Department of Orthodontics, University Medical Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
Department of Operative Dentistry, University Medical Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
BMC Oral Health. 2022 Dec 15;22(1):605. doi: 10.1186/s12903-022-02636-x.
Relapse after orthognathic surgery seems to depend on diverse factors. Proffit et al. postulated in 2007 a "hierarchy of stability" (Head Face Med 6:66, 2007), ranking posttreatment stability after various orthognathic procedures, but no systematically reviewed evidence was provided. Therefore, the aim of this review was to investigate the extent of class II relapse in orthognathic surgery of Angle class II patients depending on the surgical procedure used.
Seven databases were searched for randomized and controlled clinical trials to compare relapse in surgical procedures for Angle class II patients. After duplicate study selection, data extraction and risk of bias assessment were performed with the ROBINS-I tool as well as data synthesis by frequency distribution, followed by assessment of the quality of evidence with GRADE.
Four non-randomized cohort-studies with a total of 132 patients were included. Bimaxillary procedures as well mandibular advancement procedures proved to be highly stable. Single jaw interventions at the maxilla achieved mostly stable results at sagittal dimension and problematic stability in the vertical dimension. However, there were only limited data available with low quality of evidence.
Limited existing evidence of low quality partly support the postulated hierarchy of stability of Proffit et al. (Head Face Med 6:66, 2007) and indicates that a surgical correction of class II dysgnathia with bimaxillary procedures and mandibular advancement seems to be highly stable. However, additional studies are needed to address the relation between relapse and surgical orthognathic intervention. Trial registration PROSPERO 2019 CRD42019144873.
正颌手术后的复发似乎取决于多种因素。Proffit 等人于 2007 年提出了“稳定性等级”（Head Face Med 6:66, 2007），对各种正颌手术后的治疗后稳定性进行了排序，但没有提供系统的综述证据。因此，本研究旨在调查不同正颌手术方法治疗安氏Ⅱ类错（牙合）患者的Ⅱ类复发程度。
在 7 个数据库中搜索了比较安氏Ⅱ类错（牙合）患者手术方法复发的随机对照临床试验。经过重复研究选择、数据提取和 ROBINS-I 工具的偏倚风险评估，以及频率分布的数据综合，然后使用 GRADE 评估证据质量。
纳入了 4 项非随机队列研究，共 132 例患者。双颌手术和下颌前突手术被证明是高度稳定的。上颌单颌手术在矢状方向上大多获得稳定的结果，但在垂直方向上稳定性存在问题。然而，只有有限的数据且证据质量较低。
有限的现有低质量证据部分支持 Proffit 等人提出的稳定性等级（Head Face Med 6:66, 2007），并表明双颌手术和下颌前突手术矫正Ⅱ类错（牙合）畸形具有高度稳定性。然而，需要进一步的研究来探讨复发与手术正颌干预之间的关系。试验注册 PROSPERO 2019 CRD42019144873。
