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Jiang Y, Yang Z, Qi Y, Peng J, Li Z, Liu X, Yi B, Wang X, Chen G, Han B, Xu T, Jiang R. Early and 1-year postsurgical stability and its factors in patients with complicated skeletal Class Ⅲ malocclusion treated by conventional and surgery-first approach: A prospective cohort study. Am J Orthod Dentofacial Orthop 2023; 164:728-740. [PMID: 37516951 DOI: 10.1016/j.ajodo.2023.04.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/01/2023] [Accepted: 04/01/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION This study aimed to compare postsurgical stability between conventional (CSA) and surgery-first (SFA) approaches and investigate its prognostic factors in patients with a skeletal Class Ⅲ extraction. METHODS Twenty and 19 patients treated with LeFort I osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) with premolar extraction were enrolled in SFA and CSA groups, respectively. Serial cone-beam computed tomography images obtained before surgery, immediately after surgery (T1), 3 months after surgery, and 12 months after surgery were used for 3-dimensional quantitative analysis. The condyle was segmented for analyzing volumetric changes. Repeated measures analysis of variance, independent t test, and chi-square test were used to compare time-course and intergroup differences. Pearson and Kendall correlation and multivariate linear regression analyses were used to explore prognostic factors affecting skeletal stability. RESULTS In both CSA and SFA, postsurgical relapse mainly occurred in the mandible sagittal and vertical dimensions and during the first 3 months after surgery. Stability in SFA was significantly less than that in CSA. Intraoperatively, inferolateral condylar displacement with proximal segment inwards, clockwise rotation, and return movements after surgery were observed regardless of the treatment approach. The condylar volume remained stable over time. Multivariate regression analysis showed that posterior vertical dimension (VD) at T1 (-1.63 mm), surgical amount of mandibular setback (-10.33 mm), surgical condylar downwards displacement (-1.28 mm), and anterior overjet at T1 (6.43 mm) were the most important predictors of early mandibular relapse (r2 = 0.593). CONCLUSIONS The risk of early relapse could be reduced by controlling the anterior, middle, and posterior constraints provided by the prediction model.
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Affiliation(s)
- Yiran Jiang
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zhongpeng Yang
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yuhan Qi
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jiale Peng
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zili Li
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaojing Liu
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Biao Yi
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaoxia Wang
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Gui Chen
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Bing Han
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Tianmin Xu
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China; National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory for Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing, China.
| | - Ruoping Jiang
- Department of Orthodontics, NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology, Beijing, China; National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory for Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing, China.
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Kim YH, Kim I, Kim YJ, Kim M, Cho JH, Hong M, Kang KH, Lim SH, Kim SJ, Kim N, Shin JW, Sung SJ, Baek SH, Chae HS. The prediction of sagittal chin point relapse following two-jaw surgery using machine learning. Sci Rep 2023; 13:17005. [PMID: 37813915 PMCID: PMC10562368 DOI: 10.1038/s41598-023-44207-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 10/04/2023] [Indexed: 10/11/2023] Open
Abstract
The study aimed to identify critical factors associated with the surgical stability of pogonion (Pog) by applying machine learning (ML) to predict relapse following two-jaw orthognathic surgery (2 J-OGJ). The sample set comprised 227 patients (110 males and 117 females, 207 training and 20 test sets). Using lateral cephalograms taken at the initial evaluation (T0), pretreatment (T1), after (T2) 2 J-OGS, and post treatment (T3), 55 linear and angular skeletal and dental surgical movements (T2-T1) were measured. Six ML modes were utilized, including classification and regression trees (CART), conditional inference tree (CTREE), and random forest (RF). The training samples were classified into three groups; highly significant (HS) (≥ 4), significant (S) (≥ 2 and < 4), and insignificant (N), depending on Pog relapse. RF indicated that the most important variable that affected relapse rank prediction was ramus inclination (RI), CTREE and CART revealed that a clockwise rotation of more than 3.7 and 1.8 degrees of RI was a risk factor for HS and S groups, respectively. RF, CTREE, and CART were practical tools for predicting surgical stability. More than 1.8 degrees of CW rotation of the ramus during surgery would lead to significant Pog relapse.
