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

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

References

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  • 2. Altug-Atac AT, Bolatoglu H, Memikoglu UT. Facial Soft Tissue Profile Following Bimaxillary Orthognathic Surgery. Angle Orthod. 2008;78(1):50-57.
  • 3. Contemporary Treatment of Dentofasiyal Deformity. Proffit WR, White RP, Jr., Sarver DM. St. Louis: Mosby. 2003:237-238.
  • 4. Bjork A. Prediction of mandibular growth rotation. Am J Orthod. 1969;55(6):585-599.
  • 5. Jokić D, Jokić D, Uglešić V, Macan D, Knežević P. Soft tissue changes after mandibular setback and bimaxillary surgery in Class III patients. Angle Orthod. 2013;83(5):817-823.
  • 6. Øland J, Jensen J, Elklit A, Melsen B. Motives for surgical-orthodontic treatment and effect of treatment on psychosocial well-being and satisfaction: a prospective study of 118 patients. J Oral Maxil Surg. 2011;69(1):104-113.
  • 7. Upton PM, Sadowsky PL, Sarver DM, Heaven TJ. Evaluation of video imaging prediction in combined maxillary and mandibular orthognathic surgery. Am J Orthod Dentofacial Orthop. 1997;112(6):656-665.
  • 8. Sinclair PM, Kilpelainen P, Phillips C, White RP, Jr., Rogers L, Sarver DM. The accuracy of video imaging in orthognathic surgery. Am J Orthod Dentofacial Orthop. 1995;107(2):177-185.
  • 9. Aharon PA, Eisig S, Cisneros GJ. Surgical prediction reliability: a comparison of two computer software systems. Int J Adult Orthodon Orthognath Surg. 1997;12(1):65-78.
  • 10. Bjork A, Skieller V. Growth of the maxilla in three dimensions as revealed radiographically by the implant method. Br J Orthod. 1977;4(2):53-64.
  • 11. Suh HY, Lee HJ, Lee YS, Eo SH, Donatelli RE, Lee SJ. Predicting soft tissue changes after orthognathic surgery: The sparse partial least squares method. Angle Orthod. 2019;89(6):910-916.
  • 12. Chew MT, Koh CH, Sandham A, Wong HB. Subjective evaluation of the accuracy of video imaging prediction following orthognathic surgery in Chinese patients. J Oral Maxillofac Surg. 2008;66(2):291-296.
  • 13. Nihara J, Takeyama M, Takayama Y, Mutoh Y, Saito I. Postoperative changes in mandibular prognathism surgically treated by intraoral vertical ramus osteotomy. Int J Oral Maxillofac Surg. 2013;42(1):62-70.
  • 14. Kim KA, Chang YJ, Lee SH, An HJ, Park KH. Three-dimensional soft tissue changes according to skeletal changes after mandibular setback surgery by using cone-beam computed tomography and a structured light scanner. Prog Orthod. 2019;20(1):25.
  • 15. Shi Y, Shang H, Tian L, Bai S, Liu W, Liu Y. Three-dimensional study of facial soft tissue changes in patients with skeletal Class III malocclusion before and after orthognathic surgery. Chin J Rep Rec Surg. 2018;32(5):612-616.
  • 16. Surgical Orthodontic Treatment. Turvey TO, White RP, ed. St Louis, Mo: Mosby-Year Book; 1991:248–263.
  • 17. Dentofacial deformities, integrated orthodontic and surgical correction. Epker BN, Stella JP, Fish LC. 2nd ed. St Louis, MO: Mosby Year Book; 1995:276
  • 18. Lee JY, Kim YI, Hwang DS, Park SB. Int J Oral Maxillofac Surg. 2013;42(6):790-795.
  • 19. Seon S, Lee HW, Jeong BJ, Lee BS, Kwon YD, Ohe JY. Study of soft tissue changes in the upper lip and nose after backward movement of the maxilla in orthognathic surgery. J Korean Assoc Oral Maxillofac Surg. 2020;31;46(6):385-392.
  • 20. Jakobsone G, Stenvik A, Espeland L. Soft tissue response after Class III bimaxillary surgery. Angle Orthod. 2013;83(3):533-539.
  • 21. Chew MT. Soft and hard tissue changes after bimaxillary surgery in Chinese Class III patients. Angle Orthod. 2005;75(6):959-963.
  • 22. Jakobsone G, Stenvik A, Espeland L. Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery. Angle Orthod. 2012;82(3):441-447.
  • 23. Naoumova J, Soderfeldt B, Lindman R. Soft tissue profile changes after vertical ramus osteotomy. Eur J Orthod. 2008;30(4):359-365.
  • 24. Stella JP, Streater MR, Epker BN, Sinn DP. Predictability of upper lip soft tissue changes with maxillary advancement. J Oral Maxil Surg.1989;47(7):697-703.
  • 25. Oliver BM. The influence of lip thickness and strain on upper lip response to incisor retraction. Am J Orthod. 1982;82(2):141-149.
  • 26. Coban G, Yavuz I, Karadas B, Demirbas AE. Three-dimensional assessment of nasal changes after maxillary advancement with impaction using stereophotogrammetry. Korean J Orthod. 2020;25;50(4):249-257.
  • 27. Bhagat SK, Kannan S, Babu MRR, et al. Soft Tissue Changes Following Combined Anterior Segmental Bimaxillary Orthognathic Procedures. J Maxillofac Oral Surg. 2019;18(1):93-99.
  • 28. Lines PA. Soft tissue changes in relationship to movement of hard structures in orthognathic surgery: a preliminary report. J Oral Surg. 1974;32:891-896.
  • 29. Epker BN. Superior surgical repositioning of the maxilla: long term results. J Maxillofac Surg. 1981;9(4):237-246.
  • 30. Marsan G, Oztas E, Kuvat SV, Cura N, Emekli U. Changes in soft tissue profile after mandibular setback surgery in Class III subjects. Int J Oral Maxillofac Surg. 2009; 38(3):236-240.
  • 31. Mobarak KA, Espeland L, Krogstad O, Lyberg T. Soft tissue profile changes following mandibular advancement surgery: predictability and long-term outcome. Am J Orthod Dentofacial Orthop. 2001;119(4):353-367.
  • 32. Möhlhenrich SC, Kötter F, Peters F, et al. Effects of different surgical techniques and displacement distances on the soft tissue profile via orthodontic-orthognathic treatment of class II and class III malocclusions. Head Face Med. 2021;14;17(1):13.
  • 33. Gjorup H, Athanasiou AE. Soft-tissue and dentoskeletal profile changes associated with mandibular setback osteotomy. Am J Orthod Dentofacial Orthop. 1991;100(4):312-323.
  • 34. Seifi M, Jafarpour Boroujeni M, Tabrizi R, Tahmasbi S. Association between Lateral Cephalometric Changes in X-Y Coordinate System and Profile Changes among Skeletal Class III Patients after Orthognathic Surgery. World J Plast Surg. 2020;9(3):282-289.
Year 2022, Volume: 32 Issue: 1, 85 - 91, 15.02.2022
https://doi.org/10.17567/ataunidfd.1037986

