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Type of maxillary segment mobilization affects three-dimensional nasal morphology

Published:September 20, 2020DOI:https://doi.org/10.1016/j.bjps.2020.08.119

      Summary

      Background

      Surgical mobilization of the maxillary segment affects nasal morphology. This study assessed the impact of the type of maxillary mobilization on the three-dimensional (3D) nasal morphometry.

      Methods

      Pre- and postsurgery cone beam computed tomography-derived facial image datasets of consecutive patients who underwent two-jaw orthognathic surgery were reviewed. Using preoperative 3D facial models as the positional reference of the skeletal framework, 12-month postoperative 3D facial models were classified into four types of maxillary mobilizations (advancement [n = 83], setback [n = 24], intrusion [n = 55], and extrusion [n = 52]) and four types of final maxillary positions (anterosuperior [n = 44], anteroinferior [n = 39], posterosuperior [n = 11], and posteroinferior [n = 13]). Six 3D soft tissue nasal morphometric parameters were measured, with excellent intra- and interexaminer reliability scores (ICC>0.897) for all the measurements. The 3D nasal change for each nasal parameter was computed as the difference between postoperative and preoperative measurement values.

      Results

      The intrusion maxillary mobilization resulted in a significantly (all p<0.05) larger 3D nasal change in terms of alar width, alar base width, and nostril angle parameters, and a smaller change in terms of the nasal tip height parameter than the extrusion maxillary mobilization; however, no significant (all p>0.05) difference was observed between advancement and setback maxillary mobilizations. The anterosuperior and posterosuperior maxillary positions had a significantly (all p<0.05) larger 3D nasal change in terms of the alar base width and nostril angle than the anteroinferior and posteroinferior maxillary positions.

      Conclusion

      The type of maxillary mobilization affects the 3D nasal morphometry.

      Keywords

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      References

        • Denadai R.
        • Chou P.Y.
        • Pai B.C.J.
        • et al.
        Skeletofacial reconstruction for cleft-related deformities: four decades of evolving cleft care.
        Ann Plast Surg. 2020; https://doi.org/10.1097/SAP.0000000000002187
        • Chou P.Y.
        • Denadai R.
        • Yao C.F.
        • et al.
        History and evolution of orthognathic surgery at Chang Gung Craniofacial Center: lessons learned from 35-year experience.
        Ann Plast Surg. 2020; 84: S60‐S68
        • Nguyen P.D.
        • Caro M.C.
        • Smith D.M.
        • Tompson B.
        • Forrest C.R.
        • Phillips J.H
        Long-term orthognathic surgical outcomes in Treacher Collins patients.
        J Plast Reconstr Aesthet Surg. 2016; 69 (402‐408)
        • Qin Z.
        • Zhang Z.
        • Li X.
        • Wang Y.
        • Wang P.
        • Li J
        One-stage treatment for maxillofacial asymmetry with orthognathic and contouring surgery using virtual surgical planning and 3D-printed surgical templates.
        J Plast Reconstr Aesthet Surg. 2019; 72 (97‐106)
        • Wu T.Y.
        • Lin H.H.
        • Lo L.J.
        • Ho C.T
        Postoperative outcomes of two- and three-dimensional planning in orthognathic surgery: a comparative study.
        J Plast Reconstr Aesthet Surg. 2017; 70 (1101‐1111)
        • Wang Y.
        • Li J.
        • Xu Y.
        • Huang N.
        • Shi B.
        • Li J
        Accuracy of virtual surgical planning-assisted management for maxillary hypoplasia in adult patients with cleft lip and palate.
        J Plast Reconstr Aesthet Surg. 2020; 73: 134‐140
        • Udomlarptham N.
        • Lin C.H.
        • Wang Y.C.
        • Ko E.W
        Does two-dimensional vs. three-dimensional surgical simulation produce better surgical outcomes among patients with class III facial asymmetry.
        Int J Oral Maxillofac Surg. 2018; 47: 1022-1031
        • Khamashta-Ledezma L.
        • Naini F.B.
        • Manisali M
        Review of nasal changes with maxillary orthognathic surgery.
        J Istanb Univ Fac Dent. 2017; 51: S52-S61
        • Paredes de Sousa Gil A.
        • Guijarro-Martínez R.
        • Haas Jr, O.L.
        • Hernández-Alfaro F
        Three-dimensional analysis of nasolabial soft tissue changes after Le Fort I osteotomy: a systematic review of the literature.
        Int J Oral Maxillofac Surg. 2019; 48: 1185-1200
        • Chen C.Y.
        • Lin C.C.
        • Ko E.W
        Effects of two alar base suture techniques suture techniques on nasolabial changes after bimaxillary orthognathic surgery in Taiwanese patients with class III malocclusions.
        Int J Oral Maxillofac Surg. 2015; 44: 816-822
        • Denadai R.
        • Chou P.Y.
        • Yao C.F.
        • et al.
        Effect of Le Fort I maxillary repositioning on 3D nasal tip rotation: a comparative study with implication for the Asian nose.
        Plast Reconstr Surg. 2020; ([in press])
        • Seo H.J.
        • Denadai R.
        • Lo L.J
        Long-term nasal growth after primary rhinoplasty for bilateral cleft lip nose deformity: a three-dimensional photogrammetric study with comparative analysis.
        J Clin Med. 2019; 8: e602
      1. Chou P.Y., Denadai R., Yao C.H., et al. Impact of the different types of Le Fort I maxillary surgical movement on distinct nasal width changes: a photogrammetric analysis. 2019. [in publication]

