Changes in nasal and labial soft tissues after surgical repositioning of the maxilla

Betts, Norman J.

doi:10.1016/0278-2391(89)90687-3

Cited by 50 publications

(96 citation statements)

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“…The morphologic changes in the external nose are mainly accompanied by positional changes in the maxilla through Le Fort 1 osteotomy. 2,4,6,16 In this study, the direction of maxillary movement after the Le Fort 1 osteotomy was mainly advancement and posterior impaction, resulting in a steeper occlusal plane. Although the skeletal Class III malocclusion of Koreans is primarily due to mandibular prognathism (48%) rather than a retrognathic maxilla, 17 the prevalence of bimaxillary surgery in the Korean orthodontic population is much higher than the mandibular set back alone.…”

Section: Discussionmentioning

confidence: 75%

“…2,3,23,24 The frontal morphology of the nose is important for balanced facial esthetics, and its shape is a signature indicating ethnicity, race, age, and gender. 7,9,13 Previous studies have used different methodologies to quantify nasal morphology, such as cephalometrics, 1,5 standardized full-facial photographs, 3,8 stereophotogrammetry, 26 fabrication of nasolabial casts, 6 and three-dimensional imaging. 4,16 Recently, three-dimensional digital imaging has been used to make a reliable quantitative assessment of the nasal changes in both the area and volume; however, the high cost needed for this process can be a disadvantage.…”

Section: Discussionmentioning

confidence: 99%

“…6 To confirm whether a narrow nose was more susceptible to changes after surgery, the subjects were further divided into two groups. Group 1, the narrow-nose group (n ϭ 5 for each gender), was composed of those with a significantly narrower presurgical alar width than the mean value within our subjects.…”

Section: Examination Of Susceptibility To Nasal Widening After Surgerymentioning

confidence: 99%

“…[1][2][3] Many studies have reported secondary morphological changes in the nose, including alar flaring after a Le Fort 1 osteotomy. [1][2][3][4][5][6] The changes might be advantageous for patients with a narrow nose, but they can have a negative effect on the overall esthetics of the face in those with a wide nasal width. This is extremely important particularly for the Asian population because their noses have a wider width and flatter appearance than European Americans, [7][8][9] while the overall prevalence of severe skeletal Class III requiring orthognath- ic surgery is apparently high.…”

Section: Introductionmentioning

confidence: 99%

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Nasal Changes after Surgical Correction of Skeletal Class III Malocclusion in Koreans

Chung

Lee

Park

et al. 2008

The Angle Orthodontist

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Objective: To quantify the changes in the nose after bimaxillary surgery to correct skeletal Class III malocclusion and to test the hypothesis that there is no change in the nasal width following bimaxillary surgical correction of skeletal Class III when a nasal cinch is properly used. Materials and Methods: Sixty-five adult Korean skeletal Class III patients who had received maxillary advancement/impaction and mandibular set-back surgery in conjunction with an alar base cinch suture were evaluated. The anthropometric variables of the nasal region were measured directly on the soft-tissue surface before and 6 months after surgery. Results: After surgery, the alar width and alar base width had increased significantly (P Ͻ .001), while the nasal tip projection decreased (P Ͻ .001). The nostril morphology also showed widening (P Ͻ .001). There was a trend for females with a narrow alar width presurgically to have a larger amount of nasal widening compared with those with a broader alar width (P Ͻ .05). Conclusion:There is a high probability of nasal and nostril widening after bimaxillary surgery for skeletal Class III malocclusion in Koreans despite the careful performance of alar cinch suture. Nevertheless, the authors believe that alar cinch suture was positive in limiting the nasal widening to the minimum and would consider routine application during bimaxillary surgery for skeletal Class III especially for female patients with a narrow nose who are susceptible to these changes.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Examination Of Susceptibility To Nasal Widening After Surgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Nasal Changes after Surgical Correction of Skeletal Class III Malocclusion in Koreans

