Soft tissue changes after mandibular setback and bimaxillary surgery in Class III patients

Abstract

Objective: To evaluate the relationship between soft tissue and bone structure for Class III patients before and after bilateral sagittal split osteotomy (BSSO) and bimaxillary orthognathic surgery; to determine the impact of other factors on soft tissue change; and to evaluate correlations between thickness of tissue before surgery, SNA, SNB, and ANB angles, and soft tissue changes. Materials and Methods: The study included 78 Class III patients treated only with BSSO or with BSSO and Le Fort I osteotomy. Lateral cephalograms were taken before and 3 months to 1 year after surgery. After all points of the Zagreb82 and Legan and Burstone profile analysis were traced, the ratio of five soft tissue points before and after surgery was evaluated. Results: Soft tissue between points Sn and A and upper lip showed statistically significant changes for patients treated with bimaxillary surgery and BSSO. Only gender had an influence on soft tissue change. The correlation between soft tissue thickness and changes after surgery was significant. A change in SNB angle correlated with upper lip thickness for patients treated with BSSO but not for patients treated with BSSO and Le Fort I. SNA angle changes correlated with soft tissue changes between points Sn and A. Conclusion: Results of this study show soft tissue changes after BSSO and BSSO and Le Fort I and eliminate the deficiencies that were indicated in the meta-analysis of soft tissue changes from a previous study. (Angle Orthod. 2013;83:817-823.)

Distalization of the mandibular dentition with a ramal plate for skeletal Class III malocclusion correction

“…(Am J Orthod Dentofacial Orthop 2016;150:364-77) A severe anteroposterior skeletal discrepancy in a pa-tientwithaClassIIImalocclusionisgenerallytreated with orthognathic surgery.However,a mild to moderate skeletal Class III malocclusion can be treated by either surgery or camouflage. 1,2 Traditionally, patients who were reluctant to undergo surgical procedures to improve their Class III dental relationships turned to camouflage orthodontic treatment with different extraction patterns according to the proclination of the mandibular incisors and the amount of negative overjet. [3][4][5] Recently, temporary skeletal anchorage devices (TSADs) have decreased the need for extractions and surgical procedures.…”

Computer-Aided Planning in Orthognathic Surgery: A Comparative Study with the Establishment of Burstone Analysis-Derived 3D Norms

“…Moreover, the studies of soft tissue cephalometric norms in Caucasian and Singaporean Chinese populations did not perform gender-stratified analysis [12,24], limiting a direct comparison with the current 3D Taiwanese Chinese data. The Bustone cephalometric method used in this study is a quantitative technique commonly employed for orthognathic surgical planning and outcome assessment [11][12][13][14][15][16][17][18][19][20][21][22][23][24]. However, other methods exist which use 3D digital image-based measurements to enhance the arsenal of strategies and possibilities of clinicians.…”

“…In 1978, Burstone developed the "Cephalometrics for Orthognathic Surgery" [11,12]-a detailed analytical method which is widely accepted and used in the fields of orthodontics and orthognathic surgery [13][14][15][16][17][18][19][20][21][22][23][24]. This two-dimensional (2D) image-based cephalometric method includes clinically useful facial bone (linear and angular measurements in horizontal and vertical directions) and soft-tissue (facial form and lip position) analysis [11,12].…”

Three-dimensional longitudinal evaluation of facial mimicry in orthognathic class III surgery

“…Although many previous studies have focused on long-term skeletal and dental stability and soft tissue or airways changes after orthognathic surgery, a few ones have analyzed changes in in verbal and nonverbal facial movements 16,20,21 .…”