Does Clockwise Rotation of Maxillomandibular Complex Using Surgery-First Approach to Correct Mandibular Prognathism Improve Facial Appearance?
Journal
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
ISSN: 1531-5053
Titre abrégé: J Oral Maxillofac Surg
Pays: United States
ID NLM: 8206428
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
19
03
2023
revised:
29
08
2023
accepted:
29
08
2023
medline:
5
12
2023
pubmed:
25
9
2023
entrez:
24
9
2023
Statut:
ppublish
Résumé
Facial aesthetics may be optimized based on a deeper understanding of soft tissue changes after orthognathic surgery. The purpose of the study was to delineate facial soft tissue changes after clockwise rotation (CWR) of the maxillomandibular complex (MMC) to correct mandibular prognathism using the surgery-first approach. This prospective cohort study enrolled patients over 18 years of age with skeletal Class III malocclusion in the craniofacial center. The patients were excluded with previous history of craniofacial syndrome, orthognathic surgery trauma, infection at surgical sites, chin deviation (menton deviation ≥4 mm), 2 or more missing data points after surgery, or without informed consent. This study compared significant facial changes before (T0) and after orthodontic debonding (T1) in the CWR and control groups. The patients were divided in accordance with maxillary occlusal plane change (OPC) after surgery into CWR (OPC >4°) and control (OPC ≤4°) groups. The primary outcome variable was frontal lip curvature (FLC: Right Cheilion-Stomion-Left Cheilion, degree) with or without upper lip curving upward at T1, where upper lip curving upward was considered more favorable. The covariates included age, sex, and various cephalometric measurements. The Mann-Whitney U test, paired, and independent t-test were implemented to compare the intragroup and intergroup differences. Statistical significance was indicated by P value <.05. The study comprised 34 patients (21 women) in the control group and 37 (29 women) in the CWR group; their mean ages were 23.64 ± 4.38 and 24.21 ± 3.84 years, respectively (P value = .562). At T1, the CWR group had significant increased FLC (P value = .001), alar width (P value = .034), and lower vermilion height (P value = .018), and decreased lower lip length (P value = .004). The high FLC group had significant decreased upper lip projection (P value = .002) and increased nasolabial angle (P value = .013). The significant relationship between CWR and high FLC was supported by the χ Greater CWR of the MMC increased FLC and lower vermilion height and reduced lower lip length. High FLC resulting from the CWR of the MMC improved facial appearance by moving the upper lip curve upward.
Sections du résumé
BACKGROUND
BACKGROUND
Facial aesthetics may be optimized based on a deeper understanding of soft tissue changes after orthognathic surgery.
PURPOSE
OBJECTIVE
The purpose of the study was to delineate facial soft tissue changes after clockwise rotation (CWR) of the maxillomandibular complex (MMC) to correct mandibular prognathism using the surgery-first approach.
STUDY DESIGN, SETTING, SAMPLE
UNASSIGNED
This prospective cohort study enrolled patients over 18 years of age with skeletal Class III malocclusion in the craniofacial center. The patients were excluded with previous history of craniofacial syndrome, orthognathic surgery trauma, infection at surgical sites, chin deviation (menton deviation ≥4 mm), 2 or more missing data points after surgery, or without informed consent. This study compared significant facial changes before (T0) and after orthodontic debonding (T1) in the CWR and control groups.
PREDICTOR VARIABLE
METHODS
The patients were divided in accordance with maxillary occlusal plane change (OPC) after surgery into CWR (OPC >4°) and control (OPC ≤4°) groups.
MAIN OUTCOME VARIABLE
METHODS
The primary outcome variable was frontal lip curvature (FLC: Right Cheilion-Stomion-Left Cheilion, degree) with or without upper lip curving upward at T1, where upper lip curving upward was considered more favorable.
COVARIATES
UNASSIGNED
The covariates included age, sex, and various cephalometric measurements.
ANALYSES
METHODS
The Mann-Whitney U test, paired, and independent t-test were implemented to compare the intragroup and intergroup differences. Statistical significance was indicated by P value <.05.
RESULTS
RESULTS
The study comprised 34 patients (21 women) in the control group and 37 (29 women) in the CWR group; their mean ages were 23.64 ± 4.38 and 24.21 ± 3.84 years, respectively (P value = .562). At T1, the CWR group had significant increased FLC (P value = .001), alar width (P value = .034), and lower vermilion height (P value = .018), and decreased lower lip length (P value = .004). The high FLC group had significant decreased upper lip projection (P value = .002) and increased nasolabial angle (P value = .013). The significant relationship between CWR and high FLC was supported by the χ
CONCLUSION
CONCLUSIONS
Greater CWR of the MMC increased FLC and lower vermilion height and reduced lower lip length. High FLC resulting from the CWR of the MMC improved facial appearance by moving the upper lip curve upward.
Identifiants
pubmed: 37743044
pii: S0278-2391(23)01091-1
doi: 10.1016/j.joms.2023.08.226
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1466-1475Informations de copyright
Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.