Abstract
BackgroundSoft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors.MethodsPositional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery.ResultsMaxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values.ConclusionThe horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.
Highlights
Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance
To make a surgical plan for Facial asymmetry (FA), the maxillary midline deviation is evaluated by measuring the distance between the maxillary dental midline and facial midline, and the philtrum midpoint is frequently used as a reference point for the facial midline [18, 19]
This study aimed to investigate the horizontal change of the philtrum according to bimaxillary surgery and to analyze the relationship between the horizontal change of the philtrum and the amount of surgical movement of the maxilla and mandible
Summary
Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. The severity of FA is mainly influenced by hard tissue asymmetry of the mandible and maxilla [2], soft tissue asymmetry, such as lip canting or philtrum deviation, is an important factor that can cause an unbalanced facial appearance [3, 4]. The amount of midline deviation is difficult to estimate, which results in decreased precision of the surgical plan To overcome these problems, this study aimed to investigate the horizontal change of the philtrum according to bimaxillary surgery and to analyze the relationship between the horizontal change of the philtrum and the amount of surgical movement of the maxilla and mandible
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