Digital evaluation with ABO eCRE of treatment quality and efficiency with completely customized lingual and prefabricated vestibular appliances in combined orthodontic-orthognathic therapy: a retrospective cohort study

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Abstract

Abstract Background Precise orthodontic pre-surgical decompensation is a critical prerequisite for optimal outcomes in orthognathic surgery. However, the relative effectiveness of completely customized lingual appliances (CCLAs) versus prefabricated vestibular multibracket appliances (PVMAs) remains insufficiently established. This study compared the decompensation efficiency, treatment quality, and overall clinical performance of these two appliances. Methodology The study included 60 consecutive patients who underwent orthodontic-orthognathic surgery: 30 with CCLA and 30 with PVMA. To ensure quality, the digital ABO CRE for each scanned model was evaluated using OnyxCeph3™ diagnostic software, and the efficiency of each appliance was recorded in the respective patient files. Both groups underwent the same evaluation protocol involving initial, intermediate (pre-surgery) and final casts. An additional set-up model was included for the CCLA group only. Results Both groups exhibited comparable baseline scores (mean difference 5.83; 95% CI 1.69 to 9.98). CCLAs demonstrated lower ABO scores than the PVMA group after the decompensation phase (mean difference − 9.23; 95% CI -13.38 to -5.09) and in the final assessment (mean difference − 9.30; 95% CI − 13.44 to -5.16). The largest differences between groups were observed for the alignment criteria in both jaws at the intermediate and final assessments, as well as for all intermaxillary criteria. Treatment efficiency particularly during the decompensation phase, was significantly improved in the CCLA group. Conclusion CCLAs demonstrated superior efficiency and higher treatment quality compared with PVMAs in patients undergoing combined orthodontic–orthognathic therapy. The use of CCLAs in combination with orthognathic surgery appears to represent a high-quality treatment approach for correcting pronounced skeletal discrepancies and may serve as a reliable alternative to PVMA in appropriately selected patients.

Authors 6

1. Franziska Alina Lang Aachen

   RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University

2. Norbert Alexander Lang Aachen

   RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University

3. Gwendolyn Isabella Lode Aachen

   RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University

4. Frank Hölzle Aachen

   RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University

5. Rogerio Bastos Craveiro Aachen

   RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University

6. Michael Wolf Aachen

   RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University