Long-term Stability of Combined Orthodontic-surgical Treatment of Skeletal Open Bite: A Retrospective Study

Objective: To study long-term skeletal and dento-alveolar stability 15 years after surgical-orthodontic correction of skeletal open bite. Methods: Ten open bite patients (8 females and 2 males) who had undergone orthodontic treatment in combination with bimaxillary surgery at Hannover Medical School were reviewed. All patients underwent Le Fort I osteotomies combined with bilateral sagittal split osteotomy. The cephalometric records of these patients were examined at the start of orthodontic treatment (T1), before surgery (T2), immediately after surgery (T3), medium-term after surgery (average 1.5 years, T4) and long-term after surgery (average 15 years, T5). Eight skeletal and five dental cephalometric measurements were selected. Skeletal and dento-alveolar changes were evaluated. Results: Moderate skeletal relapse has been observed 15 years after surgery in skeletal open bite patients treated by bimaxillary surgery. Approximately half of the total surgical changes in PP-SN, MP-SN and ANS-Me remained. Two-thirds of surgical changes in N-Me, N-ANS and S-Go remained. Except that the anterior part of maxilla relapsed completely 1.5 years after surgery, other skeletal relapses occurred mainly in the late follow-up period. Overbite remained quite stable 15 years after surgery, which was mainly due to the upper and lower incisors eruption during the long-term period. Conclusion: Treatment of skeletal open bite via Le Fort I and bilateral sagittal split osteotomies appears to be a clinically successful and stable procedure.