Evaluation of Soft Tissue Changes in Skeletal Class III Patients After Bimaxillary Orthognathic Surgery with Stereophotogrammetry

Abstract

Aim: To examine the changes after bimaxillary orthognathic surgery in soft tissues of patients with skeletal Class III malocclusion using three-dimensional (3D) photographic imaging. Materials and Methods: This study was conducted on 28 patients, 11 female, 17 male, who treated with one-piece Le Fort I in the maxilla along with bilateral sagittal split osteotomy in the mandible in Erciyes University Faculty of Dentistry Department of Orthodontics ( mean age 20.4 ± 3.01, range 17.03 - 31.16). While the maxillary advancement amount was 4.70 ± 1.20 mm; impaction amount was 2.23 ± 0.97 mm. The amount of mandibular set-back was 4.23 ± 1.56 mm. 3D stereophotogrammetric recordings were taken just before and at least 6 months after the operation. The data were evaluated as a single group, as no difference was observed between genders. "paired t test" was used for statistical analysis. Results: In the sagittal direction, maxillary lengths, mandibular convexity angle, soft tissue A and ANB angles increased statistically significantly. The maxillary convexity angle, mandibular lengths and corpus lengths, facial convexity angle, total facial convexity angle and soft tissue B angle were statistically significantly decreased. In the transverse direction, nasal and nasal base widths increased statistically significantly. In the vertical direction, maxillary height, upper vermilion height, the ratio of mid-face height to lower face height increased statistically significantly, lower vermillion height, lower lip length, mandibular height, mid and lower face heights, anterior face height, vertical and mentolabial angles were statistically significantly decreased. Conclusion: This study may be useful in predicting postoperative soft tissue changes and to what extent patient’s expectations can be satisfied in skeletal Class III patients.

Keywords

• skeletal class III
• bimaxillary orthognatgic surgery
• stereophotogrammetry

İskeletsel Sınıf III Bireylerin Çift Çene Ortognatik Cerrahi Sonrası Yumuşak Doku Değişimlerinin Stereofotogrametri ile Değerlendirilmesi

Abstract

Amaç: İskeletsel Sınıf III malokluzyona sahip hastaların yumuşak dokularında meydana gelen değişikliklerin üç boyutlu (3D) fotografik görüntüleme yöntemi ile incelenmesidir. Gereç ve Yöntem: Çalışmamız Erciyes Üniversitesi Diş Hekimliği Fakültesi Ortodonti Anabilim Dalı’nda üst çenede tek parçalı Le Fort I, alt çenede bilateral sagital split osteotomisi ile çift çene ortognatik cerrahi tedavisi görmüş 11’i kadın 17’si erkek toplam 28 hasta üzerinde yapılmıştır (yaş ortalaması 20,4 ± 3,01, yaş aralığı 17,03 - 31,16). Üst çene ilerletme miktarı ortalama 4,70 ± 1,20 mm iken; gömme miktarı 2,23 ± 0,97 mm’dir. Alt çene geri alma miktarı ise ortalama 4,23 ± 1,56 mm’dir. 3D stereofotogrametrik kayıtlar operasyondan hemen önce ve en az 6 ay sonra alınmıştır. Veriler cinsiyetler arasında farklılık gözlenmediği için tek grup olarak değerlendirilmiştir. İstatistiksel analiz için ‘paired t testi’ kullanılmıştır. Bulgular: Sagital yönde maksiller uzunluklar, mandibular konveksite açısı, yumuşak doku A ve ANB açıları istatistiksel olarak anlamlı şekilde artmıştır. Maksiller konveksite açısı, mandibular uzunluklar ve korpus uzunlukları, yüz konveksite açısı, total yüz konveksite açısı ve yumuşak doku B açısı istatistiksel olarak anlamlı şekilde azalmıştır. Transvers yönde burun genişliği ve burun tabanı genişliği istatistiksel olarak anlamlı şekilde artmıştır. Vertikal yönde ise maksiller yükseklik, üst vermilyon yüksekliği, orta yüz yüksekliğinin alt yüz yüksekliğine oranı istatistiksel olarak anlamlı şekilde artarken; alt vermilyon yüksekliği, alt dudak uzunluğu, mandibular yükseklik, orta ve alt yüz uzunlukları, ön yüz yüksekliği, vertikal ve mentolabial açılar istatistiksel olarak anlamlı şekilde azalmıştır. Sonuç: Çalışmamız iskeletsel Sınıf III hastalarda ameliyat sonrası yumuşak doku değişimlerinin ve hasta beklentilerinin ne ölçüde karşılanabileceğinin öngörülebilmesi açısından faydalı olabilir.

Keywords

• iskeletsel sınıf III
• bimaksiller ortognatik cerrahi
• stereofotogrametri

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