Abstract
Objectives
To measure the effect of orthognathic surgery on Class II:1 profile silhouette esthetics and to identify pretreatment parameters and thresholds for consistent esthetic improvement.
Methods
Pre- and posttreatment black profile silhouettes of 20 patients with Class II:1 malocclusion who had received combined orthodontic/orthognathic treatment were evaluated retrospectively by 20 European orthodontists and laypeople each using a visual analogue scale (VAS). A variety of pretreatment skeletal and facial angles were measured cephalometrically and on the silhouette profiles. Descriptive statistics and Pearson’s correlation coefficients were calculated.
Results
The population showed a mean VAS improvement of 12.6%. VAS changes were significantly and directly related to pretreatment ANB in all evaluator groups (r = 0.48–0.59), whereas the interrelation with the degree of pretreatment profile convexity angle was less clear and statistically significant for the orthodontic evaluators only (r = −0.34 to −0.51). The highest correlation coefficients in all evaluator groups were seen for the relationship with pretreatment VAS scores (r = −0.64 to −0.73).
Conclusion
The lower the pretreatment VAS score and the profile convexity angles or the larger the pretreatment ANB angles were, the more the VAS improved. Pretreatment thresholds for consistent improvements were as follows: VAS score < 20 mm, ANB > 8°, and profile angle ≤ 155°.
Zusammenfassung
Ziel
Erfassung der Auswirkung einer kombiniert kieferorthopädisch/kieferchirurgischen Klasse-II:1-Behandlung auf das Gesichtsprofil sowie Identifikation prätherapeutischer Faktoren und Grenzwerte, die eine definitiv vorhersagbare Verbesserung der Profilästhetik versprechen.
Methode
Aus den prä- und posttherapeutischen Profilfotos von 20 kombiniert kieferorthopädisch/kieferchirurgisch behandelten Klasse-II:1-Patienten wurden schwarze Scherenschnittprofile angefertigt. Diese wurden mittels visueller Analogskala (VAS) von jeweils 20 europäischen Kieferorthopäden und Laien beurteilt. Diverse prätherapeutische skelettale und faziale Parameter wurden kephalometrisch und anhand der Scherenschnittprofile bestimmt. Die statistische Auswertung erfolgte deskriptiv und mit dem Korrelationskoeffizienten nach Pearson.
Ergebnisse
Die untersuchte Patientengruppe zeigte eine mittlere VAS-Verbesserung von 12,6%. In allen Beurteilergruppen korrelierten die VAS-Veränderungen signifikant und direkt mit dem prätherapeutischen ANB-Winkel (r = 0,48 bis 0,59), der Zusammenhang mit der prätherapeutischen Profilkonvexität dagegen war weniger deutlich und nur in der kieferorthopädischen Beurteilergruppe statistisch signifikant (r = −0,34 bis −0,51). Die höchsten Korrelationskoeffizienten aller Beurteilergruppen waren für den Zusammenhang von post- und prätherapeutischen VAS-Beurteilungen zu beobachten (r = −0,64 bis −0,73).
Schlussfolgerung
Je niedriger der prätherapeutische VAS-Wert und der Profilkonvexitätswinkel waren bzw. je größer der prätherapeutische ANB-Winkel, desto höher war die VAS-Verbesserung. Als prätherapeutische Grenzwerte für eine konstante Profilverbesserung erwiesen sich ein VAS-Wert < 20 mm, ein ANB-Winkel > 8° und ein Profilkonvexitätswinkel ≤ 155°.
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The study protocol was approved by the ethical committee of the Justus-Liebig-University Gießen (No. 145/13). This article does not contain any studies with human participants or animals performed by any of the authors.
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Klaus, K., Heumann, C. & Ruf, S. Effect of orthognathic surgery on profile esthetics in Class II:1 malocclusions. J Orofac Orthop 78, 472–479 (2017). https://doi.org/10.1007/s00056-017-0099-8
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DOI: https://doi.org/10.1007/s00056-017-0099-8