Optimising Orthognathic Surgery: A Comparative Review of the Conventional and Surgery-First Approaches
DOI:
https://doi.org/10.24191/cos.v13i1.6211Keywords:
orthognathic surgery, surgery-first approach, conventional orthognathic approach, facial asymmetry, postoperative stabilityAbstract
Objectives: This review explores and compares the Conventional Orthognathic Approach and the Surgery-First Approach in orthognathic surgery.
Materials and Methods: A comprehensive narrative review was conducted by systematically examining peer-reviewed literature, including clinical trials, retrospective studies, systematic reviews, and meta-analyses. Databases such as PubMed, Scopus, and Web of Science were searched using relevant keywords including “Conventional Orthognathic Approach,” “Surgery-First Approach,” and “Orthognathic Surgery.” Studies were selected based on their relevance to the comparative evaluation of COA and SFA in terms of treatment duration, surgical planning complexity, postoperative stability, complication rates, and patient-reported outcomes.
Results: The SFA demonstrated several advantages, including earlier facial improvement, reduced total treatment time, and improved patient cooperation. Patients treated with SFA often reported enhanced psychological well-being due to the early correction of facial aesthetics. On the other hand, COA remains widely used due to its predictable occlusal outcomes and suitability for a broader patient population. Both approaches showed similar long-term skeletal and dental stability in many studies. In terms of complications, both approaches had comparable safety profiles, though SFA demands greater surgical precision. Notably, SFA also showed promising results in selected cases of facial asymmetry and did not appear to increase the risk of temporomandibular joint dysfunction when carefully managed.
Conclusions: Both COA and SFA are effective and safe strategies in orthognathic surgery. The choice should be guided by patient-specific needs and clinical judgment. SFA may be preferred when quicker aesthetic results and shorter treatment duration are priorities, assuming careful planning and appropriate case selection.
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