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Soft tissue outcome after mandibular advancement—an anthropometric evaluation of 171 consecutive patients

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Abstract

Objectives

There is an ongoing discussion in the literature about preoperative planning and postoperative evaluation of orthognathic surgery and its impact on facial appearance and aesthetics.

Materials and Methods

We present an anthropometric and cephalometric evaluation of orthognathic surgery results based on reference anthropometric data. In 171 Class II patients, mandibular advancement by bilateral sagittal split osteotomy was performed. Preoperative as well as 3 and 9 months postoperative standardized frontal view and profile photographs and lateral cephalograms were evaluated in a standardized manner by use of 21 anthropometric indices. In cephalograms, SNA and SNB angle as well as Wits appraisal were investigated. Results of anthropometric and cephalometric measurements were correlated.

Results

Lower vermilion contour, vermilion and cutaneous total lower lip height, nose–lower face height, nose–face height, upper face–face height, upper lip– and chin–mandible height index showed significant pre- to postoperative changes as well as SNB angle and Wits appraisal. Furthermore, medial–lateral cutaneous upper lip height, vermilion and cutaneous total lower lip height and philtrum–mouth width index presented significant correlations to cephalometric measurements.

Conclusions

The investigated anthropometric indices and cephalometric measurements presented reproducible results related to surgery. The correlation of cephalometric to anthropometric measurements has been proven useful for preoperative planning and postoperative evaluation of orthognathic surgery patients.

Clinical relevance

The presented anthropometric measurements and their observed correlation to cephalometric measurements could lead to a better prediction and optimized planning of the soft tissue result in orthognathic surgery patients and thereby improve the aesthetic outcome.

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References

  1. de Almeida MD, Bittencourt MA (2009) Anteroposterior position of mandible and perceived need for orthognathic surgery. J Oral Maxillofac Surg 67(1):73–82. doi:10.1016/j.joms.2008.06.049

    Article  PubMed  Google Scholar 

  2. Magro-Filho O, Magro-Ernica N, Queiroz TP, Aranega AM, Garcia IR, Jr. (2010) Comparative study of 2 software programs for predicting profile changes in Class III patients having double-jaw orthognathic surgery. Am J Orthod Dentofacial Orthop 137 (4):452 e451-455; discussion 452–453. doi:10.1016/j.ajodo.2009.02.027

    Google Scholar 

  3. Miller L, Morris DO, Berry E (2007) Visualizing three-dimensional facial soft tissue changes following orthognathic surgery. Eur J Orthod 29(1):14–20. doi:10.1093/ejo/cjl037

    Article  PubMed  Google Scholar 

  4. Eckhardt CE, Cunningham SJ (2004) How predictable is orthognathic surgery? Eur J Orthod 26(3):303–309

    Article  PubMed  Google Scholar 

  5. Edler R, Agarwal P, Wertheim D, Greenhill D (2006) The use of anthropometric proportion indices in the measurement of facial attractiveness. Eur J Orthod 28(3):274–281. doi:10.1093/ejo/cji098

    Article  PubMed  Google Scholar 

  6. Baik HS, Kim SY (2010) Facial soft-tissue changes in skeletal Class III orthognathic surgery patients analyzed with 3-dimensional laser scanning. Am J Orthod Dentofacial Orthop 138(2):167–178. doi:10.1016/j.ajodo.2010.02.022

    Article  PubMed  Google Scholar 

  7. Farkas LG, Munro IR (1987) Anthropometric facial proportions in medicine. Thomas, Springfield

    Google Scholar 

  8. Farkas LG (1981) Anthropometry of the head and face in medicine. Elsevier, New York

    Google Scholar 

  9. Edler R, Rahim MA, Wertheim D, Greenhill D (2010) The use of facial anthropometrics in aesthetic assessment. Cleft Palate Craniofac J 47(1):48–57. doi:10.1597/08-218.1

    Article  PubMed  Google Scholar 

  10. Gonzalez-Ulloa M (1962) Quantitative principles in cosmetic surgery of the face (profileplasty). Plast Reconstr Surg Transplant Bull 29:186–198

