الفهرس 
Title: The assessment of maxillary stability in bimaxillary orthognathic patients treated by mandible-first approach versus maxilla-first approach Randomized controlled clinical trail
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Abstract
Aim: Is there a difference for the maxillary stability between maxilla-first and mandible-first approaches in the management of skeletal class III malocclusion by bimaxillary orthognathic surgery? Methodology: 24 class III patients requiring bimaxillary orthognathic surgery were selected from the out-patient clinic of Oral&Maxillofacial Surgery Department, Faculty of Dentistry. Cairo University. Patients were randomly divided into two equal groups, group I (maxilla first approach) and group II (mandible first approach). All patients were scanned by CBCT preoperative (P0), immediate post-operative (P1), and 6 months post-operatively (P2). Virtual planning included the fabrication of Computer Aided Design\Computer Aided Manufacturing CAD\CAM occlusal splints to reproduce the surgical planning intra-operatively. Hard tissue landmarks were used as a reference points to evaluate the maxillary stability in both approaches which was done by subtracting (P2-P1). All measures were statistically evaluated as numerical values of mean and st.deviation Results: For the maxillary stability the p.value between the two groups was 0.074.For the assessment of virtual planning at SNA and SNB between the two groups it was for group I (0.50 ± 0.25, 0.46 ± 0.26 with p.value 0.91) and for group II (0.48±.030, 0.55±0.34 with p.value 0.15). Conclusion: There was no statistical significant difference between the two groups for the maxillary stability and the virtual planning. The mandible-first approach has close results to the maxilla-first approach and the CAD\CAM occlusal splints can accurately reproduce the virtual planning intra-operatively