Predicting soft tissue changes in maxillary impaction surgery: a comparison of two video imaging systems

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Medical Imaging

Background:

• Accurate prediction of soft tissue profile changes is crucial for orthognathic surgery outcomes.
• Video imaging systems offer a potential tool for pre-surgical planning and patient consultation.

Purpose of the Study:

• To compare the accuracy of Orthognathic Treatment Planner (OTP) and Prescription Portrait (Portrait) in predicting soft tissue profile changes following maxillary impaction surgery.
• To assess the subjective perception of prediction accuracy by clinicians and laypersons.

Main Methods:

• Retrospective comparison of computer-generated soft tissue profile predictions with actual postsurgical results.
• Quantitative analysis of linear and vertical discrepancies between predicted and actual profiles.
• Subjective evaluation of prediction image realism using visual analog scales by orthodontists, surgeons, and laypeople.

Main Results:

• Neither system demonstrated high accuracy in vertical measurements or lower lip contour prediction.
• Prescription Portrait exhibited greater accuracy in the y-axis direction for pronasale, inferior labial sulcus, and pogonion (P < 0.05).
• Portrait's prediction images received higher subjective ratings from evaluators in five out of eight facial areas compared to OTP.

Conclusions:

• Prescription Portrait offers improved accuracy over OTP for predicting certain soft tissue landmarks after maxillary impaction.
• Subjective assessments indicate a preference for Portrait's predictions, though limitations exist in accurately predicting lip and chin aesthetics.
• Further refinement of video imaging systems is needed to enhance prediction accuracy for all facial features in orthognathic surgery planning.