Stability of Pre-Orthodontic Orthognathic Surgery Using Intraoral Vertical Ramus Osteotomy Versus Conventional Treatment

Sung Hwan Choi, Chung Ju Hwang, Hyoung Seon Baik, Young Soo Jung, Kee Joon Lee

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)


Purpose Postoperative skeletal and dental changes were evaluated in patients with mandibular prognathism who underwent mandibular setback surgery using an intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontic treatment. Material and Methods This retrospective cohort study included consecutive patients with skeletal Class III malocclusions who underwent IVRO. Patients treated with pre-orthodontic orthognathic surgery (POGS) were compared with patients treated with conventional surgery (CS) with presurgical orthodontics (control) using lateral cephalograms (taken preoperatively, 7 days postoperatively, and 12 months postoperatively). Predictor (group and timing), outcome (cephalometric measurements over time), and other (ie, baseline characteristics) variables were evaluated to determine the differences in postoperative horizontal and vertical positional changes of the mandible, such as point B. Baseline demographics were similar between the groups (N = 37; CS group, n = 17; POGS group, n = 20). The data were analyzed with an independent t test, the Mann-Whitney U test, the Fisher exact t test, Pearson correlation analysis, and simple linear regression analysis. Results The mean setback of the mandible at point B was similar, but the mandible of the POGS group, particularly the distal segment, moved superiorly during the postoperative period in conjunction with the removal of premature occlusal contacts (P <.001). In the CS group, the mandible had significantly more backward movement 12 months after surgery compared with the POGS group (P <.01). In the POGS group, horizontal and vertical postsurgical changes were linearly correlated with the amount of setback and vertical movement of the mandible. Conclusions Mandibular setback surgery using IVRO without presurgical orthodontics leads to considerably different postoperative skeletal and dental changes compared with conventional treatment, with more superior movement being observed at point B during the 1-year postoperative period.

Original languageEnglish
Pages (from-to)610-619
Number of pages10
JournalJournal of Oral and Maxillofacial Surgery
Issue number3
Publication statusPublished - 2016 Mar 1

Bibliographical note

Funding Information:
This study was supported by a research grant from the College of Dentistry, Yonsei University , 2014.

Publisher Copyright:
© 2016 American Association of Oral and Maxillofacial Surgeons.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology


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