Related Experiment Video
Updated: Jul 15, 2025
Treatment of Facial Deformities using 3D Planning and Printing of Patient-Specific Implants
Published on: May 23, 2020
Does Clockwise Rotation of Maxillomandibular Complex Using Surgery-First Approach to Correct Mandibular Prognathism
Chatuthat Wannalerkngam1, Suraj Prasad Sinha2, Thuy-Duong Tran-Duy3
1Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan; Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Background:
Facial aesthetics may be optimized based on a deeper understanding of soft tissue changes after orthognathic surgery.
Purpose:
The purpose of the study was to delineate facial soft tissue changes after clockwise rotation (CWR) of the maxillomandibular complex (MMC) to correct mandibular prognathism using the surgery-first approach.
Study Design, Setting, Sample:
This prospective cohort study enrolled patients over 18 years of age with skeletal Class III malocclusion in the craniofacial center. The patients were excluded with previous history of craniofacial syndrome, orthognathic surgery trauma, infection at surgical sites, chin deviation (menton deviation ≥4 mm), 2 or more missing data points after surgery, or without informed consent. This study compared significant facial changes before (T0) and after orthodontic debonding (T1) in the CWR and control groups.
Predictor Variable:
The patients were divided in accordance with maxillary occlusal plane change (OPC) after surgery into CWR (OPC >4°) and control (OPC ≤4°) groups.
Main Outcome Variable:
The primary outcome variable was frontal lip curvature (FLC: Right Cheilion-Stomion-Left Cheilion, degree) with or without upper lip curving upward at T1, where upper lip curving upward was considered more favorable.
Covariates:
The covariates included age, sex, and various cephalometric measurements.
Analyses:
The Mann-Whitney U test, paired, and independent t-test were implemented to compare the intragroup and intergroup differences. Statistical significance was indicated by P value <.05.
Results:
The study comprised 34 patients (21 women) in the control group and 37 (29 women) in the CWR group; their mean ages were 23.64 ± 4.38 and 24.21 ± 3.84 years, respectively (P value = .562). At T1, the CWR group had significant increased FLC (P value = .001), alar width (P value = .034), and lower vermilion height (P value = .018), and decreased lower lip length (P value = .004). The high FLC group had significant decreased upper lip projection (P value = .002) and increased nasolabial angle (P value = .013). The significant relationship between CWR and high FLC was supported by the χ2 test (P value = .018) and multiple logistic regression (P value = .017).
Conclusion:
Greater CWR of the MMC increased FLC and lower vermilion height and reduced lower lip length. High FLC resulting from the CWR of the MMC improved facial appearance by moving the upper lip curve upward.
More Related Videos
19:53Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
05:54Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021