Abstract
Both deep understanding and reliable prediction of postoperative soft tissue changes are crucial for planning orthognathic surgery. Instead of estimating soft tissue responses by measuring individual landmark changes, this study aimed to investigate the relationship (ratio) between soft and hard tissue movements in different facial regions through three-dimensional cone-beam computed tomography (CBCT). Preoperative and postoperative CBCT images were superimposed using the surface registration method on the basis of the cranial base, and 10 facial regions of interest were defined. Region-based volumetric subtractions between the preoperative and postoperative segments were performed. The volumetric differences and surface of each region were used to estimate the average movement. Correlation and regression analyses were performed to examine the relationships between the corresponding soft and hard tissue movements. An overall pattern of facial soft tissue movement was observed in patients with prognathism who underwent orthognathic surgery. The experiment results have shown that mean ratios for the average soft-to-hard tissue movements in the facial regions varied, which may not exactly be similar to the published reports because of the population biocharacteristics and study methods, but the trend is in agreement with the previous studies. Additionally, the prediction capability of the regression model was significantly high, ranging from 0.786 to 0.857, in upper lip, upper vermilion, and chin regions, thus demonstrating that the skin outline changes in these critical regions could be reliably predicted from the underlying bone movements. These results could likely be applied in future soft tissue simulation in orthognathic surgery.
Highlights
Orthognathic surgery corrects maxillomandibular deformity associated with dental malocclusion through osteotomy and repositioning of the maxilla and mandible to achieve an ideal occlusal relationship and facial appearance
This study aimed to investigate a general trend of relationship of the facial soft tissue changes with the underlying skeletal movement in the designated facial regions of interest after two-jaw orthognathic surgery for patients with prognathism through 3D cone-beam computed tomography (CBCT)
The 10 regions were classified into three horizontal sections on the basis of the location for LeFort I osteotomy or BSSO: upper, middle, and lower (Fig 6)
Summary
Orthognathic surgery corrects maxillomandibular deformity associated with dental malocclusion through osteotomy and repositioning of the maxilla and mandible to achieve an ideal occlusal relationship and facial appearance. Relationship between soft and hard tissue changes after orthognathic surgery. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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