Comparative Study of the Effect of Paranasal Augmentation With Autologous Bone in Orthognathic Surgery

Abstract

The purpose of the present study was to compare the effectiveness of the 3 orthognathic surgical options among the patients who had had mandibular prognathism with a concave midfacial profile. A total of 72 patients with mandibular prognathism with a concave midfacial profile were divided into 3 groups. We compared the lateral profile changes using lateral cephalograms. The images were taken before surgery (T0) and at least 6months to 1year after surgery (T1). After computerization of the preoperative cephalograms (T0), the surgical changes (T1 minus T0) were measured by computerizing the postoperative cephalograms. Group 1 (n=21) had undergone bilateral sagittal split osteotomies, group 2 (n=36) had undergone bilateral sagittal split osteotomy with autologous bone paranasal augmentation, and group 3 (n=15) had undergone bilateral sagittal split osteotomies and Le Fort I osteotomy. After surgery, all the landmarks and values showed changes. Among them, quantitative changes could be observed in all the cheek points and cheek lines. The average of the overall cheek points had increased by ∼0.56mm in group 1, ∼1.85mm in group 2, and ∼2.39mm in group 3, horizontally. The results of the present study suggest approximately comparative values among the 3surgical options for patients and surgeons considering orthognathic surgery. In addition, autologous bone paranasal augmentation can be considered as an alternative for Le Fort I osteotomy in specific conditions.