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Delayed Soft Tissue Changes after Clockwise Rotation of the Maxillo-Mandibular Complex.

Jin-Ju Kwon1, Young-Hoon Kang2, Dae-Seok Hwang1,3

  • 1Department of Oral and Maxillofacial Surgery, Dental Research Institute, Pusan National University Dental Hospital, Yangsan.

The Journal of Craniofacial Surgery
|February 4, 2022
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Summary

Delayed soft tissue changes in the maxilla-mandibular complex after orthognathic surgery are minimal. This study found no significant soft tissue alterations between 6 and 21 months post-operation, indicating stability after initial healing.

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Area of Science:

  • Orthognathic surgery outcomes
  • Maxillofacial reconstruction
  • 3D imaging analysis

Background:

  • Orthognathic surgery is used to correct jaw discrepancies.
  • Understanding long-term soft tissue changes is crucial for patient satisfaction.
  • Clockwise repositioning is a specific surgical technique.

Purpose of the Study:

  • To evaluate delayed soft tissue changes of the maxilla-mandibular complex (MMC).
  • To assess these changes using 3D cone-beam computed tomography (CBCT).
  • To analyze outcomes after clockwise repositioning orthognathic surgery.

Main Methods:

  • 21 patients underwent clockwise rotational orthognathic surgery.
  • 3D CBCT scans were taken pre-surgery, immediately post-surgery, at 6 months, and 21 months.
  • 9 soft tissue landmarks were measured to analyze changes in transverse, vertical, and anteroposterior dimensions.

Main Results:

  • The nasal tip (Pronasale) showed immediate upward and forward movement.
  • Soft tissue gonions shifted downward and forward between immediate post-op and 6 months.
  • No significant soft tissue changes were observed between 6 and 21 months post-surgery (P < 0.05).

Conclusions:

  • No significant delayed soft tissue changes occur 6-21 months after orthognathic surgery.
  • This stability suggests that soft tissue remodeling is complete after initial edema resolution and hard tissue healing.
  • Findings indicate predictable long-term soft tissue stability following this surgical procedure.