Effect of setback Le Fort I osteotomy on midfacial soft-tissue changes as evaluated by cone-beam computed tomography superimposition for cases of skeletal Class III malocclusion

• Published in: International journal of oral and maxillofacial surgery Vol. 42; no. 6; pp. 790 - 795
• Main Authors: Lee, J.-Y, Kim, Y.-I, Hwang, D.-S, Park, S.-B
• Format: Journal Article
• Language: English
• Published: Denmark Elsevier Ltd 01.06.2013
• Subjects: Adult; CBCT superimposition; Cephalometry; Cone-Beam Computed Tomography - methods; Dentistry; Face - anatomy & histology; Female; Humans; Male; Malocclusion, Angle Class III - diagnostic imaging; Malocclusion, Angle Class III - surgery; Mandible - surgery; Maxilla - surgery; maxillary setback; Nasolabial Fold - anatomy & histology; Osteotomy, Le Fort; Osteotomy, Sagittal Split Ramus; Retrospective Studies; soft tissue change; Subtraction Technique; Surgery; Suture Techniques; Treatment Outcome; Young Adult; soft tissue change; CBCT superimposition; maxillary setback
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2012.11.012

Abstract This study employed the cone-beam computed tomography (CBCT) superimposition method to evaluate postoperative midfacial soft-tissue changes in cases of skeletal Class III malocclusion after double-jaw surgery with setback and vertical reduction Le Fort I osteotomy. A retrospective study was carried out on 15 patients who had undergone maxillary setback Le Fort I osteotomy and mandibular setback sagittal split ramus osteotomy with alar cinch suturing and V-Y soft-tissue closure. Three dimensional CBCT volume scans were recorded preoperatively (T0) and 6 months postoperatively (T1) to measure soft-tissue changes of the upper lip and midface. Post-surgery, soft-tissue landmarks in the cheek and paranasal areas had moved forward; the soft-tissue thickness at the A-point had markedly increased ( P < 0.05); there was no significant change in the subnasale, and the midline of the soft-tissue of the upper-lip area had moved backward. The extent of the mean soft-tissue change at the labrale superius was greater than that at the other soft-tissue landmarks of the upper lip. The results suggest that maxillary setback movement of the maxilla by alar cinch suturing has a beneficial effect on paranasal soft-tissue and lip contours for patients with protrusive lip and acute nasolabial angle.