Anchor Plate Efficiency in Postoperative Orthodontic Treatment Following Orthognathic Surgery via Minimal Presurgical Orthodontic Treatment

PURPOSE: The efficiency of an anchor plate placed during orthognathic surgery via minimal presurgical orthodontic treatment was evaluated by analyzing the mandibular relapse rate and dental changes. METHODS: The subjects included nine patients with Class III malocclusion who had bilateral sagittal split osteotomy at the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital, after minimal presurgical orthodontic treatment. During orthognathic surgery, anchor plates were placed at both maxillary buttresses. The anchor plates were used to move maxillary teeth backward and for maximum anchorage of Class III elastics to minimize mandibular relapse during the postoperative orthodontic treatment. The lateral cephalometric X-ray was taken preoperatively (T0), postoperatively (T1), and one year after the surgery (T2). Seven measurements (distance from Pogonion to line Nasion-Nasion perpendicular [Pog-N Per.], angle of line B point-Nasion and Nasion-Sella [SNB], angle of line maxilla 1 root-maxilla 1 crown and Nasion-Sella [U1 to SN], distance from maxilla 1 crown to line A point-Nasion [U1 to NA], overbite, overjet, and interincisal angle) were taken. Measurements at T0 to T1 and T1 to T2 were compared and differences tested by standard statistical methods. RESULTS: The mean skeletal change was posterior movement by 13.87±4.95 mm based on pogonion from T0 to T1, and anterior movement by 1.54±2.18 mm from T1 to T2, showing relapse of about 10.2%. There were significant changes from T0 to T1 for both Pog-N Per. and SNB (P <0.05). However, there were no statistically significant changes from T1 to T2 for both Pog-N Per. and SNB. U1 to NA that represents the anterior-posterior changes of maxillary incisor did not differ from T0 to T1, yet there was a significant change from T1 to T2 (P <0.05). CONCLUSION: This study found that the anchor plate minimizes mandibular relapse and moves the maxillary teeth backward during the postoperative orthodontic treatment. Thus, we conclude that the anchor plate is clinically very useful.