{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:05:34Z","timestamp":1780067134359,"version":"3.54.0"},"reference-count":32,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the effect of postsurgical orthodontic treatment between using clear aligners (CA) or fixed appliances (FA) on the postsurgical stability of patients with mandibular prognathism in the surgery-first approach (SFA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This retrospective study included 54 patients with mandibular prognathism who underwent surgical orthodontic treatment with isolated mandibular setback surgery. The patients were divided into two groups according to the mechanics of postsurgical orthodontic treatment: the CA group included 27 patients treated with clear aligners, and the FA group included 27 patients treated with brackets during postoperative orthodontic treatment. Cone beam computed tomography scans were taken before, immediately after, and at 3, 6, and 12 months postsurgery to assess mandibular relapse. The measurements of postsurgical mandibular relapse including horizontal and vertical positions were compared according to the treatment progress and groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Total postsurgical mandibular relapse at pogonion was 3.2 mm in the CA group and 2.2 mm in the FA group. Relapse was higher at 3 months postsurgery in both groups, with an average forward movement of 1.4 mm in the CA group and 1.7 mm in the FA group. Relapse in the CA group showed no significant changes over time, indicating persistence beyond the initial period. In contrast, the FA group showed a significant reduction in relapse by 3 months. Overall, the CA group tended to have greater and more persistent relapse than the FA group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Careful consideration of skeletal relapse is needed in the postsurgical management of patients treated with clear aligners in SFA treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/022125-151.1","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:32:19Z","timestamp":1759451539000},"page":"173-180","source":"Crossref","is-referenced-by-count":0,"title":["Postsurgical stability in mandibular prognathism patients undergoing a surgery-first approach: influence of postoperative orthodontic approach using clear aligners vs fixed appliances"],"prefix":"10.2319","volume":"96","author":[{"given":"Kyungmin Clara","family":"Lee","sequence":"first","affiliation":[{"name":"Professor, Department of Orthodontics, Chonnam National University, School of Dentistry, Gwangju, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i1945-7103-96-2-173-b01","series-title":"Biomed J","first-page":"184","article-title":"Systematic review of the surgery-first approach in orthognathic surgery","volume":"37","author":"Huang","year":"2014","unstructured":"Huang CS,\nHsu SS,\nChen YR. Systematic review of the surgery-first approach in orthognathic surgery. Biomed J. 2014;37:184\u2013190."},{"key":"i1945-7103-96-2-173-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"448","article-title":"Surgery first in orthognathic surgery: A systematic review of the literature","volume":"149","author":"Peir\u00f3-Guijarro","year":"2016","unstructured":"Peir\u00f3-Guijarro MA,\nGuijarro-Mart\u00ednez R,\nHern\u00e1ndez-Alfaro F. Surgery first in orthognathic surgery: A systematic review of the literature. Am J Orthod Dentofacial Orthop. 2016;149:448\u2013462."},{"key":"i1945-7103-96-2-173-b03","series-title":"J Oral Maxillofac Surg","first-page":"2422","article-title":"Does the surgery-first approach produce better outcomes in orthognathic surgery? A systematic review and meta-analysis","volume":"75","author":"Yang","year":"2017","unstructured":"Yang L,\nXiao YD,\nLiang YJ,\nWang X,\nLi JY,\nLiao GQ. Does the surgery-first approach produce better outcomes in orthognathic surgery? A systematic review and meta-analysis. J Oral Maxillofac Surg. 2017;75:2422\u20132429."},{"key":"i1945-7103-96-2-173-b04","series-title":"The Surgery-First Orthognathic Approach","article-title":"Total treatment time in the surgery-first orthognathic approach","author":"Choi","year":"(2021)","unstructured":"Choi JW,\nLee JY. (2021). Total treatment time in the surgery-first orthognathic approach. In: The Surgery-First Orthognathic Approach. Springer, Singapore."},{"key":"i1945-7103-96-2-173-b05","series-title":"J Oral Maxillofac Surg","first-page":"781","article-title":"Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement","volume":"69","author":"Liou","year":"2011","unstructured":"Liou EJ,\nChen PH,\nWang YC,\nYu CC,\nHuang CS,\nChen YR. Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement. J Oral Maxillofac Surg. 2011;69:781\u2013785."},{"key":"i1945-7103-96-2-173-b06","series-title":"J Clin Epidemiol","first-page":"344","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"61","author":"von Elm","year":"2008","unstructured":"von Elm E,\nAltman DG,\nEgger M,\nPocock SJ,\nG\u00f8tzsche PC,\nVandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344\u2013349."},{"key":"i1945-7103-96-2-173-b07","series-title":"J Oral Maxillofac Surg","first-page":"2540","article-title":"Sequential changes in pharyngeal airway dimensions after mandibular setback surgery and its correlation with postsurgical stability in patients with mandibular prognathism","volume":"79","author":"Kim","year":"2021","unstructured":"Kim H,\nLee KC. Sequential changes in pharyngeal airway dimensions after mandibular setback surgery and its correlation with postsurgical stability in patients with mandibular prognathism. J Oral Maxillofac Surg. 2021;79:2540\u20132547."},{"key":"i1945-7103-96-2-173-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"87","article-title":"Evaluation of alveolar bone changes around mandibular incisors during surgical orthodontic treatment of patients with mandibular prognathism: aurgery-first approach vs conventional orthognathic surgery","volume":"163","author":"Kee","year":"2023","unstructured":"Kee YJ,\nMoon HE,\nLee KC. Evaluation of alveolar bone changes around mandibular incisors during surgical orthodontic treatment of patients with mandibular prognathism: aurgery-first approach vs conventional orthognathic surgery. Am J Orthod Dentofacial Orthop. 2023;163:87\u201394."},{"key":"i1945-7103-96-2-173-b09","article-title":"Global Industry Analysts, Inc. Research and Markets","author":"Clear Aligners: Global Strategic Business Report","year":"(2024)","unstructured":"Clear Aligners: Global Strategic Business Report. Global Industry Analysts, Inc. Research and Markets (2024). https:\/\/www.researchandmarkets.com\/reports\/5302393\/clear-aligners-global-strategic-business-report#src-pos-12"},{"key":"i1945-7103-96-2-173-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"540","article-title":"Invisalign A to Z","volume":"121","author":"Wong","year":"2002","unstructured":"Wong B. Invisalign A to Z. Am J Orthod Dentofacial Orthop. 2002;121:540\u2013541."},{"key":"i1945-7103-96-2-173-b11","series-title":"BMC Oral Health","first-page":"68","article-title":"Treatment outcome and efficacy of an aligner technique-regarding incisor torque, premolar derotation and molar distalisation","volume":"14","author":"Simon","year":"2014","unstructured":"Simon M,\nKeilig L,\nSchwarze J,\nJung B,\nBourauel C. Treatment outcome and efficacy of an aligner technique-regarding incisor torque, premolar derotation and molar distalisation. BMC Oral Health. 2014; 14:68."},{"key":"i1945-7103-96-2-173-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"259","article-title":"Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index","volume":"151","author":"Gu","year":"2017","unstructured":"Gu J,\nTang J,\nSkulsi B, et al. Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index. Am J Orthod Dentofacial Orthop. 2017;151:259\u2013266."},{"key":"i1945-7103-96-2-173-b13","series-title":"J Oral Maxillofac Surg","first-page":"1469.e1","article-title":"Three-dimensional evaluation of the postsurgical stability of mandibular setback with the surgery-first approach: comparison between patients with symmetry and asymmetry","volume":"77","author":"Sun","year":"2019","unstructured":"Sun L,\nLee KM. Three-dimensional evaluation of the postsurgical stability of mandibular setback with the surgery-first approach: comparison between patients with symmetry and asymmetry. J Oral Maxillofac Surg. 2019;77:1469.e1\u20131469.e11."},{"key":"i1945-7103-96-2-173-b14","series-title":"Korean J Orthod","first-page":"249","article-title":"Comparison of dimensional accuracy between direct-printed and thermoformed aligners","volume":"52","author":"Koenig","year":"2022","unstructured":"Koenig N,\nChoi JY,\nMcCray J,\nHayes A,\nSchneider P,\nKim KB. Comparison of dimensional accuracy between direct-printed and thermoformed aligners. Korean J Orthod. 2022;52:249\u2013257."