Surgical Occlusion Setup and Skeletal Stability of Correcting Cleft-Associated Class III Deformity Using Surgery-First Bimaxillary Surgery.

Abstract

This study aimed to assess the 3-dimensional quantitative characteristics of the surgical occlusion setup in surgery-first cleft orthognathic surgery, and to evaluate its influence on postsurgical skeletal stability. This prospective study was composed of 35 patients with unilateral cleft lip and palate and class III deformity who consecutively underwent 2-jaw surgery with the surgery-first approach. Digitized dental models were analyzed to quantify the 3-dimensional characteristics of the final surgical occlusion setup. Cone-beam computed tomography was used to measure the 3-dimensional surgical skeletal movement and postsurgical skeletal stability. The correlation between skeletal stability and surgical occlusal contact or surgical skeletal movement was also evaluated. Patients treated with the surgical occlusion setup had a large incisor overjet and positive overbite, as well as buccal cross-bite and open bite on second molars. Occlusal contact on 3 segments was present in 51.4% of the patients, and the average number for tooth contact was 4.3 teeth. No correlation was found between maxillary or mandibular stability and surgical occlusal contact. However, a significant correlation was found between maxillary and mandibular stability and the surgical skeletal movement. The surgical occlusion for correction of cleft-associated class III deformity using the surgery-first approach was characterized by large overjet and positive overbite, along with posterior cross-bite and open bite. On average, there was occlusal contact on 4 to 5 teeth; half of surgical occlusion setups had contact on 3 segments. The postsurgical skeletal stability was related not to the surgical occlusal contact but to the surgical skeletal movement. Therapeutic, III.