Comparative Analysis of Root Resorption in Surgery-first Approach vs Conventional Orthognathic Approach: A Cone Beam Computed Tomography Study.

Authors

Jiaqi Zhou, Xiaoran Zhang, Zuping Wu, Xinyi Fang, Mengjie Wu, Xiaoxia Feng

Published in

The Journal of craniofacial surgery. Oct 13, 2026. Epub Oct 13, 2026.

Abstract

This retrospective clinical study aimed to compare root resorption between the surgery-first approach (SFA) and conventional orthognathic approach (COA) using cone-beam computed tomography (CBCT).
Forty-one skeletal class III patients who underwent combined orthognathic surgery and non-extraction orthodontic treatment were included. According to surgical timing, participants were divided into the conventional orthognathic approach (COA) group (n=21) and the surgery-first approach (SFA) group (n=20). Root length and volume were measured on pre- and post-treatment CBCT scans. Intra-group changes in root dimensions were analyzed using paired t tests. Inter-group differences were evaluated using independent-samples t tests for tooth-specific analyses and a linear mixed model for overall assessment.
Root resorption was observed in both groups after treatment completion. Compared with the COA group, the SFA group exhibited a lower prevalence of mild-to-moderate root resorption and a higher proportion of unaffected teeth. Significant inter-group differences in root length reduction were observed across all maxillary teeth and mandibular incisors (P<0.05). The linear mixed model revealed a reduction of 0.21 mm in overall root resorption in the SFA group (P=0.002), although its clinical significance may be limited. Regarding volume loss, no significant differences were observed between the groups, except for the maxillary central incisors (P=0.037). Consistent with these findings, the linear mixed model demonstrated no significant difference in volume loss between the two groups (P=0.238).
Compared with COA, SFA did not increase the risk of root resorption and might have a protective potential in non-extraction cases.

PMID:
42866870
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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