SURGICAL AND ORTHODONTIC TREATMENT METHODS IN PATIENTS WITH BIMAXILLARY PROTRUSION - A SYSTEMATIC REVIEW.

Background: The acceptable goal of treatment of bimaxillary protrusion is the retraction of maxillary and mandibular incisors with a resultant decrease in soft tissue convexity. This can be achieved by both surgical and orthodontic treatment methods. The aim of this study was to conduct a systematic literature review on the outcome of either method and other associated factors.

Methodology: Electronic databases (PubMed, Cochrane, Medline) were searched to identify studies that assessed hard and soft tissues changes in patients treated for bimaxillary protrusion with surgery or orthodontics. Abstracts that appeared to fulfill the initial selection criteria were selected, and the full-text original articles were retrieved and analyzed. Only articles that fulfilled the final selection criteria were finally considered. Their references were also hand-searched for possible missing articles from the database searches.

Results: The initial literature search identified 215 articles while 71 full text articles were retrieved for further analysis. Twenty-four publications were included in the final review. Most of the studies were retrospective with no randomized control trial. The studies showed high heterogeneity in type and technique of space closure, anchorage, orthodontic appliance and surgery. Surgical treatment was carried out for more severe cases than orthodontic treatment. Both methods achieved increased inter-incisal angle, however shorter treatment time appeared to be associated with surgery.

Conclusion: Satisfactory outcome were achieved with both treatment protocols. However, surgery was more indicated in severe cases.