SOFT TO HARD TISSUE RATIOS AFTER BIMAXILLARY ORTHOGNATHIC SURGERY IN CLASS III PATIENTS

Year 2022, Volume: 32 Issue: 1, 85 - 91, 15.02.2022

Kevser Kurt Demirsoy Gökmen Kurt

https://doi.org/10.17567/ataunidfd.1037986

Abstract

Abstract
Objective: The aim of this study was to assess the changes of facial soft tissue profile and determine the soft to hard tissue ratios, and develop a new mathematical formulation between hard and soft tissues for two dimensional simulation systems in Class III patients.
Methods: Twenty skeletal Class III patients were included in this study. Preoperative (T0) and posttreatment (T1) cephalometric variables were assessed on lateral cephalograms. Method error was determined by redigitizing 10 patients’ measurements 3 weeks after initial digitization. Presurgical and postsurgical cephalometric measurements were compared with dependent two-sample t-test and statistical significance set at P < .05.
Results: Our material was homogeneous in terms of gender and maxillary and mandibular movement. In the maxilla the soft to hard tissue ratios were as follows; 23% for the tip of the nose, 45% for Sn, 70% for A*, and 60% for Ls. Sagitally, the soft to hard tissue ratios for mandible were; Li 77%, B* 101%, Pog* 83%, 81% for Gn*, and 95% for Me*point. According to the results, it was found that the soft tissue B point (B*) moved equally with the mandible (101%), and the tip of the nose (Pn) is the soft tissue point that was least affected by the movement of the underlying skeletal structure (0.23%).
Conclusion: The significant improvement in facial profiles of skeletal Class III orthognathic surgery patients after maxillary advancement and mandibular setback surgery is primarily related to the backward movement of the mandible. The correlation between soft and hard tissues in the mandible is higher than in the maxilla. As a result of our study, new formulations and soft to hard tissue ratios were developed for 2D prediction methods.
Key words: Soft to hard tissue ratios, bimaxillary surgery, profile changes

ÖZ
Amaç: Bu çalışmada, çift çene cerrahisi geçirmiş iskeletsel Sınıf III hastalarda yumuşak doku profilindeki değişiklikleri değerlendirmek ve yumuşak-sert doku takip oranlarını belirleyerek iki boyutlu simülasyon sistemleri için bir formülasyon oluşturmak amaçlanmıştır.
Yöntemler: Bu çalışmaya 20 iskeletsel Sınıf III hasta dâhil edilmiştir. Ameliyat öncesi (T0) ve ortodontik tedavi bittikten sonra (T1) sefalometrik değişkenler lateral sefalogramlarda ölçülmüştür. Yöntem hatası, ilk ölçümlerden üç hafta sonra on hastanın ölçümlerinin yeniden tekrarlanmasıyla belirlenmiştir. T0 ve T1 sefalometrik ölçümlerini karşılaştırmak için bağımlı iki örneklem t-testi kullanılmış ve istatistiksel anlamlılık P < .05 olarak belirlenmiştir.
Bulgular: Bireylerin cinsiyet, maksiller ve mandibular hareket açısından homojen dağılım gösterdiği belirlenmiştir. Sagital düzlemde maksilla için yumuşak-sert doku takip oranları; Burun ucu için %23, Subnasale için %45, yumuşak doku A* noktası için %70 ve üst dudak en ön noktası (Ls) için %60 olarak bulunmuştur. Mandibulada sagital düzlemde yumuşak-sert doku takip oranları ise; alt dudak en ön noktası (Li) için %77, yumuşak doku B* noktası için %101, yumuşak doku Pogonion* noktası için %83, yumuşak doku Gnathion* için %81 ve yumuşak doku Menton* noktası için %95 olarak bulunmuştur. Burun ucu alttaki iskelet yapısının hareketinden en az etkilenen anatomik alan olurken (%23), yumuşak doku B noktası (B*) iskeletsel B noktası ile neredeyse eşit oranda hareket eden anatomik nokta olmuştur (%101).
Sonuç: Maksilladaki yumuşak ve sert doku arasındaki korelasyonun mandibulaya göre daha düşük olduğu ve çift çene ortognatik cerrahi hastalarının yüz profillerindeki belirgin düzelmenin öncelikli sebebinin mandibulanın geriye doğru hareketi ile ilgili olduğu bulunmuştur. Bu çalışma ile çift çene cerrahisi sonrası yumuşak doku değişikliklerini tahmin etmek için formülasyonlar ve yumuşak-sert doku oranları geliştirilmiştir.
Anahtar Kelimeler: Yumuşak-sert doku oranları, çift çene cerrahisi, profil değişiklikleri.

Keywords

Soft to hard tissue ratios, bimaxillary surgery, profile changes

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