A Perioral Soft Tissue evaluation after Orthognathic Surgery Using Three-Dimensional Computed Tomography Scan

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Medical Imaging

Background:

• Facial appearance significantly impacts social and psychological well-being.
• Accurate jaw positioning in orthognathic surgery is vital, yet soft tissue response may not directly mirror skeletal movements.
• Careful evaluation of soft tissue changes post-orthognathic surgery is essential for successful outcomes.

Purpose of the Study:

• To evaluate perioral soft tissue alterations following orthognathic surgical procedures.
• To compare pre- and post-operative lip width, nasolabial angle, and mentolabial angle using 3D computed tomography (3DCT).

Main Methods:

• Ten patients undergoing orthognathic surgery for various deformities were included.
• Pre- and post-operative 3DCT scans were acquired 12 months apart using an iCT 256 slice scanner.
• Changes were analyzed using Dicom PMS D view software.

Main Results:

• Significant changes were noted in the nasolabial angle after maxillary advancement (1.81°) and setback (2.73°).
• Mandibular setback procedures significantly increased the mentolabial angle (3.27°).
• Mandibular advancement resulted in variable mentolabial angle changes (increase of 3.6°, decrease of 7.6°).

Conclusions:

• 3DCT revealed significant changes in nasolabial and mentolabial angles but not lip width.
• 3DCT is a dependable tool for three-dimensional soft tissue assessment in orthognathic surgery.
• Predicting nasolabial angle changes requires considering underlying factors beyond skeletal movement.