Current Trends in Orthognathic Surgery in Poland—A Retrospective Analysis of 124 Cases

Orthognathic Surgery Trending: Retrospective Ten Years Cases Analysis in Nineveh Province, Iraq

AIMS

The study aimed at analyzing patient's case sheets in regard to the incidence of skeletal discrepancy present in cases and its relation with the demographic profile of the sample. All these are chronicled for more than 10 years periods.

METHODOLOGY

This is a retrospective study analysis of the orthognathic case sheets for more than 10 years period. The total numbers of patients are 678. Patient's case sheet was already prepared by the Multi-Disciplinary Team Orthognathic Surgery Clinic in Al-Salam Teaching Hospital, which is the only authorized committee in Nineveh Health Directorate.

RESULTS

The highest age percentage is between (18 and 27 y/76%). Angle class III cases are the uppermost cases (36%) from the total. A significant P value is clear at the level ≤0.05 and ≤0.01 between surgery type and discrepancy in anterior segmental osteotomies (upper and lower) which is performed in bi-maxillary protrusion cases and Angle class II cases (0.01**). Similarly, anterior segmental osteotomies (upper jaw only) which are indicated in both open bite and Angle Class II cases documented as a statistically significant P value (0.02*). The positive correlation is shown in all variables with the disharmony or facial discrepancies. Esthetic and beauty as causes for treatment recorded more than function in relation to time series.

CONCLUSION

This study documents that patients with skeletal class III accounted for the largest percentage (64%) in the study group. A high increase in patients number seeking treatment for their discrepancy is obvious with time from 2009 till 2022.

Orthognathic correction and corticobasal implant-supported prostheses as a treatment modality for partial edentulism with mandibular prognathism: A case report and review of literature

Introduction

Mandibular prognathism manifests as elongation of the mandible in the anteroposterior direction, resulting in a sunken appearance of the middle third of the face and sad look of the eyes. It adversely affects esthetics, function, and oral health, reducing the patients' self-esteem. It therefore presents a significant challenge.

Presentation of case

A 23-year-old woman presented with prognathic features characterized by mandibular protrusion, maxillary retrusion, a prominent chin, and reduce self-esteem. Intraoral examination revealed multiple extracted teeth, severe fracture of the crown at 23, mobility of the fixed prosthesis on 13, 14, 15, and 16, a root stump of 18, and periodontally compromised teeth (31, 32, 33, 41, and 42).

A multidisciplinary team formulated the following treatment plan: stage 1, orthognathic osteotomy to retrude the mandible at 34 and 44; stage II, fabrication of transitional acrylic partial dentures; and stage III: fabrication of definitive corticobasal implant-supported prostheses. The patient was delighted with the treatment and complied with the oral hygiene instructions and follow-up program. After 7 years of function, the patient presented without complaints and exhibited significant improvement in oral health, self-esteem, and quality of life.

Discussion

The management of mandibular prognathism requires a multidisciplinary approach. The treatment implemented was considered the optimal option that aligned with the recommendations of several researchers to reduce facial disfigurement and rehabilitate the edentulous state.

Conclusion

The use of corticobasal implant-supported prostheses for the rehabilitation of patients with partial edentulism can significantly improve the treatment outcome following orthognathic surgery in cases with mandibular prognathism.

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Mandibular prognathism may adversely affect the patient’s esthetic and function and quality of life.

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Orthodontic surgery can improve the patient esthetic without replacing the missing dentition

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The patient was rehabilitated using corticobasal implant-supported prostheses.

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The esthetics, function, and oral hygiene improved significantly.

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This treatment modality enhances the patient’s self-esteem and improves the patient’s quality of life.