Hierarchy of surgical stability in orthognathic surgery: overview of systematic reviews |
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| Institution: | 1. Institute of Maxillofacial Surgery, Teknon Medical Centre, Barcelona, Spain;2. Department of Oral and Maxillofacial Surgery, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil;3. Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain;4. Department of Oral and Maxillofacial Surgery, Universidade Franciscana, Santa Maria, Rio Grande do Sul, Brazil;5. Department of Oral and Maxillofacial Surgery, Universidad de Costa Rica, San Pedro, San José, Costa Rica;1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen;2. Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center, San Antonio, TX, USA;1. Chief, Maxillofacial Institute, Quirón-Teknon Medical Center Barcelona, Barcelona; Professor and Department Head, Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain;2. Chief, Face Surgery Center, Parma; Professor and Department Head, Department of Maxillofacial Surgery, Università degli Studi di Firenze, Firenze, Italy;3. DDS Fellow, Maxillofacial Institute, Quirón-Teknon Medical Center Barcelona, Barcelona, Spain;4. Attending Surgeon, Face Surgery Center, Parma, Italy;6. Attending Surgeon, Maxillofacial Institute, Quirón-Teknon Medical Center Barcelona, Barcelona; Associate Professor, Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain;5. Attending Surgeon, Maxillofacial Institute, Quirón-Teknon Medical Center Barcelona, Barcelona; Associate Professor, Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain;1. Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Republic of Korea;2. Smile Again Orthodontic Center, Seoul, Republic of Korea;3. Eastman Dental Clinic, Seoul, Republic of Korea;1. Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands;2. Department of Orthodontics, University of Ghent, Ghent, Belgium;3. Department of Orthodontics and Dentofacial Orthopaedics, University of Bern, Bern, Switzerland;4. Department of Orthodontics, Palacky University Olomouc, Olomouc, Czech Republic;1. Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen;2. Clinical Professor, Departments of Oral and Maxillofacial Surgery and Orthodontics, Texas A&M University Baylor College of Dentistry, Baylor University Medical Center, Dallas, TX;1. Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Yemen;2. Clinical Professor, Departments of Oral and Maxillofacial Surgery and Orthodontics, Texas A&M University Baylor College of Dentistry, Baylor University Medical Center, Dallas, TX |
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| Abstract: | The purpose was to perform an overview of systematic reviews in order to create a hierarchical scale of stability in orthognathic surgery with the aid of the highest level of scientific evidence. The systematic search was conducted in the PubMed, Embase, and Cochrane Library databases. The grey literature was investigated in Google Scholar and a manual search was done of the references lists of included studies. Fifteen studies were included in the final sample, of which eight were systematic reviews and seven were meta-analyses. These were assessed for methodological quality using the AMSTAR 2 tool and all were considered to be of medium to high methodological quality. The clinical studies included in the 15 reviews and meta-analyses were classified by the review authors as having a moderate to high potential for risk of bias. The hierarchical pyramid of stability in orthognathic surgery was established, with two surgical procedures considered highly unstable: (1) maxillary expansion with semi-rigid internal fixation evaluated at the dental level in the posterior region, and (2) clockwise rotation of the mandible with rigid internal fixation of bicortical screws in the sagittal direction. |
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| Keywords: | orthognathic surgery stability recurrence systematic review overview of systematic reviews |
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