Study supports clear aligners for orthognathic surgery patients

Patients needing orthognathic surgery generally have orthodontic treatment before and after. Researchers wondered if clear-aligner therapy was a valid option for patients who need this surgery.

The researchers compared patients who underwent conventional orthodontic therapy with those who underwent clear-aligner therapy in their study, published in the Journal of Craniofacial Surgery (July/August 2019, Vol. 30:5, pp. 1488-1491). Perioperative and short-term clinical outcomes were not compromised with clear-aligner treatment, they found.

Patients needing orthognathic surgery for dentofacial deformities traditionally have worn orthodontic hardware before and after the surgery. An alternative to conventional devices, clear-aligner therapy uses a series of trays to reach the same clinical outcome.

The researchers conducted a retrospective chart review to compare perioperative outcomes between two groups of patients who needed a triple-jaw orthognathic procedure: 13 patients who wore Invisalign (Align Technology) and 20 treated with conventional fixed appliances. Their mean age was just under 20 years.

The researchers found no significant differences between the two groups in six categories:

• Operating time
• Concurrent teeth extraction
• Fat grafting
• Hospital stay duration
• Diet advancement
• Narcotic analgesic use

There were nine patients (four who wore Invisalign) with sufficient 3D images to allow for volumetric analysis. Postoperative edema was not significantly different between the groups (44.29 ± 23.16 cm³ for conventional appliances compared with 37.36 ± 31.19 cm³ for Invisalign).

The type of orthodontic treatment did not prevent successful outcomes, the researchers concluded.

"The present study demonstrates that complex multiple-jaw orthognathic procedures can be successfully performed in Invisalign patients," wrote the study authors, led by Hadyn Kankam, who conducted the research while at the department of surgery at the Yale University School of Medicine in New Haven, CT.