Comparison of Different Decompensation Approaches on Facial Profile in Orthodontic–Orthognathic Treatment for Skeletal Class III Patients

Background The objective of the present study was to assess the hard and soft tissue differences of skeletal Class III malocclusion patients treated with orthodontic–orthognathic surgery treatment between two decompensation approaches including extraction of maxillary premolars in preoperative orthodontics and clockwise rotation of the maxilla in orthognathic surgery. Methods 22 skeletal Class III patients with the crowding of maxillary dental arch less than 3mm were included in this study. These patients were divided into two groups: extraction group and non-extraction group. Lateral cephalograms taken before preoperative orthodontic treatment and after postoperative orthodontic treatment were used to analyze the differences of hard and soft tissues between two groups. Independent t test was used to evaluate the differences of variables between extraction group and non-extraction group. Results After treatment, there was significant difference of Wits between extraction group and non-extraction group (− 4.34 mm vs − 2.82 mm, respectively, P <0.05). Co-Gn was significantly greater in non-extraction group than in extraction group (77.18 mm vs 71.58 mm, P <0.05). U1-SN and L1-MP in extraction group were significantly closer to the normal values than non-extraction group ( P <0.05). Regarding the change of variables before and after orthodontic–orthognathic treatment, NLA (7.25° vs 1.46°, P <0.01) and G-Sn-Pog’ (8.06° vs 4.62°, P <0.05) were significantly greater in extraction group than in non-extraction group. Conclusion For patients with skeletal Class III malocclusion, extraction of maxillary premolars in preoperative orthodontic treatment can more effectively eliminate the dental compensation and achieve a more harmonious facial profile compared to clockwise rotation of the maxilla in orthognathic surgery. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .