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. 2014 Jul-Dec;4(2):132-7.
doi: 10.4103/2231-0746.147095.

Soft tissue changes and its stability as a sequlae to mandibular advancement

Uday Kiran Uppada  1 , Ramen Sinha  1 , D Sreenatha Reddy  1 , Dushyanth Paul  1
Affiliations

Soft tissue changes and its stability as a sequlae to mandibular advancement

Uday Kiran Uppada et al. Ann Maxillofac Surg. 2014 Jul-Dec.

Abstract

Purpose of the study: To predict the changes and evaluate the stability that occurs in the soft tissues following the skeletal movement subsequent to surgical advancement of the mandible through bilateral sagittal split osteotomy and to provide the patient reliable information with regard to esthetic changes that can be expected following the treatment.

Materials and methods: Twenty adult patients diagnosed with skeletal class II malocclusion and underwent bilateral sagittal split osteotomy for mandibular advancement by a mean of 8 mm using rigid fixation were included in the study. Soft tissue changes brought about by the surgical procedure and their stability over a period of time were evaluated prospectively using 12 linear (4 vertical and 8 horizontal) and 4 angular measurements on profile cephalograms which were taken preoperatively after the pre-surgical orthodontics (T1) and postoperatively with duration of 1 month (T2) and 6 months (T3) respectively.

Results: It was observed that compared to the linear measurements, the angular measurements showed significant changes. The improvement in the esthetic outcome is a direct reflection of the angular changes whereas the linear changes played a contributing role. Following mandibular advancement surgery the profiles of the patients was perceived to have improved with reduction in the facial convexity, an increase in the lower facial height, decrease in the depth of the mentolabial sulcus and improvement in the lip competency with lengthening, straightening and thinning of the lower lip.

Conclusion: The soft tissue response and its stability depends on the stability of the surgical procedure itself, postsurgical growth and remodeling of the hard tissues and soft tissue changes as a result of maturation and aging.

Keywords: Bilateral sagittal split ramus osteotomy; orthognathic maxilla; profile cephalogram; retrognathic mandible.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Linear parameters for soft tissue evaluation
Figure 2
Figure 2
Angular parameters for soft tissue evaluation
Figure 3
Figure 3
Case 1 - (a) Pre surgical phase, (b) Immediate postsurgical phase, (c) Late postsurgical phase, (d) Cephalometric tracing in the presurgical phase, (e) Cephalometric tracing in the immediate postsurgical phase, (f) Cephalometric tracing in the late postsurgical phase
Figure 4
Figure 4
Case – 2 (a) Pre surgical phase, (b) Immediate postsurgical phase, (c) Late postsurgical phase, (d) Cephalometric tracing in the pre surgical phase, (e) Cephalometric tracing in the immediate postsurgical phase, (f) Cephalometric tracing in the late postsurgical phase, (g) Pre surgical cephalogram, (h) Immediate postsurgical cephalogram, (i) Late postsurgical cephalogram
Figure 5
Figure 5
Case – 3 (a) Pre surgical phase, (b) Immediate postsurgical phase, (c) Late postsurgical phase, (d) Cephalometric tracing in the pre surgical phase, (e) Cephalometric tracing in the immediate postsurgical phase, (f) Cephalometric tracing in the late postsurgical phase, (g) Pre surgical cephalogram, (h): Immediate postsurgical cephalogram, (i) Late postsurgical cephalogram
Figure 6
Figure 6
Case – 4 (a) Presurgical phase, (b) Late postsurgical phase
See this image and copyright information in PMC

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