Evaluation of surgery -first orthognathic approach in correction of dentofacial skeletal deformities (A longitudinal observational study)

Background: Ortho-First orthognathic surgery protocol was the widely accepted for treatment of skeletal deformities however the long duration of the whole treatment, worsening of the appearance by the orthodontic preparation that precede the surgery and the skeletal stability all were still a point of discussion. The purpose of this research was to appraise the surgery-first orthognathic approach in management of dentofacial skeletal deformities in both postsurgical skeletal stability outcomes and the whole treatment plan duration. Materials and Methods: The study operated on twelve adult patients with class III skeletal deformities with or without skeletal asymmetry that meeting our inclusion criteria, the patients were evaluated clinically and radiologically with time regimen of 3 months postoperatively and 3 months after debonding. Evaluation was performed by panoramic and lateral Cephalometric radiological examinations and study casts to assess the treatment consequence. Results: The whole treatment plan period ranged from 6 to 16 months (average, 10.58 months). The average age of the patients was 21.78 ± 2.94years. The statistical analysis showed that changes in skeletal cephalometric landmarks were significant in comparison between the presurgical and postsurgical as well as the post orthodontic treatment cephalometrics and no significant difference between the immediate postoperative cephalometric analysis and post-debonding cephalometric one which indicates favorable skeletal stability along the postsurgical orthodontic treatment. Conclusions: Surgery first orthognathic approach serves as a reliable option for management of dentofacial deformities. It has demonstrated to produce good effects and enhanced acceptance with its direct and quick bone correction