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Differences in soft-tissue thickness changes after bimaxillary surgery between patients with vertically high angle

Sung-Hwan Choi1, Hyemin Lee2, Jae Joon Hwang3

  • 1Department of Orthodontics, Institute of Craniofacial Deformity, and BK21 PLUS Project, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea.

American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics
|October 31, 2020
PubMed
Summary

Bimaxillary surgery for skeletal Class III malocclusion may slightly increase pogonion soft-tissue thickness in high-angle patients. However, complete normalization of the lower lip area is not fully achieved post-surgery.

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Area of Science:

  • Orthodontics and Maxillofacial Surgery
  • Skeletal Malocclusion Research
  • Facial Plasticity Studies

Background:

  • Skeletal Class III malocclusion with mandibular prognathism presents unique challenges in soft-tissue changes after corrective surgery.
  • Vertical facial patterns can influence treatment outcomes and aesthetic results.

Purpose of the Study:

  • To evaluate soft-tissue thickness changes following bimaxillary surgery in patients with skeletal Class III malocclusion.
  • To analyze these changes based on differing vertical facial patterns (normal vs. high mandibular plane angle).

Main Methods:

  • Forty-three Korean patients with skeletal Class III malocclusion undergoing bimaxillary surgery were categorized into normal-angle (N) and high-angle (H) groups based on the mandibular plane angle (SN-MP).
  • 3D cone-beam computed tomography (CBCT) was used to assess hard and soft-tissue landmarks before and after surgery.
  • Postoperative soft-tissue thickness was compared to a control group with skeletal Class I malocclusion.

Main Results:

  • Preoperative pogonion (Pog) thickness was significantly less in the high-angle group (H) compared to the normal-angle group (N).
  • A weak positive linear relationship was found between the presurgical SN-MP angle and postoperative soft-tissue Pog thickness change.
  • Despite surgical correction, the soft-tissue area below the lower lips did not achieve complete normalization.

Conclusions:

  • Soft-tissue pogonion thickness may show a slight increase after bimaxillary surgery in skeletal Class III patients with higher preoperative mandibular plane angles.
  • Complete normalization of the soft-tissue profile, particularly in the lower lip area, remains a challenge even after surgical intervention.