Soft Tissue Changes Following Combined Anterior Segmental Bimaxillary Orthognathic Procedures

Abstract

Aims & objectives To analyze the soft tissue response in patients treated by combined anterior segmental bimaxillary procedures. Methods A Prospective, observational and analytical study was carried out for a period of 2 years involving 37 patients with predefined inclusion and exclusion criteria; lateral cephalograms were taken by the same operator on the standardized unit immediately before and 6 months after surgery; hard and soft tissue landmarks were measured in millimeters to both horizontal and vertical reference lines; any differences in distances were recorded as a surgical change; appropriate statistical test was carried; level of significance was p \ 0.05. Results All patients underwent anterior maxillary osteotomy with 34 anterior mandibular osteotomies, 2 advancement genioplasties and 1 reduction genioplasty. Analysis showed significant angular, horizontal and vertical change. The significant differences in skeletal variables were observed in N-Pg distance, overjet, overbite, U1-NF angle, L1-Mp angle and soft tissue variables like labiomental angle, upper-lower lip protrusion, upper-lower lip length and lower incisor to labrale inferius distance. Nasolabial angle, interlabial gap and upper incisor exposure were extremely significant. Conclusion Soft tissue response to surgery is perhaps more predictable after 6 months, so this may be a treatment modality of choice in adult bimaxillary/dentoalveolar protrusion patients who need instant esthetic facial results.

Comparison of Effects Between Total Maxillary Setback Osteotomy and Anterior Maxillary Segmental Osteotomy on Nasolabial Morphology

“…Plastic and Reconstructive Surgery • December 2023 1084e function. However, three-dimensional movement of the maxilla is accompanied by changes in the soft tissues of the nasolabial region, 4,[15][16][17][18][19][23][24][25][26][27][28][29][30][31][32][33][34][35] raising concerns for surgeons. Le Fort I osteotomy, a versatile total maxilla repositioning technique that corrects maxillary deformities, is often used in orthognathic surgery.…”

Soft to Hard Tissue Ratios After Bimaxillary Orthognathic Surgery in Class Iii Patients

“…In contrast, in another study in which combined anterior segmental osteotomies were performed, it was reported that the nasolabial angle increased by an average of 15.5°. 27 The nasolabial angle change differs according to the surgical technique applied in the maxilla.…”

Changes in Facial Profile after Modified Anterior Maxillary Subapical Osteotomy

“…The varying degree of Ls/Is ratio may be attributable to differences in the amount of maxillary anterior segment setback between the ANS and Is. The Ls/Is ratio ranges from 0.33 to 0.97 in the literature [ 4 , 5 , 18 , 19 ]. Lew et al [ 4 ] reported a 0.44:1 ratio of Ls/Is (5.93 mm setback) using the Wunderer [ 9 ] method.…”

“…In the group with a point A setback of ≥4 mm, the ratios of Sn/ANS and Prn/ANS were 0.367 and 0.354, respectively. Bhagat et al [ 19 ] reported a Prn/ANS ratio of 0.52. We observed Sn/ANS and Prn/ANS ratios of 0.72 and 0.54, respectively.…”