Soft and hard tissue changes after bimaxillary surgery in Turkish female Class III patients

Marşan, Gülnaz; Cura, Nil; Emekli, Ufuk

doi:10.1016/j.jcms.2008.07.004

Cited by 67 publications

(54 citation statements)

References 25 publications

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“…The observed effect on the contour of the chin (decrease of mentolabial angle) when the mandible was repositioned upward (openbite group) is in accordance with the findings of a study of Marşan et al, 20 who reported a correlation between an increase in the depth of the mentolabial fold and a decrease in the lower facial height.…”

Section: Discussionsupporting

confidence: 91%

“…This effect may have influenced the result in the non-open-bite groups, in particular, having greater setbacks and to some extent disguised the effect of the maxillary advancement. This is one of the factors that may explain low soft to hard tissue ratios for the upper lip reported in T2 T1 to T2 T1 T2 T1 to T2 T1 T2 T1 some bimaxillary studies 13,19,20 compared to ratios for isolated maxillary advancement. 6,10,11 This assumption was supported by the regression analysis, which revealed that the upper lip position was positively correlated with movement of the lower incisors.…”

Section: Discussionmentioning

confidence: 99%

“…It has been proposed 13,14 that the soft tissue changes after Class III bimaxillary surgery are similar to the changes that occur following singlejaw surgery of the maxilla or mandible. Nevertheless, studies 13,[15][16][17][18][19][20] related to bimaxillary procedures have so far reported great variation in ratios for the soft to hard tissue changes (Table 1).…”

Section: Introductionmentioning

confidence: 99%

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Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery

Jakobsone

Stenvik

Espeland

2012

The Angle Orthodontist

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Objective: To quantify the relative soft tissue profile response to the skeletal changes resulting from bimaxillary surgery to correct Class III malocclusion in patients with different vertical incisor relationships presurgery. Materials and Methods: The sample comprised lateral cephalograms of 80 consecutive patients before and 2 months after surgery. All patients had one-piece Le Fort I and bilateral sagittal split osteotomies. Patients were divided in three subgroups according to their preoperative characteristics, as follows: (1) open-bite patients, (2) patients with positive overbite and the upper lip resting on upper incisors, and (3) patients with positive overbite and the upper lip resting on lower incisors (lipblock). Trimmed means of soft to hard tissue ratios were calculated for the subgroups. Regression analyses were performed to examine factors influencing the soft tissue changes. Results: There were strong correlations between the horizontal movement of upper incisors and upper lip in patients with open bite (r 5 0.77) and in patients with positive overbite and upper lip resting on upper incisors (r 5 0.85). The upper lip followed the maxilla with a ratio of 0.5:1. In patients with lip-block, the association between maxillary repositioning and upper lip changes was weak. In all groups a strong association between horizontal soft and hard tissue changes was observed for the lower lip and chin, but the pattern differed depending on the vertical movement of the mandible. Conclusions: In the prediction of soft tissue response it is important to take into account the vertical incisor relationship, particularly in patients with lip-block. (Angle Orthod. 2012;82:441-447.)

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery

Jakobsone

Stenvik

Espeland

2012

The Angle Orthodontist

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“…16 In particular, correction of the lower facial area by mandibular setback in Class III patients to achieve an improved facial profile with a reduced facial convexity angle and a less accentuated chin may lead to an extreme alteration in appearance. 17 On the one hand, the radical change in the profile with reduction of the facial convexity angle may contribute significantly to the delay in getting used to the new appearance, which was shown through the negative correlation with the changes in self-consciousness scores, whereas on the other hand, profile changes, including reduction of the labiomental angle and extension of the N-Pg distance, positively affected the QoL. Indeed, this led to a significant decrease of the impact scores of OH-5 and OH-6 postoperatively and therefore to increased psychological comfort.…”

Section: Discussionmentioning

confidence: 99%

Changes in quality of life and their relation to cephalometric changes in orthognathic surgery patients

