Three-Dimensional Analysis of Midfacial Soft Tissue Changes after Maxillary Posterior Impaction and Intraoral Vertical Ramus Osteotomy for Mandibular Setback in Class III Patients

Seung Won Seo, Young Soo Jung, Hyoung Seon Baik

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

This study investigated the correlation between the 3-dimensional changes in midfacial soft tissues, including the parasagittal area and maxilla-mandible complex, after Le Fort I maxillary posterior impaction and bilateral intraoral vertical ramus osteotomy (B-IVRO), using cone-beam computed tomography (CBCT). This retrospective study included 22 skeletal Class III patients (6 men and 16 women; mean age 21.6 years) who underwent orthognathic surgery. Three-dimensional CBCT images taken before and 1 year after surgery were superimposed based on the cranial base. Midfacial soft tissues, including those in the parasagittal area (paranasal area, anterior cheek area, lateral cheek area) and midsagittal areas of the face, were evaluated using reconstructed CBCT images. Correlations and the ratios between soft tissue and hard tissue movement were calculated. After surgery, both paranasal areas showed significant forward movement (about 2.0 mm) and the largest upward movement (about 0.15 mm) among the 3 areas. The paranasal areas moved forward with a ratio of 0.5, according to vertical movement of B. Orthognathic surgery using Le Fort I maxillary posterior impaction with B-IVRO mandibular setback results in forward movement of midfacial soft tissues, even though sagittal movement of the maxilla is limited because facial muscles and retaining ligaments pull the redundant soft tissues, which are caused by vertical movement of the maxilla-mandible. This midfacial soft tissue change with maxillary posterior impaction could be advantageous to patients who have paranasal depression and protrusion of the upper lip owing to proclined upper incisors, which are prevalent among Asian Class III patients.

Original languageEnglish
Pages (from-to)1789-1796
Number of pages8
JournalJournal of Craniofacial Surgery
Volume28
Issue number7
DOIs
Publication statusPublished - 2017 Oct 1

Bibliographical note

Publisher Copyright:
© 2017 by Mutaz B. Habal, MD.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology

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