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Introduction: The aim of this before-after clinical trial was to evaluate nasolabial soft tissue changes in the frontal plane after bimaxillary surgery., Methods: A total of 20 skeletal Class III Iranian patients needing bimaxillary Le Fort I osteotomy plus mandibular setback surgery were enrolled in this trial. Patients underwent 4.02 ± 1.02 mm of maxillary advancement (Le Fort I osteotomy, 4.33 ± 1.21 mm in men, 3.81 ± 0.86 mm in women) and 7.13 ± 1.74 mm of mandibular setback (intraoral vertical ramus osteotomy, 7.71 ± 2.33 mm in men, and 6.74 ± 1.16 mm in women). Data were acquired via 2D frontal photographs. We compared pretreatment baseline (T 1 ), preoperative postorthodontic treatment (T 2 ), and postoperative (T 3 ) anthropometric measurements using repeated-measures ANOVA and Bonferroni tests (α = 0.05)., Result: The 20 patients (12 men, 8 women) were aged 21.85 ± 1.75 years. Between T 1 and T 2 , nasal width, cutaneous upper labial heights increased overall; cutaneous lower labial height decreased (P < 0.05). Between T 2 and T 3 , nasal width, widths of the philtrum and mouth, cutaneous upper-lip height, vermilion height of the lower lip, lateral upper-lip height increased; the upper-lip vermilion height and cutaneous lower lip height decreased (P < 0.05). The changes ranged between 0.5 and 5 mm., Conclusion: The applied orthognathic surgery procedures might widen the alar base and mouth width. It might increase the lateral upper-lip height, vermilion height of the lower lip, and cutaneous and overall upper-lip heights while reducing upper-lip vermilion height and shortening the overall lower-lip height.

Abstract: The aims of this study were to analyze possible contributing factors to intraoperative clockwise rotation (CWR) of the proximal segment (PS), which is known to be a primary factor for relapse after mandibular setback with sagittal split ramus osteotomy (SSRO) and to evaluate the correlation between the CWR of the PS and relapse tendency. The sample was comprised of 47 patients who underwent SSRO for mandibular setback. Lateral cephalograms were analyzed. The vertical difference between the inferior borders of the PS and the distal segment at the vertical osteotomy line for SSRO after setback of the distal segment (vertical bony step, VBS) was the most predictable factor for CWR of the PS (p < 0.001), and it correlated significantly with the gonial angle, the surgical change in SNB, and the downward movement of the maxilla (p < 0.05). Patients with large CWR of the PS showed a greater tendency in horizontal relapse than patients with small CWR of the PS (p < 0.05). Such relapse patterns could be prevented with adequate surgical planning designed to reduce the VBS, such as maxillary posterior impaction or the intentional guidance of the PS to maintain the original position of the PS without CWR. [Copyright &y& Elsevier]

Objectives: The aim of this study was to determine the validity of a manual cephalometric method used for predicting the post-operative soft tissue profiles of patients who underwent mandibular setback surgery and compare it to a computerized cephalometric prediction method (Dentofacial Planner). Lateral cephalograms of 18 adults with mandibular prognathism taken at the end of pre-surgical orthodontics and approximately one year after surgery were used., Methods: To test the validity of the manual method the prediction tracings were compared to the actual post-operative tracings. The Dentofacial Planner software was used to develop the computerized post-surgical prediction tracings. Both manual and computerized prediction printouts were analyzed by using the cephalometric system PORDIOS. Statistical analysis was performed by means of t-test., Results: Comparison between manual prediction tracings and the actual post-operative profile showed that the manual method results in more convex soft tissue profiles; the upper lip was found in a more prominent position, upper lip thickness was increased and, the mandible and lower lip were found in a less posterior position than that of the actual profiles. Comparison between computerized and manual prediction methods showed that in the manual method upper lip thickness was increased, the upper lip was found in a more anterior position and the lower anterior facial height was increased as compared to the computerized prediction method., Conclusions: Cephalometric simulation of post-operative soft tissue profile following orthodontic-surgical management of mandibular prognathism imposes certain limitations related to the methods implied. However, both manual and computerized prediction methods remain a useful tool for patient communication.