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Frontal Changes in the Lower Face After Clockwise Rotation of the Maxillomandibular Complex Without Perisurgical Orthodontic Treatment in Angle Class I and Skeletal Class III Women

  • Original Article
  • Craniofacial/Maxillofacial
  • Published:
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Abstract

Background

Orthognathic surgery has become more popular to slenderize a wide lower face and to improve facial esthetics in Asian patients with normal occlusion. Clockwise rotation (CR) of the maxillomandibular complex (MMC) steepens the mandibular plane. This study performed a quantitative analysis on the influence of CR on slenderness of the lower face from the frontal view.

Patients and Methods

This retrospective study included 36 female patients with Angle Class I occlusion and skeletal Class III pattern. The subjects underwent CR of the MMC without perioperative orthodontic treatment and change in the occlusion only for the purpose of esthetic improvement. Linear and angular variables were measured on a cephalogram and three-dimensional computed tomography (3D CT) obtained before and at least 6 months after surgery. Data were analyzed using paired t tests and Spearman correlations. Univariate regression analysis was used to predict the postoperative change according to the amount of posterior impaction.

Results

The mean posterior impaction was 3.81 mm. All mandibular plane angle (MPA) measurements were increased (ranged from 5.69° to 13.12°, p < 0.001), exhibiting a significant correlation with the amount of posterior impaction. Bigonial width measurements were decreased after surgery (ranged from 4.97 to 5.51 mm, p < 0.001). Among the MPAs derived from the 3D CT, the coronal projection from the frontal view exhibited a discrepancy between right and left side.

Conclusions

The changes in linear and angular measurements in this study indicate that the lower face becomes narrower and more slender as the MMC rotates in a clockwise direction. Orthognathic surgery with CR has the advantage of increasing the MPAs and obtaining natural soft tissue contouring while minimizing the amount of bone resection.

Level of Evidence IV

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References

  1. Borzabadi-Farahani A, Eslamipour F, Shahmoradi M (2016) Functional needs of subjects with dentofacial deformities: a study using the index of orthognathic functional treatment need (IOFTN). J Plast Reconstr Aesthet Surg 69:796–801

    Article  PubMed  Google Scholar 

  2. Lee LW, Chen SH, Yu CC, Lo LJ, Lee SR, Chen YR (2007) Stigma, body image, and quality of life in women seeking orthognathic surgery. Plast Reconstr Surg 120:225–231

    Article  CAS  PubMed  Google Scholar 

  3. Rivera SM, Hatch JP, Dolce C, Bays RA, Van Sickels JE, Rugh JD (2000) Patients’ own reasons and patient-perceived recommendations for orthognathic surgery. Am J Orthod Dentofac Orthop 118:134–141

    Article  CAS  Google Scholar 

  4. Olson RE, Laskin DM (1980) Expectations of patients from orthognathic surgery. J Oral Surg 38:283–285

    CAS  PubMed  Google Scholar 

  5. Jin H, Kim BH, Woo YJ (2006) Three-dimensional mandible reduction: correction of occlusal class I in skeletal class III cases. Aesthet Plast Surg 30:553–559

    Article  Google Scholar 

  6. Jin H (2005) Misconceptions about mandible reduction procedures. Aesthet Plast Surg 29:317–324

    Article  Google Scholar 

  7. Ricketts RM (1957) Planning treatment on the basis of the facial pattern and an estimate of its growth. Angle Orthod 27:14–37

    Google Scholar 

  8. McNamara JA Jr (1984) A method of cephalometric evaluation. Am J Orthod 86:449–469

    Article  PubMed  Google Scholar 

  9. Yang SD, Suhr CH (1995) F-H to AB plane angle (FABA) for assessment of anteroposterior jaw relationships. Angle Orthod 65:223–231

    CAS  PubMed  Google Scholar 

  10. Kim JY, Lee SJ, Kim TW, Nahm DS, Chang YI (2005) Classification of the skeletal variation in normal occlusion. Angle Orthod 75:311–319

    PubMed  Google Scholar 

  11. Baek RM, Lee SW (2010) A new condyle repositionable plate for sagittal split ramus osteotomy. J Craniofac Surg 21:489–490

    Article  PubMed  Google Scholar 

  12. Arnett GW, Gunson MJ (2004) Facial planning for orthodontists and oral surgeons. Am J Orthod Dentofac Orthop 126:290–295

    Article  Google Scholar 

  13. Reyneke JP (2009) Rotation of the occlusal plane. In: Fonseca RJ, Marciani RD, Turvery TA (eds) Oral and maxillofacial surgery, vol 3, 2nd edn. Saunders/Elsevier, St. Louis, pp 248–271

