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Frontal-view nasolabial soft tissue alterations after bimaxillary orthognathic surgery in Class III patients

Nasolabiale Weichteilveränderungen in Frontalansicht nach bimaxillärem orthognatem Eingriff bei Klasse-III-Patienten

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Abstract

Introduction

The aim of this before–after clinical trial was to evaluate nasolabial soft tissue changes in the frontal plane after bimaxillary surgery.

Methods

A total of 20 skeletal Class III Iranian patients needing bimaxillary Le Fort I osteotomy plus mandibular setback surgery were enrolled in this trial. Patients underwent 4.02 ± 1.02 mm of maxillary advancement (Le Fort I osteotomy, 4.33 ± 1.21 mm in men, 3.81 ± 0.86 mm in women) and 7.13 ± 1.74 mm of mandibular setback (intraoral vertical ramus osteotomy, 7.71 ± 2.33 mm in men, and 6.74 ± 1.16 mm in women). Data were acquired via 2D frontal photographs. We compared pretreatment baseline (T 1), preoperative postorthodontic treatment (T 2), and postoperative (T 3) anthropometric measurements using repeated-measures ANOVA and Bonferroni tests (α = 0.05).

Result

The 20 patients (12 men, 8 women) were aged 21.85 ± 1.75 years. Between T 1 and T 2, nasal width, cutaneous upper labial heights increased overall; cutaneous lower labial height decreased (P < 0.05). Between T 2 and T 3, nasal width, widths of the philtrum and mouth, cutaneous upper-lip height, vermilion height of the lower lip, lateral upper-lip height increased; the upper-lip vermilion height and cutaneous lower lip height decreased (P < 0.05). The changes ranged between 0.5 and 5 mm.

Conclusion

The applied orthognathic surgery procedures might widen the alar base and mouth width. It might increase the lateral upper-lip height, vermilion height of the lower lip, and cutaneous and overall upper-lip heights while reducing upper-lip vermilion height and shortening the overall lower-lip height.

Zusammenfassung

Einleitung

Ziel dieser klinischen Vorher-nachher-Studie war es, die nasolabialen Weichteilveränderungen in der frontalen Ebene nach bimaxillärem Eingriff zu evaluieren.

Methoden

Insgesamt 20 iranische Klasse-III-Patienten, bei denen eine kombinierte Le-Fort-I-Osteotomie und Unterkieferrückverlagerungindiziert war, wurden in die Studie aufgenommen. Erreicht wurden eine Oberkiefervorverlagerung von 4,02 ± 1,02 mm (Le-Fort-I-Osteotomie, 4,33 ± 1,21 mm bei den männlichen, 3,81 ± 0,86 mm bei den weiblichen Patienten) und eine Unterkieferrückverlagerung von 7,13 ± 1,74 mm (vertikale Osteotomie des Ramus, 7,71 ± 2,33 mm bei den männlichen und 6,74 ± 1,16 mm bei den weiblichen Patienten). Über 2-D frontale Fotografien wurden Daten erhoben. Verglichen wurde mittels ANOVA (Analysis of Variance) für wiederholte Messungen und dem Bonferroni-Test (α = 0,05) Daten jeweils zu den Zeitpunkten Baseline (T 1), präoperative postkieferorthopädische Behandlung (T 2) und postoperativ (T 3).

Ergebnis

Die Patienten (12 Männer, 8 Frauen) waren zwischen 21,85 ± 1,75 Jahre alt. Zwischen T 1 und T 2 erhöhten sich die Nasenbreite und die kutanen Oberlippenhöhen insgesamt, die kutane Unterlippenhöhe verringerte sich (p < 0,05). Zwischen T 2 und T 3 erhöhten sich die Nasenbreite, die Breite von Philtrum und Mund spalte, die kutane Höhe der Oberlippe, die Höhe des Unterlippenrots und die seitliche Oberlippenhöhe, dagegen verringerten sich die Höhe des Oberlippenrots und die kutane Unterlippenhöhe (p < 0,05). Das Ausmaß der Veränderungen lag zwischen 0,5 und 5 mm.

Schlussfolgerung

Mittels der durchgeführten Eingriffe der orthognathen Chirurgie verbreiterten sich die Nasenbasis und die Mundspalte. Zudem vergrößerten sich die laterale Oberlippenhöhe, die Höhe des Unterlippenrots sowie die kutane und die Gesamthöhe der Oberlippe, während die Höhe des Oberlippenrots und die Gesamthöhe der Unterlippe abnahmen.

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Author contributions and acknowledgments

S. Hemmatpour conceived, designed, mentored the study, and performed orthodontic treatments. F. Kadkhodaei-Oliadarani did the cephalometric and photographic analyses, wrote the thesis, and prepared Fig. 1. A. Hasani mentored the thesis. V. Rakhshan designed and performed the statistical analyses, hand-drew Fig. 2, and drafted/revised the paper. Authors wish to express their sincere gratitude to Prof. Mesgarzadeh for performing the surgeries.

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Authors and Affiliations

  1. Department of Orthodontics, Dental Branch, Islamic Azad University, Tehran, Iran

    Siamak Hemmatpour

  2. Department of Pediatric Dentistry, Dental School, Shahed University, Tehran, Iran

    Fatemeh Kadkhodaei Oliadarani

  3. Department of Maxillofacial Surgery, Dental Branch, Islamic Azad University, Tehran, Iran

    Ali Hasani

  4. Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Vahid Rakhshan

  5. Department of Dental Anatomy, Dental Branch, Islamic Azad University, Tehran, Iran

    Vahid Rakhshan

  6. No. 12, Shahed 1 Alley, Sardar Jangal Blvd, Poonak Square, Tehran, Iran

    Fatemeh Kadkhodaei Oliadarani

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  1. Siamak Hemmatpour
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  3. Ali Hasani
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  4. Vahid Rakhshan
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Correspondence to Fatemeh Kadkhodaei Oliadarani.

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Conflict of interest

S. Hemmatpour, F. Kadkhodaei-Oliadarani, A. Hasani, and V. Rakhshan declare that they have no competing interests.

Additional information

Postgraduate Student: Fatemeh Kadkhodaei-Oliadarani.

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Hemmatpour, S., Kadkhodaei Oliadarani, F., Hasani, A. et al. Frontal-view nasolabial soft tissue alterations after bimaxillary orthognathic surgery in Class III patients. J Orofac Orthop 77, 400–408 (2016). https://doi.org/10.1007/s00056-016-0047-z

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  • DOI: https://doi.org/10.1007/s00056-016-0047-z

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