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Three-Dimensional Midfacial Morphology in Skeletal Class III Patients: Postsurgical Changes and Skeletal Correlates
Chihiro Tanikawa1, Kenji Takada2
1Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University.
The Journal of Craniofacial Surgery
|August 10, 2026
Summary
Skeletal Class III malocclusion affects midfacial topography, causing flatter cheek contours. Two-jaw surgery improves cheek shape, with posterior maxillary impaction significantly enhancing cheek contour post-operation.
Area of Science:
- Craniofacial surgery
- Orthodontics
- 3D facial imaging
Background:
- Skeletal Class III malocclusion is characterized by specific midfacial underdevelopment.
- Understanding 3D facial topography is crucial for surgical planning and outcome assessment.
- Previous studies often lacked detailed 3D quantitative analysis of midfacial morphology.
Purpose of the Study:
- To quantify 3D midfacial topography in adults with skeletal Class III malocclusion.
- To evaluate morphologic changes after two-jaw surgery (Le Fort I osteotomy and bilateral sagittal split osteotomy).
- To identify skeletal factors influencing postoperative cheek contour.
Main Methods:
- Collected 3D facial surface data from 72 skeletal Class III patients and 200 controls.
- Utilized sectional-line and surface-based analyses for morphological characterization.
- Performed regression analyses correlating 3D soft tissue changes with cephalometric skeletal movements.
Main Results:
- Skeletal Class III patients presented with flatter cheek contours pre-surgery, especially in the paraorbital and malar regions.
- Two-jaw surgery improved cheek flatness, with measurements approaching those of controls.
- Posterior maxillary impaction (superior displacement of the posterior nasal spine) was significantly linked to improved cheek contour.
Conclusions:
- Established a quantitative 3D framework for assessing cheek morphology in skeletal Class III malocclusion.
- Suggests posterior maxillary impaction plays a key role in improving postoperative cheek contour.
- Forward maxillary movement primarily affects the nasal and upper lip regions.
