Summary
Background
To obtain the best surgical results in orthognathic surgery, treatment planning and
the evaluation of results should be performed on measurable three-dimensional reproductions
of the face of the patients, and compared to reference subjects.
Methods
Seven women aged 18–35 years, all with a skeletal Class III and mandibular asymmetry,
were assessed both before (on average, 2 months) and after (on average, 10.7 months)
surgical intervention (mandibular reduction by sagittal split osteotomy and LeFort
I maxillary advancement). The three-dimensional coordinates of 50 soft tissue facial
landmarks (face, eyes, nose, mouth and lips, ears) were collected with a noninvasive,
electromagnetic digitizer; facial volumes were estimated, and compared to reference
values collected in 87 healthy women of the same age and ethnic group. Inter-individual
modifications in facial shape were also assessed.
Results
Before surgery the patients had smaller faces than the reference women, with larger
lower lips and noses. A large within-group variability was found. Surgical treatment
significantly reduced total facial volume and mandibular volume, increased total and
upper lip volumes (Student's t test, p<0.05), and made all values more homogenous within the group. Shape differences were
significantly larger before than after surgery. On average, right side gonion was
the landmark that moved the most, closely followed by menton, while the tragi and
ala nasi moved the least.
The three-dimensional approach used in this study enabled quantitative evaluation
of the final soft tissue results of surgery, without submitting the patients to invasive
procedures.
Keywords
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Article info
Publication history
Published online: September 07, 2006
Accepted:
June 9,
2006
Received:
March 20,
2006
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
