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Asociación Mexicana de Cirugía Bucal y Maxilofacial, Colegio Mexicano de Cirugía Bucal y Maxilofacial, A.C.

2025, Number 1

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Rev Mex Cir Bucal Maxilofac 2025; 21 (1)

New classification of patients candidates for orthognathic surgery and proposed algorithm to establish the treatment plan in minimally invasive surgery

Carrillo RJA, González BJ, Fuentes SA

Language: Spanish
References: 16
Page: 11-17
PDF size: 368.98 Kb.


ABSTRACT

Introduction: 120 years have passed since the classification of malocclusion described by Edward H. Angle in 1899, where he referred to the careful attention to the growth and development of the jaws and muscles, along with the position of the teeth. Although this classification remains valid to this day, it does not take into account that some patients with dentofacial deformities may present alterations in the transverse, vertical and anteroposterior dimensions. By classifying dentofacial deformities, we can make a list of problems and have a tool in the diagnosis and treatment plan. Objective: to perform a new categorization of patients with dentofacial deformities who are candidates for orthognathic surgery based on an algorithm that includes the three dimensional planes, the amount of bone movements required for surgical correction, and the need to use pre conformed plates or bone distractors. Material and methods: the ADDIE analysis model was used to generate a new algorithm based on three levels (abstract, base and dependent). Results: four types of patients are described based on the spatial relationship of the three dimensions. A total of 13 patients were included, of which three were type I (23%), with mild dentofacial deformity (mild dentoskeletal discrepancies) and who required monomaxillary surgery, eight patients were type II (61.5%), with moderate dentofacial deformity requiring movement of the bone segments to correct the pitch, roll and jaw, one patient was type III (7.7%) with cleft palate sequelae who required bone grafting in the gap and one patient was type IV (7.7%) with severe dentofacial deformity who required pre conformed implants. Conclusions: the new categorization included all patients with dentofacial alterations in their three dimensions. The proposed algorithm is functional since the treatment plan optimized time and resources and was more effectively oriented toward the resolution of the cases.


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