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Quantitative Assessment Protocol for Facial Soft Tissue Volumetric Changes with Stereophotogrammetry
Published on: December 9, 2025
Soft tissue changes after mandibular setback and bimaxillary surgery in Class III patients
Davor Jokić1, Dražen Jokić, Vedran Uglešić
1Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia. drjokic@gmail.com
The Angle Orthodontist
|March 15, 2013
Summary
This study on Class III patients found that bimaxillary surgery significantly alters soft tissue, with gender influencing changes. Soft tissue thickness and specific cephalometric angles like SNA and SNB correlate with these post-surgical outcomes.
Area of Science:
- Orthognathic surgery
- Cephalometric analysis
- Facial reconstructive surgery
Background:
- Class III malocclusion presents complex skeletal and soft tissue relationships.
- Bilateral sagittal split osteotomy (BSSO) and Le Fort I osteotomy are common surgical interventions.
- Understanding soft tissue response to orthognathic surgery is crucial for predictable outcomes.
Purpose of the Study:
- To assess soft tissue and bone structure changes in Class III patients post-BSSO and bimaxillary surgery.
- To identify factors influencing soft tissue alterations.
- To correlate pre-operative tissue thickness and cephalometric angles (SNA, SNB, ANB) with post-operative soft tissue changes.
Main Methods:
- Retrospective analysis of 78 Class III patients undergoing BSSO or BSSO with Le Fort I osteotomy.
- Collection of lateral cephalograms pre- and post-surgery (3 months to 1 year).
- Evaluation of soft tissue point ratios using Zagreb82 and Legan and Burstone analyses.
Main Results:
- Statistically significant soft tissue changes observed in the upper lip and between specific points (Sn and A) following bimaxillary surgery and BSSO.
- Gender was identified as the only factor influencing soft tissue change.
- Significant correlations found between soft tissue thickness and post-surgical changes; SNB angle changes correlated with upper lip thickness (BSSO only), and SNA angle changes correlated with soft tissue changes between Sn and A.
Conclusions:
- Soft tissue changes following BSSO and bimaxillary surgery are significant and predictable.
- The findings address limitations in previous meta-analyses regarding soft tissue response to orthognathic procedures.
