Relapse after Orthodontic-Surgical Treatment: A Retrospective Longitudinal Study

Long-term stability is a crucial point in order to keep the patient’s aesthetic and functional balance. The aim of this study was to evaluate dental and skeletal relapse in patients who underwent orthodontic-surgical treatment. This retrospective study included 25 patients who corrected their dentofacial deformity through orthodontics and orthognathic surgery. The dental casts and lateral cephalograms were evaluated prior to orthodontic treatment (T0), final of orthodontic-surgical treatment (T1) and long-term retention phase (T2). The Wilcoxon test with p-value corrected by the Benjamini–Hochberg method was used to assess differences between the groups. The influence of retention duration was assessed using the Kruskal–Wallis method. The association of nominal variables and differences between quantitative variables were assessed using the Fisher and Mann–Whitney tests, respectively. No dental or skeletal variable presented statistically significant differences between the final orthodontic-surgical treatment and the long-term retention phase. Eight patients presented dental relapse (32–95% CI [12.4%; 51.7%]), but no skeletal relapse was observed in any of the 25 individuals. The type of malocclusion did not influence the relapse rate of orthodontic-surgical treatment (Fisher, p = 0.202). No differences were found between the different retention times, sex and age at the end of treatment. Orthodontic-surgical treatment showed long-term stability in the present study group.

[1]  K. Hiller,et al.  Relapse in class II orthognathic surgery: a systematic review , 2022, BMC oral health.

[2]  J. Choi,et al.  Surgery-first orthognathic approach for the correction of facial asymmetry. , 2021, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[3]  Baek-Soo Lee,et al.  Posterior bending osteotomy: An effective measure to secure facial symmetry in orthognathic surgery. , 2021, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[4]  H. Schliephake,et al.  Orthodontic incisor decompensation in orthognathic therapy—success and efficiency in three dimensions , 2020, Clinical Oral Investigations.

[5]  G. Willems,et al.  Evaluation of long-term hard tissue relapse following surgical-orthodontic treatment in skeletal class II patients: A systematic review and meta-analysis. , 2020, International journal of oral and maxillofacial surgery.

[6]  R. Jacobs,et al.  Long-term dental stability after orthognathic surgery: a systematic review. , 2020, European journal of orthodontics.

[7]  S. Bhandari,et al.  Long-Term Study of Relapse After Mandibular Orthognathic Surgery: Advancement Versus Setback , 2020, Journal of Maxillofacial and Oral Surgery.

[8]  G. Antonarakis,et al.  Vertical relapse after orthodontic and orthognathic surgical treatment in a patient with myotonic dystrophy. , 2019, European journal of paediatric dentistry.

[9]  Young-Kyun Kim,et al.  Factors Related to Relapse After Mandibular Setback Surgery With Minimal Presurgical Orthodontics. , 2019, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[10]  E. Ülkür,et al.  Patient with Severe Skeletal Class II Malocclusion: Double Jaw Surgery with Multipiece Le Fort I. , 2018, Turkish journal of orthodontics.

[11]  B. Wang,et al.  Temporomandibular joint positional change accompanies post-surgical mandibular relapse-A long-term retrospective study among patients who underwent mandibular advancement. , 2018, Orthodontics & craniofacial research.

[12]  M. Urata,et al.  Impact of the Distance of Maxillary Advancement on Horizontal Relapse After Orthognathic Surgery , 2018, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[13]  F. Hernández-Alfaro,et al.  Stability and surgical complications in segmental Le Fort I osteotomy: a systematic review. , 2017, International journal of oral and maxillofacial surgery.

[14]  A. Gaggl,et al.  Long-term skeletal and dental stability after orthognathic surgery of the maxillo-mandibular complex in Class II patients with transverse discrepancies. , 2015, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[15]  P. Wisth,et al.  Relapse and stability after mandibular setback surgery one year postoperatively: a retrospective study. , 2014, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[16]  R. Ciesielski,et al.  Evaluation of relapse after orthodontic therapy combined with orthognathic surgery in the treatment of skeletal class III , 2013, Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie.