    Google Scholar 

  14. Bang SM, Kwon YD, Kim SJ, Lee BS, Choi BJ, Ohe JY, Suh JH (2012) Postoperative stability of 2-Jaw surgery with clockwise rotation of the occlusal plane. J Craniofac Surg 23:486–490

    Article  PubMed  Google Scholar 

  15. Sonego CL, Bobrowski AN, Chagas OL Jr, Torriani MA (2014) Aesthetic and functional implications following rotation of the maxillomandibular complex in orthognathic surgery: a systematic review. Int J Oral Maxillofac Surg 43:40–45

    Article  CAS  PubMed  Google Scholar 

  16. Reyneke JP, Evans WG (1990) Surgical manipulation of the occlusal plane. Int J Adult Orthod Orthognath Surg 5:99–110

    CAS  Google Scholar 

  17. Sarver DM (2001) The importance of incisor positioning in the esthetic smile: the smile arc. Am J Orthod Dentofac Orthop 120:98–111

    Article  CAS  Google Scholar 

  18. Lee SW, Ahn SH (2103) Angloplasty revision: importance of genioplasty for narrowing of the lower face. Plast Reconstr Surg 132:435–442

    Article  Google Scholar 

  19. Betts NJ, Dowd KF (2000) Soft tissue changes associated with orthognathic surgery. Atlas Oral Maxillofac Surg Clin N Am 8:13–38

    CAS  Google Scholar 

  20. Wolford LM, Chemello PD, Hilliard FW (1993) Occlusal plane alteration in orthognathic surgery. J Oral Maxillofac Surg 51:730–740

    Article  CAS  PubMed  Google Scholar 

  21. Posnick JC, Fantuzzo JJ, Orchin JD (2006) Deliberate operative rotation of the maxillo-mandibular complex to alter the A-Point to B-Point relationship for enhanced facial esthetics. J Oral Maxillofac Surg 64:1687–1695

    Article  PubMed  Google Scholar 

  22. Choi JW, Lee JY, Oh TS, Kwon SM, Yang SJ, Koh KS (2014) Frontal soft tissue analysis using a 3 dimensional camera following two-jaw rotational orthognathic surgery in skeletal class III patients. J Craniomaxillofac Surg 42:220–226

    Article  PubMed  Google Scholar 

  23. Donatsky O, Bjorn-Jorgensen J, Hermund NU, Nielsen H, Holmqvist-Larsen M, Nerder PH (2009) Accuracy of combined maxillary and mandibular repositioning and of soft tissue prediction in relation to maxillary antero-superior repositioning combined with mandibular set back: a computerized cephalometric evaluation of the immediate postsurgical outcome using the TIOPS planning system. J Craniomaxillofac Surg 37:279–284

    Article  PubMed  Google Scholar 

  24. Aboul-Hosn Centenero S, Hernandez-Alfaro F (2012) 3D planning in orthognathic surgery: CAD/CAM surgical splints and prediction of the soft and hard tissues results—our experience in 16 cases. J Craniomaxillofac Surg 40:162–168

    Article  PubMed  Google Scholar 

  25. Cavalcanti MG, Haller JW, Vannier MW (1999) Three-dimensional computed tomography landmark measurement in craniofacial surgical planning: experimental validation in vitro. J Oral Maxillofac Surg 57:690–694

    Article  CAS  PubMed  Google Scholar 

  26. Ludlow JB, Gubler M, Cevidanes L, Mol A (2009) Precision of cephalometric landmark identification: cone-beam computed tomography vs. conventional cepahlometric views. Am J Orthod Dentofacial Orthop 136:312.e1–312.e10

    Google Scholar 

  27. Yuan L, Shen G, Wu Y, Jiang L, Yang Z, Liu J, Mao L, Fang B (2013) Three-dimensional analysis of soft tissue changes in full-face view after surgical correction of skeletal class III malocclusion. J Craniofac Surg 24:725–730

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. DA Plastic Surgery Clinic, 8F, W Tower, 54, Seocho-daero 77-gil, Seocho-gu, Seoul, Republic of Korea

    Sang Woo Lee, Kikap Kim & Seung Hyun Ahn

  2. Banobagi Plastic Surgery Clinic, Seoul, Republic of Korea

    Jeongmok Cho

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  1. Sang Woo Lee
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  2. Jeongmok Cho
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  4. Seung Hyun Ahn
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Correspondence to Seung Hyun Ahn.

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Lee, S.W., Cho, J., Kim, K. et al. Frontal Changes in the Lower Face After Clockwise Rotation of the Maxillomandibular Complex Without Perisurgical Orthodontic Treatment in Angle Class I and Skeletal Class III Women. Aesth Plast Surg 41, 641–649 (2017). https://doi.org/10.1007/s00266-017-0838-7

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  • DOI: https://doi.org/10.1007/s00266-017-0838-7

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