Orthodontic camouflage versus orthognathic surgery: A comparative analysis of long-term stability and satisfaction in moderate skeletal Class III

Xueyan Xiong, Yaxin Yu, Fengshan Chen

Department of Emergency Medicine, First Hospital, Jilin University, Changchun, China.
Laboratory of Oral Biomedical Science and Translational medicine, School & Hospital of Stomatology, Tongji University, Shanghai, China.

DOI: 10.4236/ojst.2013.31016                

Abstract

Objective: The purpose of this study was to compare long-term stability and satisfaction between orthodontic camouflage and orthognathic surgery in treatment of moderate skeletal Class III adults. Materials and Methods: A total of 25 adults females who had been treated with orthodontic camouflage for Class III malocclusions were recalled at least 3 years post-treatment to evaluate stability and satisfaction with treatment outcomes. The data were compared with similar data for long-term outcomes in 21 patients with the same Class III problems who had bimaxillary surgical correction. Results: In the camouflage patients, small mean changes in skeletal landmark positions occurred over the long term, although the changes were generally much smaller than in the surgery patients. Dental changes in the surgery group were more severe than those in the camouflage group. The camouflage patients reported fewer functional or temporomandibular joint problems than did the surgery patients. Both groups reported similar levels of overall satisfaction with treatment. Conclusion: The results suggest that both camouflage and surgical treatment in moderate skeletal Class III adults can achieve satisfactory outcomes and provide long-term stability. If patients do not readily accept surgery because of potential surgical complications or financial difficulties, camouflage treatment may be an effective alternative treatment.

Keywords

Moderate Skeletal Class III Adults; Orthodontic Camouflage; Orthognathic Surgery

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Graber, T.M., Vanarsdall, R.L. and Vig, K.W.L. (2005) Orthodontics. Current Principles and Techniques. 4th Edition, St. Louis, Mosby, 565.
[2]	Rabie, A., Wong, R. and Min, G. (2008) Treatment in borderline class III malocclusion: Orthodontic camouflage (extraction) versus orthognathic surgery. The Open Dentistry Journal, 2, 38-48. doi:10.2174/1874210600802010038
[3]	Kerr, W.J., Miller, S. and Dawber, J.E. (1992) Class III malocclusion: Surgery or orthodontics? British Journal of Orthodontics, 19, 21-24.
[4]	Stellzig-Eisenhauer, A., Lux, C.J. and Schuster, G. (2002) Treatment decision in adult patients with Class III malocclusion: Orthodontic therapy or orthognathic surgery? American Journal of Orthodontics and Dentofacial Orthopedics, 122, 27-37. doi:10.1067/mod.2002.123632
[5]	Lew, K.K. (1990) Soft tissue profile changes following orthodontic treatment of Chinese adults with Class III malocclusion. International Journal of Adult Orthodontics and Orthognathic Surgery, 5, 59-65.
[6]	Costa Pinho, T.M., Ustrell Torrent, J.M. and Correia Pinto, J.G.R. (2004) Orthodontic camouflage in the case of skeletal Class III malocclusion. World Journal of Orthodontics, 5,213-223.
[7]	De Villa, G., Huang, C., Chen, P. and Chen, Y. (2005) Bilateral sagittal split osteotomy for correction of mandibular prognathism: Long-term results. Journal of Oral and Maxillofacial Surgery, 63, 1584-1592. doi:10.1016/j.joms.2005.03.031
[8]	Joss, C. and Thüer, U. (2008) Stability of hard tissue profile after mandibular setback in sagittal split osteotomies: A longitudinal and long-term follow-up study. European Journal of Orthodontics, 30, 352-358. doi:10.1093/ejo/cjn008
[9]	Kraft, T., Boulétreau, P., Raberin, M., Etienne, C., Breton, P. and Freidel, M. (2004) [Severe Class III malocclusion: Long-term stability. Retrospective analysis of 12 cases]. Revue de Stomatologie et de Chirurgie Maxillo-Faciale, 105, 153-159. doi:10.1016/S0035-1768(04)72295-0
[10]	Busby, B.R., Bailey, L.J., Proffit, W.R., Phillips, C. and White Jr., R.P. (2002) Long-term stability of surgical class III treatment: A study of 5-year postsurgical results. International Journal of Adult Orthodontics and Orthognathic Surgery, 17, 159-170.
[11]	Mihalik, C.A., Proffit, W.R. and Phillips, C. (2003) Long-term follow-up of Class II adults treated with orthodontic camouflage: A comparison with orthognathic surgery outcomes. American Journal of Orthodontics and Dentofacial Orthopedics, 123, 266-278. doi:10.1067/mod.2003.43
[12]	Yoshioka, I., Khanal, A., Tominaga, K., Horie, A., Furuta, N. and Fukuda, J. (2008) Vertical ramus versus sagittal split osteotomies: Comparison of stability after mandibular setback. Journal of Oral and Maxillofacial Surgery, 66, 1138-1144. doi:10.1016/j.joms.2007.09.008
[13]	Uslu, O. and Akcam, M.O. (2007) Evaluation of longterm satisfaction with orthodontic treatment for skeletal class III individuals. Journal of Oral Science, 49, 31-39. doi:10.2334/josnusd.49.31
[14]	Joss, C.U. and Vassalli, I.M. (2008) Stability after bilateral sagittal split osteotomy setback surgery with rigid internal fixation: A systematic review. Journal of Oral and Maxillofacial Surgery, 66, 1634-1643. doi:10.1016/j.joms.2008.01.046
[15]	Troy, B.A., Shanker, S., Fields, H.W., Vig, K. and Johnston, W. (2009) Comparison of incisor inclination in patients with Class III malocclusion treated with orthognathic surgery or orthodontic camouflage. American Journal of Orthodontics and Dentofacial Orthopedics, 135, 146.
[16]	Baik, H. (2007) Limitations in orthopedic and camouflage treatment for class III malocclusion. Seminars in Orthodontics, 13, 158-174. doi:10.1053/j.sodo.2007.05.004
[17]	Zou, S., Hu, J., Wang, D., Li, J. and Tang, Z. (2001) Changes in the temporomandibular joint after mandibular lengthening with different rates of distraction. International Journal of Adult Orthodontics and Orthognathic Surgery, 16, 221-225.