. Wasserstein RL, Lazar NA. 2016; The ASA statement on p-values: context, process, and purpose. Am Stat. 70:129–33. DOI: 10.1080/00031305.2016.1154108.

30. Kim MS, Lim SH, Jeong SR, Park JH. 2020; Maxillary molar intrusion and transverse decompensation to enable mandibular single-jaw surgery with rotational setback and transverse shift for a patient with mandibular prognathism and asymmetry. Am J Orthod Dentofacial Orthop. 157:818–31. DOI: 10.1016/j.ajodo.2019.02.022. PMID: 32487312.