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Affiliation(s)
- Young Ho Kim
- Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, South Korea
| | - Inhwan Kim
- Department of Convergence Medicine, Asan Medical Center, Asan Medical Institute of Convergence Science and Technology, University of Ulsan College of Medicine, Seoul, Korea
| | - Yoon-Ji Kim
- Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Minji Kim
- Department of Orthodontics, College of Medicine, Ewha Woman's University, Seoul, Korea
| | - Jin-Hyoung Cho
- Department of Orthodontics, Chonnam National University School of Dentistry, Gwangju, Korea
| | - Mihee Hong
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Kyung-Hwa Kang
- Department of Orthodontics, School of Dentistry, Wonkwang University, Iksan, Korea
| | - Sung-Hoon Lim
- Department of Orthodontics, College of Dentistry, Chosun University, Gwangju, Korea
| | - Su-Jung Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Namkug Kim
- Department of Convergence Medicine, Asan Medical Center, Asan Medical Institute of Convergence Science and Technology, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Won Shin
- Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, South Korea
| | - Sang-Jin Sung
- Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Hak Baek
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Hwa Sung Chae
- Department of Orthodontics, Gwangmyeong Hospital, Chungang University, Gwangmyeong, Korea.
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Kang S, Kim YH, Baek S, Kim DW, Shin JW, Chae HS. Stability of clockwise rotation of the maxillary occlusal plane by two‐jaw surgery in patients with skeletal class
III
malocclusion. Orthod Craniofac Res 2022; 26:207-215. [PMID: 36054615 DOI: 10.1111/ocr.12601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/14/2022] [Accepted: 08/03/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of the study was to investigate the post-surgical stability of clockwise rotation of the maxillary occlusal plane (MXOP) after Le Fort I osteotomy for posterior impaction and advancement, in skeletal Class III patients who had undergone two-jaw orthognathic surgery (2J-OGS). MATERIALS AND METHODS The sample set consisted of 46 patients (18 males and 28 females). Using lateral cephalograms taken at the initial evaluation (T0), before 2J-OGS (T1), after 2J-OGS (T2) and at debonding (T3), the amount of MXOP change (criterion: 2° in ΔMXOP [between T2 and T3]) was used to assign patients to Group 1 (G1, high relapse, -3.09°) or Group 2 (G2, low relapse, -0.99°). Findings were statistically compared between the groups. RESULTS Compared with G2, G1 exhibited more severe skeletal Class III relationships and a flatter MXOP at T0, a greater increase in ΔANB, and more clockwise rotation of ΔMXOP and ΔFMA between T1 and T2. G1 also showed a greater decrease in ΔANB, higher counterclockwise rotation of ΔMXOP and upward movement of U1 between T2 and T3. Regression analysis yielded the following equation: MXOP (ΔT2-T3) = -0.37 X MXOP (ΔT1-T2) -0.43. CONCLUSIONS The higher the clockwise rotation of the MXOP during 2J-OGS in skeletal Class III patients, the greater the subsequent relapse (counterclockwise rotation) of the MXOP.
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Affiliation(s)
- Soon‐young Kang
- Department of Orthodontics, Institute of Oral Health Science Ajou University School of Medicine Suwon South Korea
| | - Young Ho Kim
- Department of Orthodontics, Institute of Oral Health Science Ajou University School of Medicine Suwon South Korea
| | - Seung‐Hak Baek
- Department of Orthodontics, School of Dentistry, Dental Research Institute Seoul National University Seoul South Korea
| | - Dong Woo Kim
- Department of Orthodontics, Institute of Oral Health Science Ajou University School of Medicine Suwon South Korea
| | - Jeong Won Shin
- Department of Orthodontics, Institute of Oral Health Science Ajou University School of Medicine Suwon South Korea
| | - Hwa Sung Chae
- Department of Orthodontics, Institute of Oral Health Science Ajou University School of Medicine Suwon South Korea
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