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Soft Tissue Response after Maxillary Step Surgery with or without ANS Reduction

Year 2021, Volume: 24 Issue: 2, 121 - 128, 31.05.2021
https://doi.org/10.7126/cumudj.810461

Abstract

Amaç: Yumuşak doku profilinin tahmini, ortognatik cerrahi planlamanın önemli bir parçasıdır. Cerrahi tekniklerdeki değişiklikler yumuşak doku yanıtını etkileyebilir. Bu çalışma, basamaklı maksiller osteotominin yumuşak doku yanıtı üzerindeki etkilerini belirlemeyi amaçlamıştır.
Gereç ve Yöntemler: Çalışmaya basamaklı maksiller osteotomi ve bilateral sagittal split ramus osteotomisi kullanılarak, maksiller ilerletme ve mandibular geri alma cerrahisi uygulanan toplam 24 hasta (17 kadın, 7 erkek) dâhil edildi. Daha sonra ANS redüksiyon pozitif (ANSR+) ve negatif grup (ANSR-) olmak üzere iki alt grup oluşturuldu. Tüm hastalarda chin sütür ve V-Y kapama teknikleri kullanılmıştır. Ameliyat öncesi ve ameliyattan 6-8 ay sonra alınan lateral sefalometrik radyografiler arşivden toplandı. Yumuşak ve sert doku değişiklikleri, eşleştirilmiş T-testi kullanılarak değerlendirildi. Sert ve yumuşak doku hareketleri arasındaki korelasyonu belirlemek için Pearson korelasyon testi kullanıldı.
Bulgular: ANSR+ grubunun maksiller yumuşak/sert doku oranları ANSR- grubundan daha düşüktü. ANSR+ ve ANSR- gruplarında oranlar Pr/ANS:% 6'ya karşı % 49, Pr/A:% 16'ya karşı % 42, Sn/A:% 52'ye karşı % 66, Ls/ U1:% 31'e karşı % 78 olarak bulunmuştur.
Sonuçlar: Basamaklı maksiller osteotomi tekniği, burun ucunun anterior yönde daha fazla desteklenmesinin istendiği hastalarda faydalı olabilir. ANS redüksiyon işlemi, burun ucu ve üst dudağın yumuşak doku yanıtında azalmaya neden olur. Subnazal bölge nispeten daha az etkilenir.

Supporting Institution

Yok.

Project Number

19-KAEK-111

Thanks

We thank Assist. Prof. xxxxxxx for the statistical analysis.