    Article  PubMed  Google Scholar 

  11. Raschke GF, Bader RD, Rieger UM, Schultze-Mosgau S (2011) Photo-assisted analysis of blepharoplasty results. Ann Plast Surg 66(4):328–333. doi:10.1097/SAP.0b013e3181fadd71

    Article  PubMed  Google Scholar 

  12. Gosman SD (1950) Anthropometric method of facial analysis in orthodontics. Am J Orthod 36(10):749–762

    Article  PubMed  Google Scholar 

  13. Sinclair PM, Kilpelainen P, Phillips C, White RP Jr, Rogers L, Sarver DM (1995) The accuracy of video imaging in orthognathic surgery. Am J Orthod Dentofacial Orthop 107(2):177–185

    Article  PubMed  Google Scholar 

  14. Upton PM, Sadowsky PL, Sarver DM, Heaven TJ (1997) Evaluation of video imaging prediction in combined maxillary and mandibular orthognathic surgery. Am J Orthod Dentofacial Orthop 112(6):656–665

    Article  PubMed  Google Scholar 

  15. Landes CA, Zachar R, Diehl T, Kovacs AF (2002) Introduction of a three-dimensional anthropometry of the viscerocranium. Part II: evaluating osseous and soft tissue changes following orthognathic surgery. J Craniomaxillofac Surg 30(1):25–34. doi:10.1054/jcms.2002.0275

    Article  PubMed  Google Scholar 

  16. Dal Pont G (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 19:42–47

    PubMed  Google Scholar 

  17. Trauner R, Obwegeser H (1957) The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. II. Operating methods for microgenia and distoclusion. Oral Surg Oral Med Oral Pathol 10(8):787–792, contd

    Article  PubMed  Google Scholar 

  18. Flowers RS, Flowers SS (1993) Diagnosing photographic distortion. Decoding true postoperative contour after eyelid surgery. Clin Plast Surg 20(2):387–392

    PubMed  Google Scholar 

  19. Holberg C, Schwenzer K, Rudzki-Janson I (2005) Three-dimensional soft tissue prediction using finite elements. Part I: implementation of a new procedure. J Orofac Orthop 66(2):110–121. doi:10.1007/s00056-005-0421-8

    Article  PubMed  Google Scholar 

  20. Holberg C, Heine AK, Geis P, Schwenzer K, Rudzki-Janson I (2005) Three-dimensional soft tissue prediction using finite elements. Part II: clinical application. J Orofac Orthop 66(2):122–134. doi:10.1007/s00056-005-0422-7

    Article  PubMed  Google Scholar 

  21. Uechi J, Okayama M, Shibata T, Muguruma T, Hayashi K, Endo K, Mizoguchi I (2006) A novel method for the 3-dimensional simulation of orthognathic surgery by using a multimodal image-fusion technique. Am J Orthod Dentofacial Orthop 130(6):786–798. doi:10.1016/j.ajodo.2006.03.025

    Article  PubMed  Google Scholar 

  22. Yanez-Vico RM, Iglesias-Linares A, Torres-Lagares D, Gutierrez-Perez JL, Solano-Reina E (2010) Three-dimensional evaluation of craniofacial asymmetry: an analysis using computed tomography. Clin Oral Investig. doi:10.1007/s00784-010-0441-7

  23. Jones RM, Khambay BS, McHugh S, Ayoub AF (2007) The validity of a computer-assisted simulation system for orthognathic surgery (CASSOS) for planning the surgical correction of class III skeletal deformities: single-jaw versus bimaxillary surgery. Int J Oral Maxillofac Surg 36(10):900–908. doi:10.1016/j.ijom.2007.05.015

    Article  PubMed  Google Scholar 

  24. Calignano F, Vezzetti E (2010) Soft tissue diagnosis in maxillofacial surgery: a preliminary study on three-dimensional face geometrical features-based analysis. Aesthetic Plast Surg 34(2):200–211. doi:10.1007/s00266-009-9410-4

