The Surgery-first Approach to Orthognathic Surgery.

The purpose of this study was to compare the outcomes between the conventional surgical approach (CSA) and the surgery-first approach (SFA) for both traditional orthognathic osteotomies (LeFort/BSSO) and anterior segmental osteotomies (ASO). This was a retrospective cohort study of patients treated at the Hanoi Plastic Surgery Center from January 2000 to December 2012. The study predictors were the type (LeFort/BSSO or ASO) and timing (CSA or SFA) of surgery. The study outcomes were total treatment time and the rates of complication and relapse. 146 patients were included in the study, of whom 99 (67.8%) were treated with traditional osteotomies and 47 (32.2%) were treated with ASO. In the traditional osteotomy group, there were no significant differences in complication (P = 0.84) or relapse (P = 0.77) rates between CSA and SFA. There were no complications or relapses in the ASO group. Total treatment time was significantly decreased when using the SFA for both orthognathic osteotomies (-3.9 months, P < 0.01) and ASO (-3.3 months, P < 0.01). Our results showed that the SFA was able to achieve similar clinical outcomes to CSA but in a shorter treatment time. The SFA was effective for not only traditional orthognathic osteotomies but also ASO.