},{"issue":"1","key":"i1945-7103-96-2-173-b15","series-title":"Prog Orthod","first-page":"49","article-title":"Force profile assessment of direct-printed aligners versus thermoformed aligners and the effects of non-engaged surface patterns","volume":"23","author":"Hertan","year":"2022","unstructured":"Hertan E,\nMcCray J,\nBankhead B,\nKim KB. Force profile assessment of direct-printed aligners versus thermoformed aligners and the effects of non-engaged surface patterns. Prog Orthod. 2022;23(1):49."},{"key":"i1945-7103-96-2-173-b16","series-title":"Prog Orthod","first-page":"23","article-title":"Forces and moments generated by 3D direct printed clear aligners of varying labial and lingual thicknesses during lingual movement of maxillary central incisor: an in vitro study","volume":"24","author":"Grant","year":"2023","unstructured":"Grant J,\nFoley P,\nBankhead B,\nMiranda G,\nAdel SM,\nKim KB. Forces and moments generated by 3D direct printed clear aligners of varying labial and lingual thicknesses during lingual movement of maxillary central incisor: an in vitro study. Prog Orthod. 2023;24:23."},{"key":"i1945-7103-96-2-173-b01","series-title":"Biomed J","first-page":"184","article-title":"Systematic review of the surgery-first approach in orthognathic surgery","volume":"37","author":"Huang","year":"2014","unstructured":"Huang CS,\nHsu SS,\nChen YR. Systematic review of the surgery-first approach in orthognathic surgery. Biomed J. 2014;37:184\u2013190."},{"key":"i1945-7103-96-2-173-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"448","article-title":"Surgery first in orthognathic surgery: A systematic review of the literature","volume":"149","author":"Peir\u00f3-Guijarro","year":"2016","unstructured":"Peir\u00f3-Guijarro MA,\nGuijarro-Mart\u00ednez R,\nHern\u00e1ndez-Alfaro F. Surgery first in orthognathic surgery: A systematic review of the literature. Am J Orthod Dentofacial Orthop. 2016;149:448\u2013462."},{"key":"i1945-7103-96-2-173-b03","series-title":"J Oral Maxillofac Surg","first-page":"2422","article-title":"Does the surgery-first approach produce better outcomes in orthognathic surgery? A systematic review and meta-analysis","volume":"75","author":"Yang","year":"2017","unstructured":"Yang L,\nXiao YD,\nLiang YJ,\nWang X,\nLi JY,\nLiao GQ. Does the surgery-first approach produce better outcomes in orthognathic surgery? A systematic review and meta-analysis. J Oral Maxillofac Surg. 2017;75:2422\u20132429."},{"key":"i1945-7103-96-2-173-b04","series-title":"The Surgery-First Orthognathic Approach","article-title":"Total treatment time in the surgery-first orthognathic approach","author":"Choi","year":"(2021)","unstructured":"Choi JW,\nLee JY. (2021). Total treatment time in the surgery-first orthognathic approach. In: The Surgery-First Orthognathic Approach. Springer, Singapore."},{"key":"i1945-7103-96-2-173-b05","series-title":"J Oral Maxillofac Surg","first-page":"781","article-title":"Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement","volume":"69","author":"Liou","year":"2011","unstructured":"Liou EJ,\nChen PH,\nWang YC,\nYu CC,\nHuang CS,\nChen YR. Surgery-first accelerated orthognathic surgery: postoperative rapid orthodontic tooth movement. J Oral Maxillofac Surg. 2011;69:781\u2013785."},{"key":"i1945-7103-96-2-173-b06","series-title":"J Clin Epidemiol","first-page":"344","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"61","author":"von Elm","year":"2008","unstructured":"von Elm E,\nAltman DG,\nEgger M,\nPocock SJ,\nG\u00f8tzsche PC,\nVandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344\u2013349."},{"key":"i1945-7103-96-2-173-b07","series-title":"J Oral Maxillofac Surg","first-page":"2540","article-title":"Sequential changes in pharyngeal airway dimensions after mandibular setback surgery and its correlation with postsurgical stability in patients with mandibular prognathism","volume":"79","author":"Kim","year":"2021","unstructured":"Kim H,\nLee KC. Sequential changes in pharyngeal airway dimensions after mandibular setback surgery and its correlation with postsurgical stability in patients with mandibular prognathism. J Oral Maxillofac Surg. 2021;79:2540\u20132547."},{"key":"i1945-7103-96-2-173-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"87","article-title":"Evaluation of alveolar bone changes around mandibular incisors during surgical orthodontic treatment of patients with mandibular prognathism: aurgery-first approach vs conventional orthognathic surgery","volume":"163","author":"Kee","year":"2023","unstructured":"Kee YJ,\nMoon HE,\nLee KC. Evaluation of alveolar bone changes around mandibular incisors during surgical orthodontic treatment of patients with mandibular prognathism: aurgery-first approach vs conventional orthognathic surgery. Am J Orthod Dentofacial Orthop. 