Adaptations in lip posture and pressure following orthognathic surgery

Lip pressures before and after orthognathic surgery were studied to evaluate the relationship between posttreatment soft-tissue adaptation and incisor stability. After all surgical procedures, physiologic adaptation resulted in the maintenance of pressures during speech and swallowing. When the maxilla was advanced by LeFort I osteotomy, a significant decrease in resting pressure of the upper lip was observed instead of the expected increase and incisor stability did not seem related to soft-tissue influences. When the mandible was advanced by sagittal split osteotomy, resting pressure did not increase as expected, but there was a tendency for incisors to become more upright after fixation release, perhaps as a rebound from labial tipping in fixation. When soft tissues were relaxed as the mandible rotated forward following superior repositioning of the maxilla, resting pressures decreased and lower incisors tended to be positioned forward as predicted by equilibrium theory.