Changes in the facial soft tissue profile after maxillary orthognathic surgery

Abstract

Objectives To compare the changes of the soft tissue profile in relation to the displacement of the underlying hard structures in maxillary orthognathic surgery and to contribute to the esthetic prediction of the facial profile after surgical procedures. Materials and methods We analyzed the sagittal changes in the facial soft tissue profile related to surgical changes in skeletal structures after maxillary osteotomy in a retrospective study. The study sample comprised 115 adult patients between the ages of 18–50 years who had undergone maxillary orthognathic surgery and interdisciplinary orthodontic treatment at the Department of Orthodontics, Ludwig-Maximilians University of Munich, Germany. LeFort I osteotomy cases in both maxillary monognathic and bignathic osteotomy procedures were included. All subjects had received rigid fixation. A cephalometric analysis of presurgical and postsurgical cephalograms was performed and the correlations between hard tissue and soft tissue change ratios were evaluated using a bivariate linear regression analysis. A vertical line through the landmark sella (S) perpendicular to the nasion-sella line (NSL) served as the reference plane. Results The subnasale (Sn) followed the A point (A) by 57%, the soft tissue A point (A′) followed the A point (A) by 73% and the upper lip, represented by the landmark labrale superius (Ls) followed the upper incisor (Is) by 73%; all three in a linear correlation with a mean prediction error of nearly 2 mm. Conclusion The scatterplots show a linear correlation with a wide spread for all three pairs of reference points. The wide spread and the high prediction error of almost 2 mm indicate low predictability of the expected lip position and Sn.

Facial profile evaluation and prediction of skeletal class II patients during camouflage extraction treatment: a pilot study

“…For those predicted to have an undesirable posttreatment facial profile, orthodontic-orthognathic treatment is preferred over camouflage extraction treatment. At present, prediction of posttreatment facial profile esthetics is mainly performed for orthognathic surgery patients [ 36 – 38 ]. To the best of our knowledge, this is the first study to predict the posttreatment facial profile esthetics of skeletal Class II extraction patients using a machine-learning method.…”

Краніометрична Характеристика Шестикутника Обличчя Людини Зрілого Віку З Різним Типом Будови Лицевого Відділу Черепа

“…Використання краніометричних точок, як загальновизнаних орієнтирів для проведення досліджень, завжди було «золотим» стандартом, але, з розвитком сучасних методів інструментальних досліджень, коли стало можливим, отримати прижиттєву краніометричну характеристику черепа людини, надало поштовх для вивчення краніології на новому рівні і поставило нові завдання для дослідників [7][8]. Крім цього, постійна модернізація хірургічних маніпуляцій обличчя, потребує уточнення та деталізації морфологічної характеристики шуканої ділянки [9][10].…”

Condylar Positional Changes in Skeletal Class II and Class III Malocclusions after Bimaxillary Orthognathic Surgery

“…Dentofacial deformity is a morphological anomaly of the maxilla and mandible and is related to different levels of functional alterations. Subjects with dentofacial deformity with retrognathism or prognathism show sagittal maxillomandibular deficiency that affects function and esthetics [5,6]. Recent studies have shown that the size of the mandibular condyle is associated with the morphology of the mandible and the type of facial deformity, indicating that subjects with a smaller mandible have smaller condyles and subjects with facial deformity due to mandibular progeny have larger condyles [7].…”