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Three dimensional evaluation of soft tissue after orthognathic surgery
Junho Jung1, Chi-Heun Lee1, Jung-Woo Lee1
1Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, 02447, Seoul, Republic of Korea.
Head & Face Medicine
|October 7, 2018
Summary
Orthognathic surgery causes significant changes in nasolabial soft tissues. Mandibular soft tissues followed bone movement more closely than maxillary tissues after surgery.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- 3D Imaging Technology
Background:
- Orthognathic surgery significantly impacts facial aesthetics, particularly nasolabial soft tissues.
- Accurate 3D evaluation of these changes is crucial for surgical planning and outcome assessment.
Purpose of the Study:
- To quantitatively assess three-dimensional nasolabial soft tissue changes following orthognathic surgery.
- To compare soft tissue response to bony movement in different surgical procedures.
Main Methods:
- Utilized structured light scanning and cone-beam computed tomography (CBCT) on 32 malocclusion patients.
- Analyzed 3D changes in 26 facial landmarks before and 3 months after orthognathic surgery.
- Calculated the ratio of soft tissue movement to underlying bony movement.
Main Results:
- Le Fort I advancement resulted in 17% forward nasal tip movement relative to bone, with decreased nasal prominence.
- Alar width increased with maxillary advancement and decreased with setback.
- Soft tissue at the chin (Li point) followed mandibular bone movement (bilateral sagittal split osteotomy) more closely (66%) than maxillary soft tissues (21-14% at Ls point).
Conclusions:
- Alar cinch suturing may not fully counteract maxillary advancement effects on the nasal complex.
- Le Fort I setback effectively prevented alar widening, though the role of suturing is unclear.
- Maxillary soft tissues show less adaptation to bony movements compared to mandibular soft tissues.
- Structured light scanning is a valuable tool for evaluating nasolabial soft tissue changes.
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