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Quantitative Assessment Protocol for Facial Soft Tissue Volumetric Changes with Stereophotogrammetry
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Facial morphology changes after total maxillary setback osteotomy.

Thomas Schouman1, Marie-Madeleine Baralle, Joël Ferri

  • 1Pitié-Salpetriere University Hospital, Department of Oral and Maxillofacial Surgery, University of Paris 6, Pierre et Marie Curie, Paris, France. thomas.schouman@psl.aphp.fr

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|May 15, 2010
PubMed
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Total maxillary setback osteotomy (TMSO) in patients with severe upper jaw prognathism can achieve good functional and aesthetic results. This procedure, often combined with bimaxillary surgery, improves facial profiles and corrects Class II deformities.

Area of Science:

  • Orthognathic surgery
  • Craniofacial surgery
  • Plastic surgery

Background:

  • Dentofacial deformities, particularly Class II malocclusion with maxillary prognathism, present significant functional and aesthetic challenges.
  • Surgical correction often involves complex osteotomies to reposition the jaws.
  • Total maxillary setback osteotomy (TMSO) is a procedure used to correct severe maxillary protrusion.

Purpose of the Study:

  • To evaluate the morphologic outcomes following total maxillary setback osteotomy (TMSO).
  • To assess the efficacy of TMSO in patients with dentofacial Class II deformity and marked upper jaw prognathism.

Main Methods:

  • A retrospective analysis of 9 patients who underwent TMSO for Class II deformity.
  • Pre- and post-operative assessments using standardized photographic comparison and X-ray superimpositions.

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  • TMSO was performed using a conventional Le Fort I osteotomy with pterygoid process resection.

    • Main Results:

    • All patients achieved Class I occlusion after a mean follow-up of at least 1 year.
    • A mean maxillary setback of 3.1 mm was achieved.
    • Significant improvement in the suborbital profile and a mean increase of 8.9 degrees in the nasolabial angle were observed.

    Conclusions:

    • TMSO can yield satisfactory functional and aesthetic results in carefully selected patients with pronounced maxillary protrusion.
    • The procedure challenges the perception of unavoidable facial alteration after maxillary setbacks.
    • Combining TMSO with bimaxillary surgery is recommended for optimal outcomes, including improved facial aesthetics and nasolabial angle opening.