Chung

Lee

Park

et al. 2008

The Angle Orthodontist

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“…[5][6][7][8][9][10][11][12] However, surgical invasiveness of two-jaw surgery is greater than that of mandibular surgery alone. Furthermore, in some patients, secondary morphological changes in the nose, such as alar flaring, have occurred after superior repositioning of the maxilla with Le Fort I osteotomy, [13][14][15][16][17][18] and soft tissue procedures such as rhinoplasty are therefore needed subsequently. 19 Recently, a new treatment method for anterior open bite with skeletal Class I and II that employs molar intrusion via anchorage with an implant such as a titanium screw has been reported.…”

Section: Introductionmentioning

confidence: 99%

Skeletal Class III and open bite treated with bilateral sagittal split osteotomy and molar intrusion using titanium screws

Togawa

Iino

Miyawaki

2010

The Angle Orthodontist

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Two-jaw surgery has been performed for the treatment of severe skeletal open bite cases to obtain stability of occlusion after treatment. If molar intrusion with titanium screws could be performed instead of surgical superior repositioning of the maxilla, the incidence of surgical invasion would be reduced. However, there have been few reports of such a therapy. This case report describes treatment for skeletal Class III and open bite with bilateral sagittal split osteotomy and intrusion of the molars using titanium screws. The patient had a concave profile, a long lower facial height, Class III malocclusion, and excessive anterior open bite following mandibular protrusion and a high mandibular plane angle. The mandible autorotated closed 3.5u following intrusion of the upper and lower molars using titanium screws during the presurgical orthodontic treatment phase. After the autorotation of the mandible, a mandibular setback with a bilateral sagittal split osteotomy was performed. The posttreatment records showed a good facial profile and occlusion. The mandible was stable 1 year after surgery. These results demonstrate that surgical orthodontic treatment combined with bilateral sagittal split osteotomy and intrusion of the molars using titanium screws can reduce the need for surgical invasion by avoidance of maxillary surgery and was effective for correcting the facial profile and occlusion in a skeletal Class III and open bite patient.

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Quantitative Assessment of Nasal Changes After Maxillomandibular Surgery Using a 3-Dimensional Digital Imaging System

Honrado

Lee

Bloomquist

et al. 2006

Archives of Facial Plastic Surgery

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Objective: To evaluate nasal changes after maxillomandibular surgery by means of images taken with a 3-dimensional digital camera. Design: Thirty-two patients (26 female and 6 male) with preoperative and postoperative 3-dimensional photographs were studied. The patients underwent maxillary movement with impaction (upward rotation), maxillary movement with lengthening (downward rotation), or maxillary movement without rotation. With the 3-dimensional imaging software, preoperative and postoperative calculations were performed for interalar width, internostril width, nasal tip projection, and columellar length from the 3-dimensional digital images. The nasolabial angle was also measured. Results: Postoperative interalar and internostril widening was significant (PϽ.05) for all 3 categories of maxillary movement. However, there was no statistically significant change in nasal tip projection and columellar length. Interestingly, movement of the maxilla with upward rotation did show a statistically significant decrease in the nasolabial angle. Conclusions: Changes to the nose clearly occur after orthognathic surgery. There was a statistically significant increase in postoperative interalar width and internostril width with maxillary movement. However, no clear correlation could be determined between amount of change and maxillary movement. Interestingly, maxillary advancement did not show any significant change in nasal tip projection or columellar length, with data showing both increases and decreases in measurements. The nasolabial angle in patients who underwent maxillary advancement with impaction (upward rotation) was the only measurement that showed a statistically significant increase.

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Changes in nasal and labial soft tissues after surgical repositioning of the maxilla

Cited by 50 publications

References 0 publications

Nasal Changes after Surgical Correction of Skeletal Class III Malocclusion in Koreans

Nasal Changes after Surgical Correction of Skeletal Class III Malocclusion in Koreans

Skeletal Class III and open bite treated with bilateral sagittal split osteotomy and molar intrusion using titanium screws

Quantitative Assessment of Nasal Changes After Maxillomandibular Surgery Using a 3-Dimensional Digital Imaging System

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