Main Article Content
Patients with severe malocclusion and dentofacial deformities often require combined orthodontic and surgical correction. The current trend in treatment protocol is changing from consisting of a traditional pre-surgical orthodontics phase for completely correcting dental position before surgery to a modified approach in performing the surgical correction before orthodontic treatment itself. Proper diagnosis and treatment planning are essential to tailor the ideal treatment sequence to each individual patient. In this case series, two patients with mandibular prognathism who received treatment by the surgery-first approach (SFA) and early surgery are presented. From the total treatment time for each patient being 17 months and 18 months 2 weeks respectively, it can be seen that this modified treatment sequence was able to significantly reduce treatment time compared to if a conventional approach had been taken. In addition, the patients benefited from immediate improvement of the facial profile after the early surgical procedure, and the short-term results were stable.
Poulton DR, Ware WH. The American academy of oral roentgenology joins our journal. Oral Surg Oral Med Oral Pathol 1959; 12: 389-90.
Behrman SJ, Behrman DA. Oral surgeons considerations in surgical orthodontic treatment. Dent Clin North Am 1988: 32: 481-507.
Liou EJW, Chen PH, Wang YC. Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement. J Oral Maxillofac Surg 2011: 69: 781-85.
Wang YC, Ko EW, Huang CS, Chen YR, Takano‑Yamamoto T. Comparison of transverse dimensional changes in surgical skeletal Class III patients with and without presurgical orthodontics. J Oral Maxillofac Surg 2010; 68: 1807-12.
Ko EW, Hsu SS, Hsieh HY, Wang YC, Huang CS, Chen YR. Comparison of progressive cephalometric changes and postsurgical stability of skeletal Class III correction with and without presurgical orthodontic treatment. J Oral Maxillofac Surg 2011; 69: 1469-77.
Baek S, Ahn HW, Kwon YH, Choi JY. Surgery-first approach in skeletal class III malocclusion treated with 2-jaw surgery: evaluation of surgical movement and postoperative orthodontic treatment. J Craniofac Surg 2010; 21: 332-38.
Hernandez-Alfaro F, Guijarro-Martinez R, Peiro-Guijarro MA. Surgery first in orthognathic surgery: what have we learned? A comprehensive workflow based on 45 consecutive cases. J Oral Maxillofac Surg 2014; 72: 376-90.
Liao YF, Chiu YT, Huang CS, Ko EW, Chen YR. Presurgical orthodontics versus no presurgical orthodontics: Treatment outcome of surgical‑orthodontic correction for skeletal class III open bite. Plast Reconstr Surg 2010; 126: 2074-83.
Choi JW, Lee JY, Yang SJ, Koh KS. The reliability of a surgery-first orthognathic approach without presurgical orthodontic treatment for skeletal class III dentofacial deformity. Ann Plast Surg 2015; 74: 333-41.
Park HM, Lee YK, Choi JY, Baek SH. Maxillary incisor inclination of skeletal Class III patients treated with extraction of the upper first premolars and two-jaw surgery: conventional orthognathic surgery vs surgery-first approach. Angle Orthod 2014; 84: 720-29.
Kim JY, Jung HD, Kim SY, Park HS, Jung YS. Postoperative stability for surgery-first approach using intraoral vertical ramus osteotomy: 12 months follow-up. Br J Oral Maxillofac Surg 2014; 52: 539-44.
Kim CS, Lee SC, Kyung HM, Park HS, Kwon TG. Stability of mandibular setback surgery with and without presurgical orthodontics. J Oral Maxillofac Surg 2014; 72: 779-87.
Hernandez-Alfaro F, Guijarro-Martinez R, Molina-Coral A, Badia- Escriche C. “Surgery first” in bimaxillary orthognathic surgery. J Oral Maxillofac Surg 2011; 69: e201-7.
Yu HB, Mao LX, Wang XD, Fang B, Shen SG. The surgery first approach in orthognathic surgery: a retrospective study of 50 cases. Int J Oral Maxillofac Surg 2015; 44:1463-67.