Abstract

Aim and objective: The main aim and objectives of this study was to determine the changes in the facial soft tissue profile following orthognathic surgery, to evaluate eventual treatment effects on stability of facial aesthetics and degree of predictability of these changes.
 Materials and method: 15 numbers of patients underwent with le fort I, anterior maxillary osteotomy, genioplasty and bimaxillary surgery. The alar base cinch suture and the V-Y closure techniques were used in each maxillary procedure. The criteria applied included an average follow-up of 6 months post-operatively.
 Results: In this study preoperative and postoperative cephalometric tracing were compared to analyze the soft tissue profile changes in relation to hard tissue changes in both upper and lower lip and chin regions after double jaw surgery. Only horizontal changes were analyzed for which an X-Y coordinate system was used. The upper lip responded variably to the direction and amount of maxillary positioning. The predictability and the significance of changes of soft tissue in relation to hard tissue are variable as it reaches towards the nose.
 Conclusion: It is important for the clinician to realize that numerous factors of variability exist so that he can understand that the soft-tissue profile will sometimes deviate quite markedly from what is expected, in spite of careful planning.

Highlights

  • The principal goal of orthognathic surgery is the establishment of a balanced and stable dentoskeletofacial complex

  • A perpendicular line was dropped from point N for hard tissue analysis and from point G for soft tissue analysis to quantify changes in horizontal direction.[4]

  • The results showed a mean change of 0.799 ± 0.0658 for shift Ls/ shift Upper Incisal Edge (UIE) which concludes a soft tissue change of 0.799 for every one millimeter of hard tissue change

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Summary

Introduction

The principal goal of orthognathic surgery is the establishment of a balanced and stable dentoskeletofacial complex. One of the objectives to this end is the achievement of an esthetically pleasing facial soft tissue envelope. This mandates that the surgeon be acutely aware of the dentalskeletal components of the face. Close collaboration between surgeon and orthodontist should allow for the correction of dentoskeletofacial deformities in order to improve function while optimizing facial esthetics.[1] Survey of the human race even from prehistoric era and analyzing archeological artifacts show awareness of beauty and facial esthetics. St. Thomas was expressing the direct and very often measurable relationship that exists between beauty and mathematics, a relationship that applies to both natural beauty and art.[2] Despite many theoretical advantages of surgery for correction of dentoalveolar and skeletal disharmony; many orthodontists still view such treatment as radical, dangerous and unpredictable. With the introduction of anterior and posterior maxillary osteotomy, total maxillary osteotomy, anterior mandibular subapical osteotomy and genioplasty; restoration of occlusal balance and facial harmony was attainable practically in all cases.[3]

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