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

Yıl 2021, Cilt: 8 Sayı: 3, 721 - 728, 31.12.2021

Gökhan Çoban , İbrahim Yavuz Ahmet Emin Demirbaş

https://doi.org/10.15311/selcukdentj.783156

Öz

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.

Anahtar Kelimeler

skeletal class III, bimaxillary orthognatgic surgery, stereophotogrammetry

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

Öz

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.

Anahtar Kelimeler

iskeletsel sınıf III, bimaksiller ortognatik cerrahi, stereofotogrametri

Kaynakça

• 1. Alami S, Aghoutan H, El Quars F, Diouny S, Bourzgui F. Early Treatment of Anterior Crossbite Relating to Functional Class III. Emerging Trends in Oral Health Sciences and Dentistry: InTech; 2015.
• 2. Klingenberg CP, Leamy LJ, Cheverud JM. Integration and modularity of quantitative trait locus effects on geometric shape in the mouse mandible. Genetics 2004;166:1909-21.
• 3. Bishara SE. Textbook of orthodontics chapter 21: WB Saunders; 2001.
• 4. Wolford L, Fields R. Diagnosis and treatment planning for orthognathic surgery. Oral Maxillofac Surg 2000;2:24-55.
• 5. Proffit WR, Fields Jr HW, Sarver DM. Contemporary orthodontics 4th edition chapter 19: Elsevier Health Sciences; 2006.
• 6. Hajeer MY, Ayoub AF, Millett DT, Bock M, Siebert J. Three-dimensional imaging in orthognathic surgery: the clinical application of a new method. Int J Adult Orthodon Orthognath Surg. 2001;17:318-30.
• 7. Wermker K, Kleinheinz J, Jung S, Dirksen D. Soft tissue response and facial symmetry after orthognathic surgery. J Craniomaxillofac Surg. 2014;42(6):e339-e45.
• 8. Naini FB, Gill DS. Orthognathic surgery: principles, planning and practice chapter 16: John Wiley & Sons; 2017.
• 9. Naini FB, Cobourne MT, McDonald F, Wertheim D. The aesthetic impact of upper lip inclination in orthodontics and orthognathic surgery. Eur J Orthod. 2014;37(1):81-6.
• 10. Sarver DM, Weissman SM. Long-term soft tissue response to LeFort I maxillary superior repositioning. Angle Orthod. 1991;61(4):267-76.
• 11. Baysal A, Ozturk MA, Sahan AO, Uysal T. Facial soft-tissue changes after rapid maxillary expansion analyzed with 3-dimensional stereophotogrammetry: A randomized, controlled clinical trial. Angle Orthod. 2016;86(6):934-42.
• 12. Verhoeven T, Coppen C, Barkhuysen R, Bronkhorst E, Merkx M, Bergé S, et al. Three dimensional evaluation of facial asymmetry after mandibular reconstruction: validation of a new method using stereophotogrammetry.Int J Oral Maxillofac Surg. 2013;42(1):19-25.
• 13. Lin H-H, Chiang W-C, Lo L-J, Hsu SS-P, Wang C-H, Wan S-Y. Artifact-resistant superimposition of digital dental models and cone-beam computed tomography images. J Oral Maxillofac Surg. 2013;71(11):1933-47.
• 14. Park J-Y, Kim MJ, Hwang SJ. Soft tissue profile changes after setback genioplasty in orthognathic surgery patients. J Craniomaxillofac Surg. 2013;41(7):657-64.
• 15. Plooij J, Swennen G, Rangel F, Maal T, Schutyser F, Bronkhorst E, et al. Evaluation of reproducibility and reliability of 3D soft tissue analysis using 3D stereophotogrammetry. Int J Oral Maxillofac Surg. 2009;38(3):267-73.
• 16. Farkas LG. Anthropometry of the Head and Face: Raven Pr; 1994.
• 17. Bishara SE, Cummins DM, Jorgensen GJ, Jakobsen JR. A computer assisted photogrammetric analysis of soft tissue changes after orthodontic treatment. Part I: methodology and reliability. Am J Orthod Dentofacial Orthop. 1995;107(6):633-9.
• 18. Chung C, Lee Y, Park K-H, Park S-H, Park Y-C, Kim K-H. Nasal changes after surgical correction of skeletal Class III malocclusion in Koreans. Angle Orthod. 2008;78(3):427-32.
• 19. Hajeer M, Millett D, Ayoub A, Siebert J. Current Products and Practices: Applications of 3D imaging in orthodontics: Part I. J Orthod. 2004;31(1):62-70.
• 20. Özdiler E. Güncel Bilgiler Işığında Ortodonti Bölüm 16. 2015:367-78.
• 21. Lübbers H-T, Medinger L, Kruse A, Grätz KW, Matthews F. Precision and accuracy of the 3dMD photogrammetric system in craniomaxillofacial application. J Craniofac Surg. 2010;21(3):763-7.
