True vertical validation in facial orthognathic surgery planning

Area of Science:

• Orthodontics and Dentofacial Orthopedics
• Plastic and Reconstructive Surgery
• Aesthetic Medicine

Background:

• Facial profile analysis is crucial for orthognathic surgery planning.
• Skeletal Class II malocclusion presents aesthetic challenges in the lower facial third.
• Objective aesthetic standards are needed for predictable surgical outcomes.

Purpose of the Study:

• To validate the True Vertical (TV) Subnasal Line standards in orthognathic surgery.
• To evaluate aesthetic changes in Class II patients undergoing orthognathic surgery.
• To identify key facial profile measures influencing aesthetic perception.

Main Methods:

• Silhouette facial profiles of three groups (normal occlusion, pre- and post-Class II surgery) were assessed by orthodontists, surgeons, and laypeople.
• Observers used a 5-point Likert scale for aesthetic evaluation.
• Key profile measures, including subnasale vertical and sagittal points, were analyzed.

Main Results:

• Aesthetic scores differed significantly between normal occlusion and pre-surgery Class II groups (p<0.001).
• Post-surgery Class II patients showed improved aesthetics, approaching normal occlusion levels.
• Significant changes were observed in profile measures like point B' and Pg' post-surgery (p<0.02).

Conclusions:

• Subnasale vertical and sagittal measures of the lower face are critical for facial aesthetics and orthognathic surgery planning.
• These aesthetic parameters offer an objective tool for planning orthodontic and surgical treatments.
• The findings support the use of specific facial soft tissue landmarks for predictable aesthetic results.