        • Seo H.J.
        • Denadai R.
        • Vamvanij N.
        • Chinpaisarn C.
        • Lo L.J
        Primary rhinoplasty does not interfere with nasal growth: a long-term three-dimensional morphometric outcome study in patients with unilateral cleft.
        Plast Reconstr Surg. 2020; 145 (1223‐1236)
        • Worasakwutiphong S.
        • Chuang Y.F.
        • Chang H.W.
        • Lin H.H.
        • Lin P.J.
        • Lo L.J
        Nasal changes after orthognathic surgery for patients with prognathism and class III malocclusion: analysis using three-dimensional photogrammetry.
        J Formos Med Assoc. 2015; 114: 112-123
        • Denadai R.
        • Chou P.Y.
        • Seo H.J.
        • et al.
        Patient- and 3D morphometry-based nose outcomes after skeletofacial reconstruction.
        Sci Rep. 2020; 10: 4246
        • Lo S.H.
        • Chen Y.A.
        • Yao C.F.
        • Liao Y.F.
        • Chen Y.R
        Is skeletal stability after bimaxillary surgery for skeletal class III deformity related to surgical occlusal contact?.
        Int J Oral Maxillofac Surg. 2019; 48: 1329-1336
        • Tran Duy T.D.
        • Chen M.C.
        • Wen-Ching Ko E.
        • Chen Y.R.
        • Huang C.S
        Does sleep quality affect temporomandibular joint with degenerative joint changes.
        J Oral Maxillofac Surg. 2019; 77: 1594-1601
        • Liao Y.F.
        • Chen Y.F.
        • Yao C.F.
        • Chen Y.A.
        • Chen Y.R
        Long-term outcomes of bimaxillary surgery for treatment of asymmetric skeletal class III deformity using surgery-first approach.
        Clin Oral Investig. 2019; 23: 1685-1693
        • Yu C.C.
        • Bergeron L.
        • Lin C.H.
        • et al.
        Single-splint technique in orthognathic surgery: intraoperative checkpoints to control facial symmetry.
        Plast Reconstr Surg. 2009; 124: 879-886
        • Honda T.
        • Lin C.H.
        • Yu C.C.
        • Heller F.
        • Chen Y.R
        The medial surface of the mandible as an alternative source of bone grafts in orthognathic surgery.
        J Craniofac Surg. 2005; 16: 123-128
        • Yao C.F.
        • Denadai R.
        • Pascasio D.C.G.
        • Chen Y.C.
        • Chen Y.R
        The medial subcoronoid process region as a novel source of bone grafts in orthognathic surgery and genioplasty.
        J Craniofac Surg. 2020; 31: 564‐567
        • Wu T.Y.
        • Denadai R.
        • Lin H.H.
        • Ho C.T.
        • Lo L.J
        The outcome of skeletofacial reconstruction with mandibular rotation for management of asymmetric skeletal class III deformity: a three-dimensional computer-assisted investigation.
        Sci Rep. 2019; 9: 13337
        • Lonic D.
        • Sundoro A.
        • Lin H.H.
        • Lin P.J.
        • Lo L.J
        Selection of a horizontal reference plane in 3D evaluation: identifying facial asymmetry and occlusal cant in orthognathic surgery planning.
        Sci Rep. 2017; 7: 2157
        • Bazina M.
        • Cevidanes L.
        • Ruellas A.
        • et al.
        Precision and reliability of Dolphin 3-dimensional voxel-based superimposition.
        Am J Orthod Dentofacial Orthop. 2018; 153: 599-606
        • Häner S.T.
        • Kanavakis G.
        • Matthey F.
        • Gkantidis N
        Voxel-based superimposition of serial craniofacial CBCTs: reliability, reproducibility and segmentation effect on hard-tissue outcomes.
        Orthod Craniofac Res. 2020; 23: 92-101
        • Sawh-Martinez R.
        • Lin A.M.
        • DeSesa C.R.
        • Wu R.T.
        • Gary C.S.
        • Steinbacher D.M
        Clockwise and counterclockwise Le Fort I movements influence nasolabial morphology differently.
