Orthognathic surgery improves compromised natural head position and pharyngeal airway in patients with Skeletal Class II or III malocclusion

Abstract Background Natural head position (NHP), pharyngeal airway and maxillofacial growth pattern are correlated. The author's previous studies proved that following surgical correction of Skeletal Class II malocclusion, the over‐extended NHP returned upright, and the pharyngeal airway space (PAS) dimension expanded. Objective The present study compares the post‐operative change in NHP and PAS after orthognathic surgery in Skeletal Class II and III malocclusion patients. Methods Patients receiving orthognathic procedures to correct Skeletal Class II or III malocclusions were reviewed in this retrospective study. Pre‐operative and 6‐week post‐operative cone‐beam computed tomography datasets were collected. Variables representing the craniofacial pattern, the NHP and the PAS were measured three‐dimensionally. Post‐operative variables were compared with their pre‐operative counterparts using either repeat‐measure 2‐way analysis of variance or Wilcoxon matched‐pairs signed rank test. Results Thirty cases of Skeletal Class II malocclusion and 13 cases of Skeletal Class III malocclusion were collected. Preoperatively, the inter‐group differences were significant in craniofacial pattern (68.14 ± 3.552 degree vs. 79.63 ± 2.497 degree, p < .0001) and the NHP (68.77 ± 11.02 degree vs. 82.83 ± 7.738 degree, p = .0002) while not significant in PAS; after surgery, the intergroup differences in craniofacial pattern and the NHP between groups decreased, and the PAS increased in both groups. Conclusion Orthognathic surgery may improve compromised NHP and increase PAS in Skeletal Class II and III malocclusion patients.