Abstract

References

  • 1. Çelebi N, Soylu E, Yıldırım MD, Durmuş HT, Varol HH, Alkan A. Ortognatik cerrahi hastalarında postoperatif kusma ve bulantının önlenmesi. Ataturk Uni J Dent Fac. 2013; 23:362-365.
  • 2. Altug-Atac AT, Bolatoglu H, Memikoglu UT. Facial Soft Tissue Profile Following Bimaxillary Orthognathic Surgery. Angle Orthod. 2008;78(1):50-57.
  • 3. Contemporary Treatment of Dentofasiyal Deformity. Proffit WR, White RP, Jr., Sarver DM. St. Louis: Mosby. 2003:237-238.
  • 4. Bjork A. Prediction of mandibular growth rotation. Am J Orthod. 1969;55(6):585-599.
  • 5. Jokić D, Jokić D, Uglešić V, Macan D, Knežević P. Soft tissue changes after mandibular setback and bimaxillary surgery in Class III patients. Angle Orthod. 2013;83(5):817-823.
  • 6. Øland J, Jensen J, Elklit A, Melsen B. Motives for surgical-orthodontic treatment and effect of treatment on psychosocial well-being and satisfaction: a prospective study of 118 patients. J Oral Maxil Surg. 2011;69(1):104-113.
  • 7. Upton PM, Sadowsky PL, Sarver DM, Heaven TJ. Evaluation of video imaging prediction in combined maxillary and mandibular orthognathic surgery. Am J Orthod Dentofacial Orthop. 1997;112(6):656-665.
  • 8. Sinclair PM, Kilpelainen P, Phillips C, White RP, Jr., Rogers L, Sarver DM. The accuracy of video imaging in orthognathic surgery. Am J Orthod Dentofacial Orthop. 1995;107(2):177-185.
  • 9. Aharon PA, Eisig S, Cisneros GJ. Surgical prediction reliability: a comparison of two computer software systems. Int J Adult Orthodon Orthognath Surg. 1997;12(1):65-78.
  • 10. Bjork A, Skieller V. Growth of the maxilla in three dimensions as revealed radiographically by the implant method. Br J Orthod. 1977;4(2):53-64.
  • 11. Suh HY, Lee HJ, Lee YS, Eo SH, Donatelli RE, Lee SJ. Predicting soft tissue changes after orthognathic surgery: The sparse partial least squares method. Angle Orthod. 2019;89(6):910-916.
  • 12. Chew MT, Koh CH, Sandham A, Wong HB. Subjective evaluation of the accuracy of video imaging prediction following orthognathic surgery in Chinese patients. J Oral Maxillofac Surg. 2008;66(2):291-296.
  • 13. Nihara J, Takeyama M, Takayama Y, Mutoh Y, Saito I. Postoperative changes in mandibular prognathism surgically treated by intraoral vertical ramus osteotomy. Int J Oral Maxillofac Surg. 2013;42(1):62-70.
  • 14. Kim KA, Chang YJ, Lee SH, An HJ, Park KH. Three-dimensional soft tissue changes according to skeletal changes after mandibular setback surgery by using cone-beam computed tomography and a structured light scanner. Prog Orthod. 2019;20(1):25.
  • 15. Shi Y, Shang H, Tian L, Bai S, Liu W, Liu Y. Three-dimensional study of facial soft tissue changes in patients with skeletal Class III malocclusion before and after orthognathic surgery. Chin J Rep Rec Surg. 2018;32(5):612-616.
  • 16. Surgical Orthodontic Treatment. Turvey TO, White RP, ed. St Louis, Mo: Mosby-Year Book; 1991:248–263.
  • 17. Dentofacial deformities, integrated orthodontic and surgical correction. Epker BN, Stella JP, Fish LC. 2nd ed. St Louis, MO: Mosby Year Book; 1995:276
  • 18. Lee JY, Kim YI, Hwang DS, Park SB. Int J Oral Maxillofac Surg. 2013;42(6):790-795.
  • 19. Seon S, Lee HW, Jeong BJ, Lee BS, Kwon YD, Ohe JY. Study of soft tissue changes in the upper lip and nose after backward movement of the maxilla in orthognathic surgery. J Korean Assoc Oral Maxillofac Surg. 2020;31;46(6):385-392.
