[Soft tissue changes of patients with skeletal class II malocclusion after orthodontic and surgical treatments]

One of the prime concerns of both the orthodontist and the oral surgeon must be the final soft tissue profile and the esthetic appearance of the patient. The purpose of this study was to evaluate the amount, direction, and predictability of the soft tissue changes associated with simultaneous skeletal changes.

The authors analyzed the recent 22 cases with skeletal class II maloclusion in Orthodontic Department, College of Stomatology, West China University of Medical Sciences with 7 male and 15 female from 20 to 30 years old. Each patient was taken standardized lateral cephalograms before the treatment and 6-12 months after the treatment. A total of 16 hard and soft tissue landmarks were evaluated in both horizontal and vertical directions.

In the horizontal directions, the soft tissue maxillary landmarks (superior labial sulcus, labrale superius, and upper lip stomion) moved posterior with a range of 2.17 to 2.33 mm. The strongest correlations were found between the posterior movement of the upper incisal edge and the three soft tissue parameters: superior labial sulcus r = 0.78, labrale superius r = 0.81, upper lip stomion r = 0.75. The soft/hard tissue ratios of the mandible anterior movement is 0.83:1 between inferior labial sulcus and B point, and 0.95:1 for Pog' to Pog. In the vertical directions, all the soft tissue mandible landmarks (Pog', inferior labial sulcus, labrale inferius, lower lip stomion) moved upward more than 2 mm. And the soft/hard tissue ratio is from 1.07:1 to 1.34:1.

The combined orthodontic and surgical treatment is an efficient way to cure skeletal class II malocclusion. All the patients regained satisfactory face appearance and profile. Although the soft tissue movement is less than the hard tissue in both jaws in the horizontal direction, the vertical movement of the mandibular soft tissue is greater than that of the underlying hard tissue.