A shorter treatment time was recorded after surgery-first approach (SFA) than conventional orthognathic approach (COA).
Postsurgical skeletal stability was not significantly different between SFA and COA.
The included systematic reviews did not report any difference in terms of complications between SFA and COA.
SFA provided immediate benefits in the quality of life due to an immediate facial improvement.
Surgery-first approach (SFA) has been introduced as an alternative for conventional orthognathic approach (COA) in the treatment of patients with dentoskeletal deformities. This review aimed to evaluate skeletal stability, treatment time, surgical complications, and quality of life in SFA and COA. Six databases were accessed up to May 2020 to obtain all systematic reviews (SRs). After title and abstract reading, data extraction was performed from eligible SRs. The methodological quality was calculated for the included SRs using the last version of A Measurement Tool to Assess Systematic Review (AMSTAR-2). Ten SRs were included in this review. A good stability of the jaws was assessed both with SFA and COA by most of low- or critically low-quality SRs. Less treatment time was reported for SFA than COA with a moderate quality level. Slightly higher complications rate was recorded with SFA than COA by SRs with low or moderate quality. A better quality of life with SFA than COA was reported by moderate- or low-quality SRs. SFA may represent a reasonable alternative to COA. However, for the heterogeneity of the included SRs, well-designed studies with a long term follow-up are needed to clarify the findings of this analysis.Le texte complet de cet article est disponible en PDF.
Keywords : Surgery-first approach, Orthognathic surgery, Skeletal stability, Treatment time, Quality of life, Surgical complication
Vol 122 - N° 2P. 162-172 - avril 2021 Retour au numéro
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