Horizontal change of philtrum after orthognathic surgery in patients with facial asymmetry

Abstract

BackgroundSoft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors.MethodsPositional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery.ResultsMaxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values.ConclusionThe horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

Which Skeletal Factors Can Affect Lip Canting in Facial Asymmetry?: Statistical Analysis

“…1 It is an interpolated flap that can be performed in several stages due to the variable blood supply. 2 Advantages include good color match, flexibility in reconstructive options, and the ability to perform the procedure under local anesthesia. 3 Disadvantages include the inability to reconstruct full auricular avulsions, the need for multiple procedures, and the lack of named arterial supply.…”

“…Postoperative changes after orthognathic surgery occur spontaneously in the facial soft tissue because of the position of the supporting bone. 2,3 Therefore, soft tissue evaluation is as important as hard tissue evaluation because it is closely related to facial appearance in cases with facial asymmetry. 4 Conventional analysis of dentofacial deformity usually includes clinical photographs and cephalometric diagnosis with frontal and lateral views.…”

“…One of the indications of orthognathic surgery is facial asymmetry, which achieves a harmonious skeletal structure and improves orofacial function. Postoperative changes after orthognathic surgery occur spontaneously in the facial soft tissue because of the position of the supporting bone 2,3 …”

Sinus mucosal healing pattern according to pterygomaxillary disjunction type after Le Fort I osteotomy

“…Le Fort I osteotomy, performed to improve skeletal malocclusion in the course of orthodontic treatment, is a commonly performed surgical method because it can achieve dramatic results by enabling free movement of the maxilla 1 , 2 . This is a surgery that is separated by crossing from the sinus wall level of the maxillary bone.…”