Skeletal relapse after orthognathic surgery

Abstract

Orthognathic surgery, performed to correct functional and aesthetic jaw and facial irregularities, significantly enhances the quality of life for patients. Despite advancements in surgical techniques and computer-assisted planning, postoperative complications such as unintentional occlusion disorders and jaw misalignments remain common. Studies reveal postoperative jaw misalignments and malocclusions in approximately 10% of cases. Relapses after bimaxillary orthognathic surgery predominantly affect maxillary movements, especially in patients with cleft lip and palate, with up to 20% relapse due to scar contraction. Deviations from the preoperative plan occur even with advanced technologies, within generally accepted tolerances of less than 2 mm for translational and 2 degrees for rotational movements. The primary causes of relapse are linked to postoperative stability rather than planning accuracy, with contributing factors including the feasibility of orthodontic pre- and post-treatment, long-standing dysgnathia leading to tooth loss, and advanced patient age. These factors should be carefully considered to minimize the risk of relapse and improve surgical outcomes.