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Related Experiment Video

Updated: Jun 10, 2026

Quantitative Assessment Protocol for Facial Soft Tissue Volumetric Changes with Stereophotogrammetry
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Published on: December 9, 2025

Soft tissue profile changes after bilateral sagittal split osteotomy for mandibular setback: a systematic review.

Christof Urs Joss1, Isabella Maria Joss-Vassalli, Stefaan J Bergé

  • 1Department of Orthodontics and Oral Biology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. christofjoss@hotmail.com

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|August 17, 2010
PubMed
Summary

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This study on bilateral sagittal split setback osteotomy found small soft tissue to hard tissue ratio changes. More prospective research is needed to draw firm conclusions on these surgical outcomes.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • Facial Plastic Surgery

Background:

  • Bilateral sagittal split setback osteotomy (BSSO) is a common procedure in orthognathic surgery.
  • Understanding soft tissue changes following BSSO is crucial for predicting aesthetic outcomes.
  • Both rigid internal fixation and wire fixation have been used for BSSO, with varying implications for soft tissue stability.

Purpose of the Study:

  • To evaluate the soft tissue to hard tissue ratio changes after bilateral sagittal split setback osteotomy (BSSO).
  • To compare these ratios between rigid internal fixation and wire fixation techniques.
  • To assess short-term versus long-term soft tissue alterations.

Main Methods:

  • A systematic literature search was conducted across multiple databases (PubMed, Medline, CINAHL, Web of Science, Cochrane Library, Google Scholar Beta).

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  • Eight articles were included in the review (2 prospective, 6 retrospective).
  • Follow-up periods ranged from 1 to 12.7 years for rigid fixation; two wire fixation studies were included.

    • Main Results:

    • Short- and long-term ratios of the lower lip to lower incisors showed minimal differences, trending towards 1:1 long-term.
    • Mentolabial fold ratios to point B remained consistently 1:1.
    • Soft tissue pogonion to pogonion ratio was 1:1 short-term, with a trend towards reduction long-term; upper lip protrusion was variable.

    Conclusions:

    • Drawing evidence-based conclusions on soft tissue changes post-BSSO is challenging due to study limitations.
    • Retrospective designs, suboptimal study quality, and lack of standardized measurements hinder reliable data.
    • High-quality prospective studies excluding adjunctive procedures like genioplasty or maxillary surgery are necessary.