  • 20. Jakobsone G, Stenvik A, Espeland L. Soft tissue response after Class III bimaxillary surgery. Angle Orthod. 2013;83(3):533-539.
  • 21. Chew MT. Soft and hard tissue changes after bimaxillary surgery in Chinese Class III patients. Angle Orthod. 2005;75(6):959-963.
  • 22. Jakobsone G, Stenvik A, Espeland L. Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery. Angle Orthod. 2012;82(3):441-447.
  • 23. Naoumova J, Soderfeldt B, Lindman R. Soft tissue profile changes after vertical ramus osteotomy. Eur J Orthod. 2008;30(4):359-365.
  • 24. Stella JP, Streater MR, Epker BN, Sinn DP. Predictability of upper lip soft tissue changes with maxillary advancement. J Oral Maxil Surg.1989;47(7):697-703.
  • 25. Oliver BM. The influence of lip thickness and strain on upper lip response to incisor retraction. Am J Orthod. 1982;82(2):141-149.
  • 26. Coban G, Yavuz I, Karadas B, Demirbas AE. Three-dimensional assessment of nasal changes after maxillary advancement with impaction using stereophotogrammetry. Korean J Orthod. 2020;25;50(4):249-257.
  • 27. Bhagat SK, Kannan S, Babu MRR, et al. Soft Tissue Changes Following Combined Anterior Segmental Bimaxillary Orthognathic Procedures. J Maxillofac Oral Surg. 2019;18(1):93-99.
  • 28. Lines PA. Soft tissue changes in relationship to movement of hard structures in orthognathic surgery: a preliminary report. J Oral Surg. 1974;32:891-896.
  • 29. Epker BN. Superior surgical repositioning of the maxilla: long term results. J Maxillofac Surg. 1981;9(4):237-246.
  • 30. Marsan G, Oztas E, Kuvat SV, Cura N, Emekli U. Changes in soft tissue profile after mandibular setback surgery in Class III subjects. Int J Oral Maxillofac Surg. 2009; 38(3):236-240.
  • 31. Mobarak KA, Espeland L, Krogstad O, Lyberg T. Soft tissue profile changes following mandibular advancement surgery: predictability and long-term outcome. Am J Orthod Dentofacial Orthop. 2001;119(4):353-367.
  • 32. Möhlhenrich SC, Kötter F, Peters F, et al. Effects of different surgical techniques and displacement distances on the soft tissue profile via orthodontic-orthognathic treatment of class II and class III malocclusions. Head Face Med. 2021;14;17(1):13.
  • 33. Gjorup H, Athanasiou AE. Soft-tissue and dentoskeletal profile changes associated with mandibular setback osteotomy. Am J Orthod Dentofacial Orthop. 1991;100(4):312-323.
  • 34. Seifi M, Jafarpour Boroujeni M, Tabrizi R, Tahmasbi S. Association between Lateral Cephalometric Changes in X-Y Coordinate System and Profile Changes among Skeletal Class III Patients after Orthognathic Surgery. World J Plast Surg. 2020;9(3):282-289.
There are 34 citations in total.

Details

Primary Language English
Subjects Dentistry
Journal Section Research Articles
Authors

Kevser Kurt Demirsoy This is me 0000-0001-7271-4377

Gökmen Kurt This is me 0000-0003-0632-2433

Publication Date February 15, 2022
Submission Date September 7, 2021
Published in Issue Year 2022 Volume: 32 Issue: 1

Cite

AMA Kurt Demirsoy K, Kurt G. SOFT TO HARD TISSUE RATIOS AFTER BIMAXILLARY ORTHOGNATHIC SURGERY IN CLASS III PATIENTS. Curr Res Dent Sci. February 2022;32(1):85-91. doi:10.17567/ataunidfd.1037986

Current Research in Dental Sciences is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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