Effects of Relapse Forces on Periodontal Status of Mandibular Incisors Following Orthognathic Surgery

Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey.
Journal of Periodontology (Impact Factor: 2.71). 12/2008; 79(11):2069-77. DOI: 10.1902/jop.2008.070576
Source: PubMed


In this case-control study, the relationship between the relapse forces and periodontal changes in the mandibular incisor region were investigated following orthognathic surgery.
Mucogingival and alveolar changes in 36 subjects with mandibular prognathism were analyzed by clinical and roentgenographic methods just before mandibular setback surgery and 7.4 months postoperatively. The results were compared to two control groups: 36 subjects with no orthodontic history and 33 orthodontic patients. The mean age of the 105 subjects was 20.21 years.
The intergroup comparisons showed significant differences in all parameters, except for the plaque index and alveolar height measurements. By an incisor proclination of 3.3 mm and a tipping of +8.5 degrees (postoperative relapse: 0.8 mm and 0.14 degrees ), the surgery group revealed significant changes in single parameters of both alveolar height and sulcus depth measurements.
Compared to both control groups, the preoperative periodontal condition of the surgery patients was less acceptable than in the orthodontically treated patients, whereas subjects without braces presented the most ideal hygienic conditions. In the short term, the decompensation process prior to mandibular setback surgery did not affect periodontal structures significantly, and the current study did not find any negative effects of early postoperative relapse forces on the mandibular incisor area.

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    • "We found no statistically significant difference for the mean change during decompensation for maxillary incisors between the Class III and Class II group, whilst the amount of decompensation achieved for the mandibular incisors for Class III patients was statistically significantly greater than in the Class II group. Interestingly, Potts et al. (5) found that most cases with retroclined incisors were not decompensated adequately prior to orthognathic surgery, whilst Ari-Demirkaya and Ilhan (17) identified that in 28% of patients with Class II malocclusion, the mandibular incisors were still protrusive at the time of surgery with angles greater than 99o. Proclination of incisors has been shown to be more achievable than retroclination (6) and our results would indicate that incisor decomensation in the mandible is more achievable than in the maxilla. "
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