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Soft tissue changes associated with mandibular subapical osteotomy.

T M Speidel, K M Marine, F W Worms

    The Angle Orthodontist
    |January 1, 1979
    PubMed
    Summary
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    Severe dental and facial disproportions can be treated with combined orthodontic-oral surgery. This approach effectively reduced lower facial height and improved lip posture, leading to more balanced facial contours.

    Area of Science:

    • Orthodontics and Oral Surgery
    • Craniofacial Surgery
    • Facial Aesthetics

    Background:

    • Accurate prediction of treatment outcomes is crucial for managing severe dental and facial disproportions.
    • Combined orthodontic and oral surgical approaches are employed for complex cases.

    Purpose of the Study:

    • To evaluate the hard and soft tissue profile changes following surgical repositioning of the anterior mandibular alveolus.
    • To compare the outcomes of standard mandibular subapical osteotomy versus the Kole procedure.

    Main Methods:

    • Retrospective analysis of pre- and post-treatment cephalometric X-rays from twelve patients.
    • Surgical interventions included standard mandibular subapical osteotomy or Kole type procedures.
    • Evaluation of changes in facial height, lip posture, and specific cephalometric measurements.

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    Main Results:

    • Surgical repositioning significantly decreased lower facial height and improved lip posture.
    • Key cephalometric changes included inferior and posterior stomion movement, altered labial sulcus concavity, and posterior vermilion movement.
    • Overbite and overjet increased, Wits analysis decreased, and facial contour angle remained unchanged.
    • The Kole group showed a greater reduction in facial height compared to the standard subapical group.

    Conclusions:

    • Combined orthodontic-oral surgery effectively reshapes the facial profile in patients with severe disproportions.
    • Both surgical techniques yield predictable changes, with the Kole procedure offering more significant facial height reduction.
    • Treatment planning should consider these predictable skeletal and soft tissue alterations for optimal results.