        Plast Reconstr Surg. 2018; 142: 1572-1581
        • Beebee H.
        • Hitchcock C.
        • Menzies P
        The oxford handbook of causation.
        Oxford University Press, 2009
        • Swinscow T.D.V
        Campbell MJ 9th ed. University of Southampton; Copyright BMJ Publishing Group, 1997 (editor)
        • Hinkle D.E.
        • Wiersma W.
        • Jurs S.G
        Applied statistics for the behavioral sciences.
        5th ed. Houghton Mifflin, Boston2003
        • Hemmatpour S.
        • Kadkhodaei Oliadarani F.
        • Hasani A.
        • Rakhshan V
        Frontal-view nasolabial soft tissue alterations after bimaxillary orthognathic surgery in Class III patients.
        J Orofac Orthop. 2016; 77: 400-408
        • Mommaerts M.Y.
        • Lippens F.
        • Abeloos J.V.
        • Neyt L.F
        Nasal profile changes after maxillary impaction and advancement surgery.
        J Oral Maxillofac Surg. 2000; 58: 470-475
        • Radney L.J.
        • Jacobs J.D.
        Soft-tissue changes associated with surgical total maxillary intrusion.
        Am J Orthod. 1981; 80: 191-212
        • Almukhtar A.
        • Ayoub A.
        • Khambay B.
        • McDonald J.
        • Ju X
        State-of-the-art three-dimensional analysis of soft tissue changes following Le Fort I maxillary advancement.
        Br J Oral Maxillofac Surg. 2016; 54: 812-817
        • DeSesa C.R.
        • Metzler P.
        • Sawh-Martinez R.
        • Steinbacher D.M
        Three-dimensional nasolabial morphologic alterations following Le Fort I.
        Plast Reconstr Surg Glob Open. 2016; 4: e848
        • Metzler P.
        • Geiger E.J.
        • Chang C.C.
        • Sirisoontorn I.
        • Steinbacher D.M
        Assessment of three-dimensional nasolabial response to Le Fort I advancement.
        J Plast Reconstr Aesthet Surg. 2014; 67: 756-763
        • Sforza C.
        • Peretta R.
        • Grandi G.
        • Ferronato G.
        • Ferrario V.F
        Soft tissue facial volumes and shape in skeletal Class III patients before and after orthognathic surgery treatment.
        J Plast Reconstr Aesthet Surg. 2007; 60: 130‐138
        • Silveira Camargos I.
        • Metzler P.
        • Persing J.
        • Alcon A.
        • Steinbacher D.M
        Nasal soft-tissue and vault deviation in unicoronal synostosis.
        J Plast Reconstr Aesthet Surg. 2015; 68 (615‐621)
        • Ackerman J.L.
        • Proffit W.R.
        • Sarver D.M.
        • Ackerman M.B.
        • Kean M.R
        Pitch, roll, and yaw: describing the spatial orientation of dentofacial traits.
        Am J Orthod Dentofac Orthop. 2007; 131: 305-310
        • Li B.
        • Zhang L.
        • Sun H.
        • Shen S.G.
        • Wang X
        A new method of surgical navigation for orthognathic surgery: optical tracking guided free-hand repositioning of the maxillomandibular complex.
        J Craniofac Surg. 2014; 25: 406-411
        • Song W.W.
        • Kim S.S.
        • Sándor G.K.
        • Kim Y.D
        Maxillary yaw as the primary predictor of maxillary dental midline deviation: 3D analysis using cone-beam computed tomography.
        J Oral Maxillofac Surg. 2013; 71: 752-762
        • 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 Dentofac Orthop. 2010; 138: 167-178
        • Jeong H.I.
        • Lee H.S.
        • Jung Y.S.
        • Park H.S.
        • Jung H.D
        Nasal soft tissue change following bimaxillary orthognathic surgery.
        J Craniofac Surg. 2017; 28: e605-e608
        • Yamada T.
        • Mishima K.
        • Moritani N.
        • et al.
        Nasolabial morphologic changes after a Le Fort I osteotomy: a three-dimensional anthropometric study.
        J Craniofac Surg. 2010; 21: 1089-1095