    Article  PubMed  Google Scholar 

  25. Koury ME, Epker BN (1992) Maxillofacial esthetics: anthropometrics of the maxillofacial region. J Oral Maxillofac Surg 50(8):806–820

    Article  PubMed  Google Scholar 

  26. Poulton DR, Ware WH (1985) Increase in mandibular and chin projection with orthognathic surgery. Am J Orthod 87(5):363–376

    Article  PubMed  Google Scholar 

  27. Kochel J, Meyer-Marcotty P, Strnad F, Kochel M, Stellzig-Eisenhauer A (2010) 3D soft tissue analysis—part 1: sagittal parameters. J Orofac Orthop 71(1):40–52. doi:10.1007/s00056-010-9926-x

    Article  PubMed  Google Scholar 

  28. O'Brien K, Wright J, Conboy F, Appelbe P, Bearn D, Caldwell S, Harrison J, Hussain J, Lewis D, Littlewood S, Mandall N, Morris T, Murray A, Oskouei M, Rudge S, Sandler J, Thiruvenkatachari B, Walsh T, Turbill E (2009) Prospective, multi-center study of the effectiveness of orthodontic/orthognathic surgery care in the United Kingdom. Am J Orthod Dentofacial Orthop 135(6):709–714. doi:10.1016/j.ajodo.2007.10.043

    Article  PubMed  Google Scholar 

  29. Quast DC, Biggerstaff RH, Haley JV (1983) The short-term and long-term soft-tissue profile changes accompanying mandibular advancement surgery. Am J Orthod 84(1):29–36

    Article  PubMed  Google Scholar 

  30. Bell WH, Jacobs JD (1981) Tridimensional planning for surgical/orthodontic treatment of mandibular excess. Am J Orthod 80(3):263–288

    Article  PubMed  Google Scholar 

  31. Pospisil OA (1987) Reliability and feasibility of prediction tracing in orthognathic surgery. J Craniomaxillofac Surg 15(2):79–83

    Article  PubMed  Google Scholar 

  32. Lin SS, Kerr WJ (1998) Soft and hard tissue changes in Class III patients treated by bimaxillary surgery. Eur J Orthod 20(1):25–33

    Article  PubMed  Google Scholar 

  33. Gaggl A, Schultes G, Karcher H (1999) Changes in soft tissue profile after sagittal split ramus osteotomy and retropositioning of the mandible. J Oral Maxillofac Surg 57(5):542–546, discussion 546-547

    Article  PubMed  Google Scholar 

  34. Jensen AC, Sinclair PM, Wolford LM (1992) Soft tissue changes associated with double jaw surgery. Am J Orthod Dentofacial Orthop 101(3):266–275

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest Statement

The authors declare that they have no conflict of interest. There were no sources of funding.

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Authors and Affiliations

  1. Department of Cranio-Maxillofacial & Plastic Surgery, Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Gregor F. Raschke, Rolf-Dieter Bader & Stefan Schultze-Mosgau

  2. Department of Plastic, Reconstructive & Hand Surgery, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    Ulrich M. Rieger

  3. Interdisciplinary Research Group of Computational Medicine, Friedrich Schiller University Jena, Bachstrasse 18, 07740, Jena, Germany

    Gregor F. Raschke, Ulrich M. Rieger, Arndt Guentsch & Oliver Schaefer

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  1. Gregor F. Raschke
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  2. Ulrich M. Rieger
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  3. Rolf-Dieter Bader
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  4. Arndt Guentsch
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  6. Stefan Schultze-Mosgau
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Correspondence to Ulrich M. Rieger.

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Raschke, G.F., Rieger, U.M., Bader, RD. et al. Soft tissue outcome after mandibular advancement—an anthropometric evaluation of 171 consecutive patients. Clin Oral Invest 17, 1415–1423 (2013). https://doi.org/10.1007/s00784-012-0821-2

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  • DOI: https://doi.org/10.1007/s00784-012-0821-2

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