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Ramal inclination in the frontal plane after bimaxillary orthognathic surgery in skeletal class III facial asymmetry

Spontaneous changes and stability

Ramal-Inklination in der Frontalebene nach bimaxillärer orthognatischer Chirurgie bei skelettaler Klasse-III-Gesichtsasymmetrie

Spontane Veränderungen und Stabilität

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to observe spontaneous changes of ramal inclination in the frontal plane (FRI) and its stability in skeletal class III asymmetry patients corrected with bimaxillary surgery. The correlation between FRI change and surgical skeletal change was also investigated.

Methods

Forty-nine patients with skeletal class III facial asymmetry who underwent orthognathic surgery with at least 1° change in FRI after surgery were analyzed. FRI and other factors were measured on frontal and lateral cephalograms before surgery (T1), after surgery (T2), and at follow-up after at least 6 months (T3). Correlation analysis was performed to determine pre- and postoperative factors associated with FRI change and stability.

Results

FRI increased significantly on the deviated side and decreased on the nondeviated side after surgery. The FRI changes remained stable during follow-up. No correlation between FRI changes and skeletal changes during surgery were found except between the change of FRI during follow-up (T3–T2) and mandibular setback amount (T2–T1), with a weak coefficient of 0.32.

Conclusion

The FRI changes after bimaxillary orthognathic surgery in skeletal class III asymmetry reduced the FRI difference between the deviated and nondeviated side and remained stable for at least 6 months after surgery. No clinically significant correlation was found between measured skeletal changes during surgery and FRI changes.

Zusammenfassung

Ziel

In dieser Studie sollten spontane Veränderungen der Ramal-Neigung in der Frontalebene (FRI) und ihre Stabilität bei Patienten mit einer skelettalen Klasse-III-Asymmetrie nach bimaxillärer chirurgischer Korrektur beobachtet werden. Darüber hinaus wurde die Korrelation zwischen der FRI-Veränderung und der durch die Operation bedingten Skelettveränderung ermittelt.

Methoden

Untersucht wurden 49 Patienten mit einer skelettalen Klasse-III-Gesichtsasymmetrie, die sich einer kieferorthopädischen Operation unterzogen hatten und bei denen die FRI im Anschluss an die Operation um mindestens 1° verändert war. Die FRI und andere Faktoren wurden auf frontalen und lateralen Kephalogrammen vor der Operation (T1), nach der Operation (T2) und beim Follow-up nach mindestens 6 Monaten (T3) gemessen. Es wurde eine Korrelationsanalyse durchgeführt, um prä- und postoperative, mit der Veränderung und Stabilität des FRI in Zusammenhang stehende Faktoren zu ermitteln.

Ergebnisse

Die FRI nahm nach der Operation auf der devianten Seite signifikant zu und auf der nichtdevianten Seite ab. Die FRI-Veränderungen blieben während der Nachuntersuchung stabil. Zwischen den FRI-Veränderungen und den Skelettveränderungen während der Operation wurde keine Korrelation gefunden, außer zwischen der FRI-Veränderung während der Nachuntersuchung (T3-T2) und dem Ausmaß der Unterkieferrücklage (T2-T1) mit einem schwachen Koeffizienten (0,32).

Schlussfolgerung

Die FRI-Veränderungen nach bimaxillärer orthognater Chirurgie bei skelettalen Klasse-III-Asymmetrien verringerten den FRI-Unterschied zwischen der devianten und der nichtdevianten Seite und blieben für mindestens 6 Monate nach der Operation stabil. Eine klinisch signifikante Korrelation zwischen den gemessenen skelettalen Veränderungen während der Operation und den FRI-Veränderungen wurde nicht nachgewiesen.

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Authors and Affiliations

  1. Department of Orthodontics, School of Dentistry, Kyung Hee University, Hoegi-dong 1, Dongdaemun-gu, 02447, Seoul, Korea (Republic of)

    Eun-Hye Park,  Ae-Rim Ha,  Kyung-A Kim,  Ki-Ho Park &  Yoon-Goo Kang

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  1. Eun-Hye Park
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  2. Ae-Rim Ha
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  3. Kyung-A Kim
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  4. Ki-Ho Park
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  5. Yoon-Goo Kang
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Correspondence to Yoon-Goo Kang.

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Conflict of interest

E.-H. Park, A.-R. Ha, K.-A. Kim, K.-H. Park and Y.-G. Kang declare that they have no competing interests.

Ethical standards

The protocol of this study was approved by the IRB of Kyung Hee University Hospital at Gangdong (IRB approval no.: KHNMC 2018-10-006-002). This study has been granted an exemption from requiring consent to participate due to the retrospective nature of the study without additional interventions. The risk of personal information leakage or infringement was evaluated as minimal with this study (approved by the IRB of Kyung Hee University Hospital at Gangdong).

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Park, EH., Ha, AR., Kim, KA. et al. Ramal inclination in the frontal plane after bimaxillary orthognathic surgery in skeletal class III facial asymmetry. J Orofac Orthop 84 (Suppl 2), 37–44 (2023). https://doi.org/10.1007/s00056-021-00344-9

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  • DOI: https://doi.org/10.1007/s00056-021-00344-9

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