Correlations Between the Pterygomaxillary Junction and Appropriate Osteotome Placement Angles During Junction Separation in Le Fort I Osteotomy.

Purpose: The authors evaluated pterygomaxillary junction angles across malocclusion patterns and identified the optimal technique for effective pterygomaxillary junction separation during Le Fort I osteotomy, focusing on appropriate osteotome angles and clinical applications.

Methods: This retrospective study included 211 patients with malocclusion who had undergone Le Fort I osteotomy at Chang Gung Craniofacial Center between December 2015 and September 2023. The patients were stratified by sex and malocclusion class (class I, II, or III).

Outcome of patients with complete cleft lip and alveolus: 20-year follow-up.

Background: Patients with cleft have functional and aesthetic impairment, and typically require several interventions as they grow. Long-term evaluation following a treatment protocol is essential, but such reports on patients with complete cleft lip and alveolus (CLA) are sparse in the literature.

Methods: A retrospective review was conducted to all patients with complete CLA born between January 1995 and August 2002 and treated at our center.

Site and severity of facial asymmetry after bimaxillary surgery for class III deformity: a case-control study.

Objectives: The study aimed (1) to evaluate the site and severity of facial asymmetry in Class III patients before and after bimaxillary surgery, and (2) to identify the influence of initial severity and positional jaw asymmetry on residual facial asymmetry.

Materials And Methods: Preoperative and postoperative cone-beam computed tomography of 65 patients with Class III facial asymmetry who underwent bimaxillary surgery were evaluated. Five midline and 14 paramedian facial soft tissue landmarks were identified to assess facial asymmetry.

Three-dimensional evaluation of skeletal stability after surgery-first bimaxillary surgery for class III asymmetry in 70 consecutive patients.

Background/purpose: Skeletal stability after orthognathic surgery is essential for positive treatment outcome. This study evaluated the stability of osteotomy segments after surgery-first bimaxillary surgery for class III asymmetry.

Materials And Methods: Seventy adults with class III asymmetry consecutively corrected through surgery-first Le Fort I and bilateral sagittal split osteotomies were investigated.

Chang Gung Forum: An Exemplary Strategy for Implementing a Multidisciplinary Network of Experts in Craniofacial Anomalies.

Introduction: The Chang Gung Forum has been dedicated to the care of craniofacial anomalies since 2000. This annual continuing medical education program focuses on orofacial cleft and surgery-first orthognathic surgery by providing up-to-date information and management guidelines. This study explored how the Chang Gung Forum has influenced medical perspectives, decisions, and practices in a multidisciplinary craniofacial team.

Surgical Occlusion Setup and Skeletal Stability of Correcting Cleft-Associated Class III Deformity Using Surgery-First Bimaxillary Surgery.

Background: This study aimed to assess the 3-dimensional quantitative characteristics of the surgical occlusion setup in surgery-first cleft orthognathic surgery, and to evaluate its influence on postsurgical skeletal stability.

Methods: This prospective study was composed of 35 patients with unilateral cleft lip and palate and class III deformity who consecutively underwent 2-jaw surgery with the surgery-first approach. Digitized dental models were analyzed to quantify the 3-dimensional characteristics of the final surgical occlusion setup.

The Rise of Online Medical Education in Craniofacial Surgery.

Background: International travel had been radically disrupted by coronavirus disease 2019 (COVID-19), leaving traditional medical conferences on a 2-year hiatus. The International Craniofacial Chang Gung Group (ICC) was thus created to disseminate knowledge related to craniofacial surgery. This study aimed to reveal how webinars fundamentally transformed the traditional format of medical conferences.

Does Clockwise Rotation of Maxillomandibular Complex Using Surgery-First Approach to Correct Mandibular Prognathism Improve Facial Appearance?

Background: Facial aesthetics may be optimized based on a deeper understanding of soft tissue changes after orthognathic surgery.

Purpose: The purpose of the study was to delineate facial soft tissue changes after clockwise rotation (CWR) of the maxillomandibular complex (MMC) to correct mandibular prognathism using the surgery-first approach.

Study Design, Setting, Sample: This prospective cohort study enrolled patients over 18 years of age with skeletal Class III malocclusion in the craniofacial center.

Modification of Sagittal Split Osteotomy in Class II Asymmetry: Optimizing Bone Contact between Proximal and Distal Segments.

Background: Computer-assisted surgical simulation (CASS) allows more precise orthognathic surgery. However, few studies have evaluated associations between CASS-designed bilateral sagittal split osteotomy (SSO) and bone contact surface in class II mandibular asymmetry. This study aims to evaluate the effects of using computer-assisted simulation and design modification of SSO to improve bony contact in skeletal class II asymmetry.

Comparative Assessment of Orthodontic and Aesthetic Outcomes after Orthognathic Surgery with Clear Aligner or Fixed Appliance Therapy.

Background: Clear aligner therapy has an aesthetic advantage over fixed appliance therapy. However, to our knowledge, no study has objectively compared patient orthodontic and aesthetic outcomes between clear aligner and fixed appliance therapies administered after orthognathic surgery (OGS).

Methods: This study included patients with no history of congenital craniofacial deformities who underwent surgery-first OGS and received clear aligner or fixed appliance therapy.

Facial Palsy after Orthognathic Surgery: Incidence, Causative Mechanism, Management, and Outcome.

Background: Facial palsy after orthognathic surgery is an uncommon but serious complication causing dissatisfaction and affecting quality of life. The occurrence could be underreported. Surgeons need to recognize this issue regarding the incidence, causative mechanism, managements, and outcome.

Long-term treatment outcome of patients with complete bilateral cleft lip and palate: a retrospective cohort study.

