Abstract
PurposeSince improvement of facial aesthetics after orthognathic surgery moves increasingly into the focus of patients, prediction of soft tissue response to hard tissue movement becomes essential for planning. The aim of this study was to assess the facial soft tissue response in skeletal class II and III patients undergoing orthognathic surgery and to compare the potentials of cephalometry and two-dimensional (2-D) photogrammetry for predicting soft tissue changes.Material and methodsTwenty-eight patients with class II relationship and 33 with class III underwent bimaxillary surgery. All subjects had available both a traced lateral cephalogram and a traced lateral photogram taken pre- and postsurgery in natural head position (median follow-up, 9.4 ± 0.6 months).ResultsFacial convexity and lower lip length were highly correlated with hard tissue movements cephalometrically in class III patients and 2-D photogrammetrically in both classes. In comparison, cephalometric correlations for class II patients were weak. Correlations of hard and soft tissue movements between pre- and postoperative corresponding landmarks in horizontal and vertical planes were significant for cephalometry and 2-D photogrammetry. No significant difference was found between cephalometry and 2-D photogrammetry with respect to soft to hard tissue movement ratios.ConclusionsThis study revealed that cephalometry is still a feasible standard for evaluating and predicting outcomes in routine orthognathic surgery cases. Accuracy could be enhanced with 2-D photogrammetry, especially in class II patients.
Highlights
During recent decades, orthognathic surgery has become widely accepted as the preferred method of correcting moderate to severe skeletal deformities including facial aesthetics
Recognition of aesthetic factors and prediction of the final facial profile play an increasingly important role in orthognathic treatment planning, since the facial profile produced by orthognathic surgery is highly significant for patients [1,2,3]
Hard tissue angles assessed by cephalometry changed significantly from pre- to postsurgery in class II and III patients (sella-nasion point A (SNA), pclass II00.041, pclass III00.015; sella-nasion point B (SNB), pclass II00.009, pclass III00.008; A intersect B (ANB), pclass II00.016, pclass III
Summary
Orthognathic surgery has become widely accepted as the preferred method of correcting moderate to severe skeletal deformities including facial aesthetics. Many studies have attempted to evaluate the relationship between hard tissue surgery and its effect on the overlying soft tissue for predicting facial changes [4,5,6]. Threedimensional (3-D) imaging techniques, including computer tomography, video imaging, laser scanning, morphanalysis, 3D sonography, and, recently, 3-D photogrammetry [7,8,9,10,11,12,13] have been developed to highlight the relationship between hard and soft tissue movements, but details of this relationship, in the vertical direction, have varied and not been fully clarified [14]. The objective of this study was to assess the facial soft tissue response in skeletal class II and III patients treated by bimaxillary
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