Hard and Soft Tissue Changes in Patients with Borderline Class III Malocclusion after Maxillary Advancement or Mandibular Setback Surgery: A Cross-Sectional Study

Abstract

Background: The primary aim of this study was to assess the esthetic profile and hard and soft tissue changes in patients with borderline class III malocclusion after maxillary advancement or mandibular setback surgery. The secondary aim was also to evaluate the patients’ face attractiveness after different surgical treatment. Materials and Methods: This observational cross-sectional study evaluated 50 patients with borderline class III malocclusion with a mean age of 29 ± 4 years treated from 2014 to 2019. They were divided into two groups based on the type of surgical treatment underwent: 13 patients were treated with mandibular setback (4 males, 9 females), and 37 patients with maxillary advancement (16 males, 21 females). Hard and soft tissue parameters were measured pre and postoperative evaluation. Frontal and profile photographs of these patients were judged by 15 orthodontists, 15 oral and maxillofacial surgeons, and 15 laypeople before and after surgery. The most and the least attractive profiles were scored 10 and 0, respectively. T-test was used to analyze normally distributed data while Mann-Whitney test for non-normally distributed data. The Kruskal-Wallis test was used to compare the esthetic judgement between the three groups of observers. Pairwise comparisons were carried out using the Mann-Whitney test. Results: Nasolabial angle, SNA, U1/NA (°), U1/NA (mm), L1/NB (°) and L1/NB (mm) were significantly different between the two groups p<0.04, p<0.001, p<0.001, p<0.005, p<0.07, p<0.08, p<0.01 respectively Orthodontists, oral and maxillofacial surgeons, and laypeople all gave a lower score to mandibular setback and higher score to maxillary advancement in terms of facial profile esthetics (P<0.001). Conclusion: Some cephalometric parameters were significantly different between the two groups. The maxillary advancement seemed to provide better results in facial profile esthetics than mandibular setback for patients with borderline class III malocclusion.

Three-Dimensional Geometric Morphometry of Facial Soft Tissue Changes After Bilateral Sagittal Split Ramus Osteotomy

“…37,38 Shortening of the lower anterior facial height had also been observed after BSSRO setback. 37,39,40 Regarding previously reported changes of the facial soft tissues after BSSRO setback, Vahiheh et al 41 found no significant change in the nasolabial angle. Lisboa et al 29 had less change in the lower lip than in the chin area, and no significant change in the paranasal area.…”

The Cephalometric Relationship between the Facial Height Ratio and the Growth Pattern in a Group of Patients from Timis County, Romania

“…At Frankfort Horizontal, this shows the downward and forward posture of the chin with reference to the upper face [18]. The quality of the treatment process, the compatibility of the soft tissues and the patient's expectations all affect the postoperative aesthetic outcome [19][20][21]. Statistical analysis: To eliminate inter-observer error, all radiographs were traced and measured by the same investigator and each measurement was repeated after 2 weeks to decrease intraobserver error.…”