Rustemeyer

Martin

Gregersen

2012

The Angle Orthodontist

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Objective: To evaluate correlations between presurgical and postsurgical changes in quality of life (QoL) and cephalometric hard and soft tissue changes in patients undergoing orthognathic surgery. Materials and Methods: The study sample consisted of 30 patients (mean age 24.3 6 4.5 years) with Class III malocclusion undergoing orthognathic surgery for mandibular setback with a median follow-up of 8.3 6 1.2 months. Presurgical and postsurgical cephalograms were traced and Oral Health Impact Profile (OHIP) questionnaires were completed. Each questionnaire consisted of 14 items designed to evaluate functional, physical, psychological, and social impacts. Results: Significant correlations between significant presurgical-to-postsurgical changes in individual items and OHIP parameters were found between labiomental angle (LA) and question 5 (''feeling self-conscious''; correlation coefficient [r] 5 0.530), between LA and question 6 (''feeling tense''; r 5 0.598), between nasion-pogonion and question 5 (r 5 0.523), and between facial convexity and question 5 (r 5 20.540). Hence, reduction of both LA and nasion-pogonion led to a significant decrease in the impact scores of items covering psychological discomfort, while reduced facial convexity led to increased impact scores. Conclusions: Although the associations were moderate, changes in QoL following cephalometric modifications should be considered as a major concern when planning orthognathic surgery. Postsurgical changes to a more convex profile after mandibular setback should be emphasized before surgery to help patients become accustomed to their new appearance more easily without negatively affecting QoL. (Angle Orthod. 2012;82:235-241.)

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“…Various fixation techniques have been used for maxillary stabilization including trans-osseous and suspension wires, intraoral skeletal fixation appliances, and bone plating (Ueki et al, 2007;Marşan et al, 2009;Mavili et al, 2009;Kretschmer et al,2010). Post-operatively, the maxilla appears to be healed and in a stable position on clinical assessment.…”

Section: Introductionmentioning

confidence: 99%

Assessment of bone healing after Le Fort I osteotomy with 3-dimensional computed tomography

Ueki

Miyazaki

Okabe

et al. 2011

Journal of Cranio-Maxillofacial Surgery

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Key words:Bone healing, Pterygoid plate, Le Fort I osteotomy, ultrasonic bone curette, 3-demensional computed tomography (3DCT) AbstractPurpose. The purpose of this study was to examine bone healing after Le Fort I osteotomy in Class III patients.Patients and Methods. The study group consisted of 18 Japanese patients with mandibular prognathism with and without asymmetry, maxillary retrognathism or open bite. A total of 36 sides were examined. Le Fort I osteotomy was performed without a pterygoid osteotome, with an ultrasonic curette used to remove interference at the pterygomaxillary region. Titanium plates (Universal Mid-face fixation module, Stryker, Freiburg, German)were used for four patients, absorbable plates (poly-L-lactic acid (PLLA): NEOFIX®, Gunze, kyoto, Japan) were used for four patients and other absorbable plates (uncalcined and unsintered hydroxyapatite and poly-L-lactic acid (uHA/PLLA): super FIXSORB®MX, Takiron Co. Ltd, Osaka, Japan) were used for ten patients, in the same manner.Postoperative computed tomography (CT) was analyzed for all patients pre-operatively and 1 year post-operative. The anterior and lateral areas between the maxillary segments were measured with 3-dimensional (3D) CT. Bone healing at the pterygomaxillary region was also assessed.Results. There were no significant differences in the area of bone defect healing among the plate types. The areas of bone defect after 1 year were significantly smaller than that immediately after surgery on the right side (p=0.0145) and left side (p=0.0010) in the frontal view and right side in the lateral view (p=0.0118). Bone healing at the pterygo-maxillary junction was found in all cases without artificial pterygoid plate fracture.14 of 22 sides with artificial pterygoid plate fracture by an ultrasonic curette showed bone continuity between the pterygoid plate and posterior part of maxilla.Conclusion. This study suggested that bony healing could occur in spaces between the segments of maxilla and pterygomaxillary regions as well as the region of the anterior and lateral walls in the maxilla, but it is not always complete within 1 year after Le Fort I osteotomy.

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Soft and hard tissue changes after bimaxillary surgery in Turkish female Class III patients

Cited by 67 publications

References 25 publications

Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery

Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery

Changes in quality of life and their relation to cephalometric changes in orthognathic surgery patients

Assessment of bone healing after Le Fort I osteotomy with 3-dimensional computed tomography

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