2023;163:87\u201394."},{"key":"i1945-7103-96-2-173-b09","article-title":"Global Industry Analysts, Inc. Research and Markets","author":"Clear Aligners: Global Strategic Business Report","year":"(2024)","unstructured":"Clear Aligners: Global Strategic Business Report. Global Industry Analysts, Inc. Research and Markets (2024). https:\/\/www.researchandmarkets.com\/reports\/5302393\/clear-aligners-global-strategic-business-report#src-pos-12"},{"key":"i1945-7103-96-2-173-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"540","article-title":"Invisalign A to Z","volume":"121","author":"Wong","year":"2002","unstructured":"Wong B. Invisalign A to Z. Am J Orthod Dentofacial Orthop. 2002;121:540\u2013541."},{"key":"i1945-7103-96-2-173-b11","series-title":"BMC Oral Health","first-page":"68","article-title":"Treatment outcome and efficacy of an aligner technique-regarding incisor torque, premolar derotation and molar distalisation","volume":"14","author":"Simon","year":"2014","unstructured":"Simon M,\nKeilig L,\nSchwarze J,\nJung B,\nBourauel C. Treatment outcome and efficacy of an aligner technique-regarding incisor torque, premolar derotation and molar distalisation. BMC Oral Health. 2014; 14:68."},{"key":"i1945-7103-96-2-173-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"259","article-title":"Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index","volume":"151","author":"Gu","year":"2017","unstructured":"Gu J,\nTang J,\nSkulsi B, et al. Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index. Am J Orthod Dentofacial Orthop. 2017;151:259\u2013266."},{"key":"i1945-7103-96-2-173-b13","series-title":"J Oral Maxillofac Surg","first-page":"1469.e1","article-title":"Three-dimensional evaluation of the postsurgical stability of mandibular setback with the surgery-first approach: comparison between patients with symmetry and asymmetry","volume":"77","author":"Sun","year":"2019","unstructured":"Sun L,\nLee KM. Three-dimensional evaluation of the postsurgical stability of mandibular setback with the surgery-first approach: comparison between patients with symmetry and asymmetry. J Oral Maxillofac Surg. 2019;77:1469.e1\u20131469.e11."},{"key":"i1945-7103-96-2-173-b14","series-title":"Korean J Orthod","first-page":"249","article-title":"Comparison of dimensional accuracy between direct-printed and thermoformed aligners","volume":"52","author":"Koenig","year":"2022","unstructured":"Koenig N,\nChoi JY,\nMcCray J,\nHayes A,\nSchneider P,\nKim KB. Comparison of dimensional accuracy between direct-printed and thermoformed aligners. Korean J Orthod. 2022;52:249\u2013257."},{"issue":"1","key":"i1945-7103-96-2-173-b15","series-title":"Prog Orthod","first-page":"49","article-title":"Force profile assessment of direct-printed aligners versus thermoformed aligners and the effects of non-engaged surface patterns","volume":"23","author":"Hertan","year":"2022","unstructured":"Hertan E,\nMcCray J,\nBankhead B,\nKim KB. Force profile assessment of direct-printed aligners versus thermoformed aligners and the effects of non-engaged surface patterns. Prog Orthod. 2022;23(1):49."},{"key":"i1945-7103-96-2-173-b16","series-title":"Prog Orthod","first-page":"23","article-title":"Forces and moments generated by 3D direct printed clear aligners of varying labial and lingual thicknesses during lingual movement of maxillary central incisor: an in vitro study","volume":"24","author":"Grant","year":"2023","unstructured":"Grant J,\nFoley P,\nBankhead B,\nMiranda G,\nAdel SM,\nKim KB. Forces and moments generated by 3D direct printed clear aligners of varying labial and lingual thicknesses during lingual movement of maxillary central incisor: an in vitro study. Prog Orthod. 2023;24:23."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/96\/2\/article-p173.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/96\/2\/article-p173.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/96\/2\/article-p173.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:13:56Z","timestamp":1780064036000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/96\/2\/article-p173.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":32,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.2319\/022125-151.1","relation":{},"ISSN":["1945-7103","0003-3219"],"issn-type":[{"value":"1945-7103","type":"electronic"},{"value":"0003-3219","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}