[17]  L. I. Nojima,et al.  Long-term skeletal and profile stability after surgical-orthodontic treatment of Class II and Class III malocclusion. , 2013, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[18]  W. Jerjes,et al.  Skeletal and dental relapses after skeletal class III deformity correction surgery: single-jaw versus double-jaw procedures. , 2013, Oral surgery, oral medicine, oral pathology and oral radiology.

[19]  B. Çakirer,et al.  Sagittal airway changes: rapid palatal expansion versus Le Fort I osteotomy during maxillary protraction. , 2012, European journal of orthodontics.

[20]  D. Torres-Lagares,et al.  Long-term stability of surgical-orthodontic correction of class III malocclusions with long-face syndrome , 2011, Medicina oral, patologia oral y cirugia bucal.

[21]  P. Wisth,et al.  Dental or skeletal relapse after sagittal split osteotomy advancement surgery? Long-term follow-up. , 2011, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[22]  Henning Müller,et al.  Fusing visual and clinical information for lung tissue classification in high-resolution computed tomography , 2010, Artif. Intell. Medicine.

[23]  T. Turvey,et al.  Long-term stability of adolescent versus adult surgery for treatment of mandibular deficiency. , 2010, International journal of oral and maxillofacial surgery.

[24]  C. U. Joss,et al.  Stability after bilateral sagittal split osteotomy advancement surgery with rigid internal fixation: a systematic review. , 2008, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[25]  U. Thüer,et al.  Stability of the hard and soft tissue profile after mandibular advancement in sagittal split osteotomies: a longitudinal and long-term follow-up study , 2007, BDJ.

[26]  T. Turvey,et al.  The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension , 2007, Head & face medicine.

[27]  L. Sandvik,et al.  LeFort I maxillary advancement: 3-year stability and risk factors for relapse. , 2005, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[28]  Ulf Olsson,et al.  A Measure of Agreement for Interval or Nominal Multivariate Observations by Different Sets of Judges , 2004 .

[29]  J. Rugh,et al.  Rigid versus wire fixation for mandibular advancement: skeletal and dental changes after 5 years. , 2002, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[30]  T. Lyberg,et al.  Mandibular advancement surgery in high-angle and low-angle class II patients: different long-term skeletal responses. , 2001, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[31]  S. Schendel,et al.  An analysis of Le Fort I maxillary advancement in cleft lip and palate patients. , 1992, Plastic and reconstructive surgery.

[32]  D. B. Tuinzing,et al.  Intra- and early postoperative complications of the Le Fort I osteotomy. A retrospective study on 410 cases. , 1991, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[33]  D. B. Tuinzing,et al.  Condylar atrophy and osteoarthrosis after bimaxillary surgery. , 1990, Oral surgery, oral medicine, and oral pathology.

[34]  J. Posnick,et al.  Skeletal Stability after Le Fort I Maxillary Advancement in Patients with Unilateral Cleft Lip and Palate , 1989, Plastic and reconstructive surgery.

[35]  G. Willems,et al.  Evaluation of long-term hard tissue remodelling after skeletal class III orthognathic surgery: a systematic review. , 2019, International journal of oral and maxillofacial surgery.

[36]  P. Wisth,et al.  Skeletal and dental stability after intraoral vertical ramus osteotomy: a long-term follow-up. , 2017, International journal of oral and maxillofacial surgery.

[37]  T. Iizuka,et al.  Short- and long-term skeletal relapse after mandibular advancement surgery. , 2006, International journal of oral and maxillofacial surgery.

[38]  K. Willmar.  On Le Fort I osteotomy; A follow-up study of 106 operated patients with maxillo-facial deformity. , 1974, Scandinavian journal of plastic and reconstructive surgery.