Korean J Orthod.  2008 Apr;38(2):83-94. 10.4041/kjod.2008.38.2.83.

Soft tissue change of the midface in skeletal class III orthognathic surgery patients

• Jung JH
• Kim SS
• Son WS
• Park SB

• KMID: 1481496
• DOI: http://doi.org/10.4041/kjod.2008.38.2.83

Abstract

PURPOSE
The first objective of this study was to compare the upper midface morpholgy, focusing on the soft tissues, between skeletal Class III maloccusion patients with midfacial depression and the norm. The second objective was to estimate and analyze the change in the upper midface soft tissues following surgical correction with maxillary advancement by Lefort I osteotomy and mandibular setback by bilateral sagittal split osteotomy (BSSRO).
METHODS
The samples consisted of 34 adult patients (15 males and 12 females) with an average age of 21years, who had severe anteroposterior discrepancy with midfacial depression. These patients had received presurgical orthodontic treatment and surgical treatment which consisted of simultaneous Lefort I osteotomy and BSSRO.
RESULTS
The correlation coefficient between changes in maxillary advancement and changes in Or' (soft tissue orbitale) was 0.599 (p < 0.05). Change in maxillary plane angle and vertical change of the maxilla were not correlated with the change in Or' (p < 0.05). The ratio of soft tissue change in Or' to maxillary advancement was 43.57 %, and 81.54 % in Sn. Regression equations between maxillary movement and Or' were devised. The r2 value was 0.476.
CONCLUSIONS
The majority of measurements in the upper midface in skeletal Class III maloccusions when compared to the norm, showed significant differences. In Class III malocclusion with midfacial depression, maxillary advancement produces soft tissue change in the upper midface.

Keyword

Skeletal class III malocclusion; midface; soft tissue change; orthognathic surgery

MeSH Terms

Adult
Depression
Humans
Male
Malocclusion
Maxilla
Orthognathic Surgery
Osteotomy

Figure

• 

  Fig 1 Landmarks and linear (Left) and angular (Right) measurements. S (Sella); N (Nasion); Or (Orbitale); Or' (Soft tissue Orbitale), the intersection point of the soft tissue on Orbitale and the FH plane; A (Subspinale, point A); Sn (Subnasale); G (Glabella); Nd, the intersection point of the FH plane and the dorsum of nose; S', the perpendicularly projected point from S onto the FH plane; N', the perpendicularly projected point from N onto the FH plane; A', the perpendicularly projected point from the point A onto the FH plane; Sn', the perpendicularly projected point from Sn onto the FH plane; G', the perpendicularly projected point from G onto the FH plane; S'-A'; S-N; S'-Or; S'-Or'; S'-G'; S'-Sn'; N'-Or; G'-Or'; A⊥FH, The distance from A point to FH plane; Or⊥NA, the distance from Or to NA line; Or'⊥GSn, the distance from Or' to GSn line; Sn⊥FH, the distance from Sn to FH plane.

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