Background: Patients with cleft lip and palate have functional and esthetic impairment and typically require multiple interventions in their life. Long-term evaluation following a treatment protocol, especially for patients with complete bilateral cleft lip and palate (BCLP), is important but was rarely reported in the literature.

Patients And Methods: A retrospective review was conducted on all patients with complete BCLP born between 1995 and 2002 and treated at our center.

Enhancing Philtrum Morphology Using Fat Grafting Combined with Percutaneous Rigottomy in Repaired Unilateral Cleft Lip.

Background: Improving the philtrum morphology of patients with a secondary cleft lip deformity has been a challenge in cleft care. Combining fat grafting with percutaneous rigottomy has been advocated for treatment of volumetric deficiency associated with a scarred recipient site. This study assessed the outcome of synchronous fat grafting and rigottomy for improvement of cleft philtrum morphology.

Surgery-First Orthognathic Approach for Correction of Dentofacial Deformity in Unilateral Cleft Lip and Palate.

Background: Although several studies have reported the advantages of the surgery-first approach for orthognathic correction of class III deformity, there is no report of the success of this approach for patients with cleft lip and palate. Therefore, the purpose of this study was to evaluate the stability and outcome of bimaxillary surgery for cleft-related dentofacial deformity using a surgery-first approach.

Methods: Forty-one patients with unilateral cleft lip and palate who consecutively underwent Le Fort I and bilateral sagittal split osteotomies for skeletal class III deformity were included.

Orthognathic Surgery to Enhance the Smile.

An esthetic smile is an integral feature of beauty. Improvement of the smile can be achieved by a combination of orthognathic surgery, orthodontics, and cosmetic dentistry. Preoperative evaluation serves to address a patient's surgical goals; it allows a surgeon to perform a detailed facial analysis and identify patients who are contraindicated for surgery.

Does Clockwise Rotation of Maxillomandibular Complex Using Surgery-First Approach to Correct Mandibular Prognathism Affect Surgical Movement and Stability?

Purpose: Orthognathic surgery (OGS) using the surgery-first approach (SFA) can decrease treatment time and increase patient satisfaction. Clockwise rotation (CWR) of the maxillomandibular complex to correct mandibular prognathism leads to optimized functional, aesthetic, and stable outcomes. This study examined the combined effect of SFA and CWR of the maxillomandibular complex to correct mandibular prognathism by comparing the surgical movement before (T0) and immediately after OGS (T1) and the stability between T1 and 12 months after OGS (T2).

Comparison of regional soft tissue changes after bimaxillary rotational surgery between class III deformity with overbite and open bite: A 3D imaging analysis.

Background: This prospective study aimed to compare regional soft tissue changes between patients with class III overbite and open bite deformities treated with bimaxillary surgery involving clockwise and counter-clockwise mandibular setback, respectively.

Material And Methods: Class III deformity adults receiving Le Fort I and bilateral sagittal split osteotomies were grouped according to the incisal occlusion: overbite (n = 30) and open bite (n = 30). Combined cone-beam CT scans and 3D facial photographs preoperative and at least 1-year postoperative were taken to assess the soft tissue changes.

The Number of Surgical Interventions and Specialists Involved in the Management of Patients with Neurofibromatosis Type I: A 25-Year Analysis.

Objective: In this study, we aim to present a single institution’s 25-year experience of employing a comprehensive multidisciplinary team-based surgical approach for treating patients with NF-1. Summary Background Data: All patients (n = 106) with a confirmed diagnosis of NF-1 who were treated using a multidisciplinary surgical treatment algorithm at Chang Gung Memorial Hospital between 1994 and 2019 were retrospectively enrolled. Patients were categorized into groups according to the anatomy involved (craniofacial and noncraniofacial groups) and the type of clinical presentation (plexiform and cutaneous neurofibromas groups) for comparative analysis.

Skeletal stability after bimaxillary surgery with surgery-first approach for class III asymmetry is not related to virtual surgical occlusal contact.

Objectives: Surgery-first orthognathic surgery is rarely used in class III asymmetry due to concerns of reduced skeletal stability from unstable surgical occlusion. This study aimed to evaluate if skeletal stability after surgery-first orthognathic surgery is related to virtual surgical occlusal contact or surgical change.

Materials And Methods: We studied 58 adults with class III asymmetry, consecutively corrected by Le Fort I osteotomy and bilateral sagittal split osteotomy using a surgery-first approach.

Comparison of stability and outcomes of surgery-first bimaxillary surgery for skeletal class III deformity between unilateral and bilateral cleft lip and palate.

Objectives: Some adults with cleft lip and palate (CLP) require orthognathic surgery due to skeletal deformity. This prospective study aimed to (1) compare skeletal stability following bimaxillary surgery for correction of class III deformity between patients with unilateral CLP (UCLP) and bilateral CLP (BCLP), and (2) identify risk factors of stability.

Materials And Methods: Adults with CLP and skeletal class III deformities who underwent surgery-first bimaxillary surgery were divided into two groups according to cleft type: UCLP (n = 30) and BCLP (n = 30).

Skeletal and upper airway stability following modified maxillomandibular advancement for treatment of obstructive sleep apnea in skeletal class I or II deformity.

Objectives: Maxillomandibular advancement (MMA) is an effective short-term treatment for obstructive sleep apnea (OSA). This study aimed to evaluate the long-term stability of the facial skeleton, upper airway, and its surrounding structures, as well as improvement in OSA following MMA.

Materials And Methods: Thirty-one adults with moderate-to-severe OSA underwent surgery-first modified MMA as primary surgery.