• 22. Moss ML. The functional matrix hypothesis revisited. 1. The role of mechanotransduction. Am J Orthod Dentofacial Orthop. 1997;112(1):8-11.
• 23. Proffit WR, Fields Jr HW, Sarver DM. Contemporary orthodontics 4th edition chapter 5: Elsevier Health Sciences; 2006.
• 24. Graber LW, Vanarsdall RL, Vig KW, Huang GJ. Orthodontics-E-Book: Current Principles and Techniques 6th edition chapter 16: Elsevier Health Sciences; 2016.
• 25. Bishara SE. Textbook of orthodontics chapter 30: WB Saunders; 2001.
• 26. Alves PVM, Zhao L, Patel PK, Bolognese AM. Three-dimensional facial surface analysis of patients with skeletal malocclusion. J Craniofac Surg. 2009;20(2):290-6.
• 27. Patel PK, Novia MV. The surgical tools: the LeFort I, bilateral sagittal split osteotomy of the mandible, and the osseous genioplasty. Clin Plast Surg. 2007;34(3):447-75.
• 28. Sforza C, Peretta R, Grandi G, Ferronato G, Ferrario VF. Three-dimensional facial morphometry in skeletal Class III patients: A non-invasive study of soft-tissue changes before and after orthognathic surgery. Br J Oral Maxillofac Surg. 2007;45(2):138-44.
• 29. Ferrario VF, Sforza C, Schmitz JH, Santoro F. Three-dimensional facial morphometric assessment of soft tissue changes after orthognathic surgeryOral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(5):549-56.
• 30. Kochel J, Meyer-Marcotty P, Strnad F, Kochel M, Stellzig-Eisenhauer A. 3D Soft tissue analysis–Part 1: Sagittal parameters. J Orofac Orthop. 2010;71(1):40-52.
• 31. Baik H-S, Kim S-Y. Facial soft-tissue changes in skeletal Class III orthognathic surgery patients analyzed with 3-dimensional laser scanning. Am J Orthod Dentofacial Orthop. 2010;138(2):167-78.
• 32. Choi JW, Lee JY, Oh T-S, Kwon SM, Yang SJ, Koh KS. Frontal soft tissue analysis using a 3 dimensional camera following two-jaw rotational orthognathic surgery in skeletal class III patients. J Craniomaxillofac Surg. 2014;42(3):220-6.
• 33. McCance A, Moss J, Wright W, Linney A, James D. A three-dimensional soft tissue analysis of 16 skeletal class III patients following bimaxillary surgery. Br J Oral Maxillofac Surg. 1992;30(4):221-32.
• 34. Kochel J, Meyer-Marcotty P, Kochel M, Schneck S, Stellzig-Eisenhauer A. 3D Soft Tissue Analysis–Part 2: Vertical Parameters. J Orofac Orthop. 2010;71(3):207-20.
• 35. Jensen AC, Sinclair PM, Wolford LM. Soft tissue changes associated with double jaw surgery. Am J Orthod Dentofacial Orthop. 1992;101(3):266-75.
• 36. Kale-Varlk S. Angular photogrammetric analysis of the soft tissue facial profile of Anatolian Turkish adults. J Craniofac Surg. 2008;19(6):1481-6.
• 37. Arnett G, Mc Laughlin R. Facial and dental planning for orthodontists and oral surgeons. 2004, St. Louis: Mosby.162.
• 38. Hemmatpour S, Oliadarani FK, Hasani A, Rakhshan V. Frontal-view nasolabial soft tissue alterations after bimaxillary orthognathic surgery in Class III patients. J Orofac Orthop. 2016;77(6):400-8.
• 39. Naini FB, Gill DS. Orthognathic surgery: principles, planning and practice Chapter 3: John Wiley & Sons; 2017. 89 p.
• 40. Işıksal E, Hazar S, Akyalçın S. Smile esthetics: perception and comparison of treated and untreated smiles. Am J Orthod Dentofacial Orthop. 2006;129(1):8-16.
• 41. Kaipatur NR, Flores-Mir C. Accuracy of computer programs in predicting orthognathic surgery soft tissue response. J Oral Maxillofac Surg. 2009;67(4):751-9.
• 42. Mobarak KA, Espeland L, Krogstad O, Lyberg T. Soft tissue profile changes following mandibular advancement surgery: predictability and long-term outcome. Am J Orthod Dentofacial Orthop. 2001;119(4):353-67.
• 43. Zoumalan RA, Larrabee WF. Anatomic considerations in the aging face. Facial Plast Surg. 2011;27(01):016-22.
• 44. Soncul M, Bamber MA. Evaluation of facial soft tissue changes with optical surface scan after surgical correction of Class III deformities. J Oral Maxillofac Surg. 2004;62(11):1331-40.
• 45. Naini FB, Gill DS. Orthognathic surgery: principles, planning and practice chapter 16: John Wiley & Sons; 2017. 341 p.