Three-dimensional assessment of nasal changes after maxillary advancement with impaction using stereophotogrammetry

Abstract

Three-dimensional assessment of nasal changes after maxillary advancement with impaction using stereophotogrammetry Objective: To evaluate the changes in the nose in three dimensions after Le Fort I osteotomy in patients with skeletal Class III malocclusion. Methods: The subjects were 40 adult patients (20 females and 20 males; mean age, 20.3 ± 3.0 years; range, 17.0 to 31.1 years) who underwent one-piece Le Fort I osteotomy with maxillary advancement and impaction treatment for maxillary hypoplasia. The mean maxillary advancement was 4.56 ± 1.34 mm, and the mean maxillary impaction was 2.03 ± 1.04 mm. Stereophotogrammetry was used to acquire three-dimensional images before and at least 6 months after surgery. Results: Alare (Al) and alare curvature (Ac) points had moved vertically and anterolaterally postoperatively. A significant increase was observed in the nasal ala width and alar base width, and no changes were noted in the columellar length, nasolabial angle, and nasal area. There was a significant relationship between maxillary impaction and nasal ala width and horizontal and sagittal positions of the bilateral Al and Ac. The only relationship found was between maxillary advancement and postoperative sagittal location of the subnasale and pronasale. Conclusions: Nasal soft tissues were highly affected by the vertical movement of the maxilla; however, the soft tissue responses were individual-dependent.

Delayed Soft Tissue Changes after Clockwise Rotation of the Maxillo-Mandibular Complex

“…21 Generally, it is considered that maxillary advancement surgery leads to nasal tip elevation. 20,22 Coban et al 7 reported a mean upward Prn movement of 1 mm and attributed this to surgical quantity. In the present study, 1.36 ± 1.64 mm upward and 1.55 ± 1.6 mm movement were observed after rotational surgery along y-and z-axes (P value < 0.01) (Supplementary Digital Content, Table 2, http://links.lww.com/SCS/D769).…”

“…As the increased number of patients have chosen bi-maxillary orthognathic surgery for esthetic reasons, it is necessary to understand postoperative changes and stability through long-term follow-up. Prior articles [6][7][8] also stated that once the postoperative swelling and edema subsides, the amount of soft tissue changes afterward is not significant in 2D analyses. Therefore, the goal of this study was to evaluate delayed soft tissue changes after clockwise repositioning of the MMC using cone-beam computed tomography (CBCT) and 3D analysis software.…”

Soft to Hard Tissue Ratios After Bimaxillary Orthognathic Surgery in Class Iii Patients

“…24,25 In our study, no significant change was observed in the nasolabial angle after surgery (P=0.933). Similarly, Coban et al 26 evaluated the changes in the nose in three dimensions after Le Fort I osteotomy in patients with skeletal Class III malocclusion concluded that there was no change was observed in the nasolabial angle. In contrast, in another study in which combined anterior segmental osteotomies were performed, it was reported that the nasolabial angle increased by an average of 15.5°.…”

3-dimensional analysis of nasal soft tissue alterations following maxillary Lefort I advancement with and without impaction using 3D photogrammetry scanner

“…This method can be used to assess changes in soft tissue and skin surface after orthognathic surgery more accurately than methods such as direct anthropometry, cephalometric photography and 2D photography [ 12 ]. Additionally, this scanner is a fast and reliable device and has an error of 0.2 to 1 mm for clinical use compared to 0.5–1 mm of laser scanners [ 14 ]. Moreover, thanks to this imaging technique, our patients were exposed to lower dose of radiation compared to similar studies using CT scans [ 1 , 25 ].…”

“…Other advantages of this method include no radiation exposure and high repeatability. It also provides the possibility of volumetric, topographic, regional, and linear evaluations [ 14 ]. This method can be used to assess soft tissue and skin surface alterations after OS more accurately than methods such as direct anthropometry, cephalometric photography, and 2D photogrammetry [ 12 ].…”