# Current Trends in Orthognathic Surgery in Poland--A Retrospective Analysis of 124 Cases
## 4 Discussion
indicate an average age of 26.7 years for orthognathically operated patients in the United States in a large population of 10,345 patients under study [28]. Furthermore, the results of our study correspond with the reports of [PERSON] et al. who found no statistically significant difference between the mean age of the patients and the type of malocclusion [21; 24]. In conclusion, amongst patients who seek surgical treatment, the group aged 20-30 is in the majority--a result of their complete bone growth. Therefore, it is possible for them to undertake surgical treatment with no consequence of inhibiting bone growth of the facial skeleton. Additionally, it is the optimum age for an orthodontist to refer the patient for complex orthodontic and surgical treatment--also as a result of the patient's emotional maturity, and when decisions result from his or her needs and not external motivation (doctor, parents) [29]. In our analysis, patients aged 21-30 also accounted for the largest percentage in the group, totaling 43.55% (n = 54), which is consistent with the reports by other authors [22; 29]. The term \"asymmetry\" is used to describe differences between homologous elements. The perfect two-sided symmetry of the face is practically non-existent. However, it usually remains subclinical and unnoticeable. The pursuit of almost perfect symmetry poses a lot of difficulties and remains the main goal of treatments for correcting deformities of the facial skeleton. The aetiology of asymmetry is frequently divided into three groups of factors: congenital, developmental, and acquired. This aetiology, however, is not always known. The asymmetry component is related to all types of skeletal malocclusion, but most frequently it coexists with skeletal Class III [24; 30]. The incidence of asymmetry in orthodontic patients ranges from 12% to 37% in the United States. It is 23% in Belgium, and 21% in Hong Kong [31]. Our analysis showed the presence of asymmetry in 21.8% of the patients undergoing surgery. In the group of patients with skeletal Class III, it was reported significantly more often (26.2% vs. 10.0%; \(p=0.046<0.05\)). Our results correspond with the authors' reports on the incidence of asymmetry in the European population, and the correlation between the incidence of a deformity and skeletal Class III was statistically confirmed. The most frequently performed type of surgery in our analysis was bimaxillary surgery in all modifications--with genioplasty and segmentation of the jaw--which was performed in 49.2% of cases. A slightly smaller percentage accounted for one jaw surgeries, on both the mandible and the maxilla, which were performed in 46.5% of cases. In our sample the proportions of one jaw to bimaxillary surgeries are similar. [PERSON] et al. report bimaxillary surgeries (Le Fort I osteotomy + BSSO) as the most frequently performed orthognathic surgeries (73.1%) in the group of patients with dentofacial deformities. One jaw surgeries accounted for 24.1% of all surgeries (including Le Fort I osteotomy which accounted for 13.2% vs. BSSO which accounted for 10.4%). Genioplasty was performed as a secondary procedure to one jaw and bimaxillary procedures [24]. Therefore, the results of our analysis partially correspond with the reports of [PERSON] et al. Numerous retrospective analyses show the dominance of bimaxillary surgeries [21; 24; 31]. It may result from the significant progress in diagnostic instruments as well as the development of awareness of the impact of orthognathic treatment on both occlusion and aesthetics of the face as well as properties of the respiratory tract, and the continuous improvement of surgical techniques, including shortening the duration of surgery [15; 16; 25; 32]. Furthermore, our study revealed a statistically significant correlation between the type of surgery and the skeletal class. In patients with skeletal Class III, bimaxillary surgeries were performed significantly more often than in patients with skeletal Class II (57.5% vs. 20.0%; \(p=0.0002\)).