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KMID : 0360120120340050311
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Journal of the Korean Society of Maxillofacial Plastic Reconstructive Surgeons
2012 Volume.34 No. 5 p.311 ~ p.319
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The Vertical Changes of Lip and Perioral Soft Tissue Following Orthognathic Surgery in Skeletal Class III Patients by a Cephalometric Analysis of Cone Beam Computed Tomography
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Lee Jong-Min
Kang Joo-Wan
Lee Jong-Ho
Kim Chang-Hyun
Park Je-Uk
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Abstract
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Purpose: The aim of this study is to evaluate the vertical changes of the lip and perioral soft tissue, following orthognathic surgery in skeletal class III patients by a cephalometric analysis of a cone beam computed tomography (CBCT).
Methods: A total of 20 skeletal class III patients, who had bimaxillary surgery with Le Fort 1 osteotomy and bilateral sagittal split ramus osteotomy, were included in this study. The surgical plan for maxilla was posterosuperior impaction with the anterior nasal spine, as the rotation center. Further, the surgical plan for mandible was also posterosuperior movement. The soft tissue changes between lateral cephalogram and CBCT were compared. And the correlations between independent variables and dependent variables were evaluated.
Results: There were no significant differences of the soft tissues changes between lateral cephalogram and CBCT. Upper lip philtrum length (SnLs), nasolabial angle increased and upper lip vermilion length (LsStms), lower lip length (StmiB’), lower lip vermilion length (StmiLi), lower lip philtrum length (LiB’) and soft tissue lower facial height (SnMe’) decreased after surgery. Change of SnLs (${\Delta}$ 수식 이미지SnLs) was influenced by vertical change of menton (${\Delta}$ 수식 이미지MeV), and change of LsStms (${\Delta}$ 수식 이미지LsStms) was influenced by upper lip thickness (ULT). Change of StmiLi’ (${\Delta}$ 수식 이미지StmiLi’) were influenced by preoperative overjet. Change of StmiB’ (${\Delta}$ 수식 이미지StmiB’) were influenced by preoperative overjet, vertical change of lower incisor (${\Delta}$ 수식 이미지L1V) and horizontal change of posterior nasal spine (${\Delta}$ 수식 이미지PNSH). Change of LiB’ (${\Delta}$ 수식 이미지LiB’) was influenced by ${\Delta}$ 수식 이미지L1V and ${\Delta}$ 수식 이미지PNSH. Change of SnMe’ (${\Delta}$ 수식 이미지SnMe’) was influenced by ${\Delta}$ 수식 이미지MeV, horizontal change of upper incisor (${\Delta}$ 수식 이미지U1H) and horizontal change of lower incisor (${\Delta}$ 수식 이미지L1H). ${\Delta}$ 수식 이미지Nasolabial angle was influenced by change of ULT (${\Delta}$ 수식 이미지ULT).
Conclusion: Both soft tissues and hard tissues can be evaluated by CBCT. Posterosuperior rotation of maxillomandibular complex resulted in increase of upper lip philtrum length and nasolabial angle, while the upper lip vermilion length, lower lip philtrum length, lower lip vermilion length, and soft tissue lower facial height showed a decrease.
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KEYWORD
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Orthognathic surgery, Cone-beam computed tomography, Skeletal class III, Soft tissue changes
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