References

  • 1. Ackerman JL, Proffit WR, Sarver DM. The emerging soft tissue paradigm in orthodontic diagnosis and treatment planning. Clinical orthodontics and research 1999;2:49-52.
  • 2. Proffit WR. Masters of esthetic dentistry: The soft tissue paradigm in orthodontic diagnosis and treatment planning: A new view for a new century. Journal of Esthetic and Restorative Dentistry 2000;12:46.
  • 3. San Miguel Moragas J, Van Cauteren W, Mommaerts MY. A systematic review on soft-to-hard tissue ratios in orthognathic surgery part I: maxillary repositioning osteotomy. J Craniomaxillofac Surg 2014;42:1341-1351.
  • 4. Khamashta-Ledezma L, Naini FB. Prospective assessment of maxillary advancement effects: maxillary incisor exposure, and upper lip and nasal changes. Am J Orthod Dentofacial Orthop 2015;147:454-464.
  • 5. Peled M, Ardekian L, Krausz AA, Aizenbud D. Comparing the effects of V-Y advancement versus simple closure on upper lip aesthetics after Le Fort I advancement. J Oral Maxillofac Surg 2004;62:315-319.
  • 6. Chew MT. Soft and hard tissue changes after bimaxillary surgery in Chinese Class III patients. Angle Orthod 2005;75:959-963.
  • 7. Altug-Atac AT, Bolatoglu H, Memikoglu UT. Facial soft tissue profile following bimaxillary orthognathic surgery. Angle Orthod 2008;78:50-57.
  • 8. Aydil B, Ozer N, Marsan G. Bimaxillary surgery in Class III malocclusion: soft and hard tissue changes. J Craniomaxillofac Surg 2013;41:254-257.
  • 9. Catherine Z, Scolozzi P. Modified Le Fort I step osteotomy for improvement of paranasal flatness in maxillary deficiency: Technical note and series of 24 cases. J Stomatol Oral Maxillofac Surg 2019;120:559-565.
  • 10. Keller EE, Sather AH. Intraoral quadrangular Le Fort II osteotomy. J Oral Maxillofac Surg 1987;45:223-232.
  • 11. Obwegeser HL. Surgical correction of small or retrodisplaced maxillae. The "dish-face" deformity. Plast Reconstr Surg 1969;43:351-365.
  • 12. Kufner J. Four-year experience with major maxillary osteotomy for retrusion. J Oral Surg 1971;29:549-553.
  • 13. Kaminishi RM, Davis WH, Hochwald DA, Nelson N. Improved maxillary stability with modified Lefort I technique. J Oral Maxillofac Surg 1983;41:203-205.
  • 14. Bennett MA, Wolford LM. The maxillary step osteotomy and Steinmann pin stabilization. J Oral Maxillofac Surg 1985;43:307-311.
  • 15. Stringer DE, Boyne PJ. Modification of the maxillary step osteotomy and stabilization with titanium mesh. J Oral Maxillofac Surg 1986;44:487-488.
  • 16. Olate S, Zaror C, Blythe JN, Mommaerts MY. A systematic review of soft-to-hard tissue ratios in orthognathic surgery. Part III: Double jaw surgery procedures. J Craniomaxillofac Surg 2016;44:1599-1606.
  • 17. Shoji T, Muto T, Takahashi M, Akizuki K, Tsuchida Y. The stability of an alar cinch suture after Le Fort I and mandibular osteotomies in Japanese patients with Class III malocclusions. Br J Oral Maxillofac Surg 2012;50:361-364.
  • 18. Schendel SA, Williamson LW. Muscle reorientation following superior repositioning of the maxilla. J Oral Maxillofac Surg 1983;41:235-240.
  • 19. Legan HL, Burstone CJ. Soft tissue cephalometric analysis for orthognathic surgery. Journal of oral surgery (American Dental Association: 1965) 1980;38:744-751.
  • 20. Lew K, Loh F, Yeo J, Loh H. Evaluation of soft tissue profile following intraoral ramus osteotomy in Chinese adults with mandibular prognathism. The International journal of adult orthodontics and orthognathic surgery 1990;5:189-197.
  • 21. Dahlberg G. Statistical methods for medical and biological students. Statistical methods for medical and biological students. 1940.
  • 22. Louis PJ, Austin RB, Waite PD, Mathews CS. Soft tissue changes of the upper lip associated with maxillary advancement in obstructive sleep apnea patients. J Oral Maxillofac Surg 2001;59:151-156.
  • 23. Soncul M, Bamber MA. Evaluation of facial soft tissue changes with optical surface scan after surgical correction of Class III deformities. J Oral Maxillofac Surg 2004;62:1331-1340.
  • 24. Davidson E, Kumar AR. A Preliminary Three-Dimensional Analysis of Nasal Aesthetics Following Le Fort I Advancement in Patients With Cleft Lip and Palate. J Craniofac Surg 2015;26:e629-633.
  • 25. Kaklamanos EG, Kolokitha O-E. Relation between soft tissue and skeletal changes after mandibular setback surgery: a systematic review and meta-analysis. Journal of Cranio-Maxillofacial Surgery 2016;44:427-435.
  • 26. Lin SS, Kerr WJ. Soft and hard tissue changes in Class III patients treated by bimaxillary surgery. Eur J Orthod 1998;20:25-33.
  • 27. Jensen AC, Sinclair PM, Wolford LM. Soft tissue changes associated with double jaw surgery. Am J Orthod Dentofacial Orthop 1992;101:266-275.
  • 28. Becker OE, Avelar RL, Dolzan Ado N, Haas OL, Jr., Scolari N, Oliveira RB. Soft and hard tissue changes in skeletal Class III patients treated with double-jaw orthognathic surgery-maxillary advancement and mandibular setback. Int J Oral Maxillofac Surg 2014;43:204-212.
Year 2021, Volume: 24 Issue: 2, 121 - 128, 31.05.2021
https://doi.org/10.7126/cumudj.810461

Abstract

Project Number

19-KAEK-111

References

  • 1. Ackerman JL, Proffit WR, Sarver DM. The emerging soft tissue paradigm in orthodontic diagnosis and treatment planning. Clinical orthodontics and research 1999;2:49-52.
  • 2. Proffit WR. Masters of esthetic dentistry: The soft tissue paradigm in orthodontic diagnosis and treatment planning: A new view for a new century. Journal of Esthetic and Restorative Dentistry 2000;12:46.
  • 3. San Miguel Moragas J, Van Cauteren W, Mommaerts MY. A systematic review on soft-to-hard tissue ratios in orthognathic surgery part I: maxillary repositioning osteotomy. J Craniomaxillofac Surg 2014;42:1341-1351.
  • 4. Khamashta-Ledezma L, Naini FB. Prospective assessment of maxillary advancement effects: maxillary incisor exposure, and upper lip and nasal changes. Am J Orthod Dentofacial Orthop 2015;147:454-464.
  • 5. Peled M, Ardekian L, Krausz AA, Aizenbud D. Comparing the effects of V-Y advancement versus simple closure on upper lip aesthetics after Le Fort I advancement. J Oral Maxillofac Surg 2004;62:315-319.
  • 6. Chew MT. Soft and hard tissue changes after bimaxillary surgery in Chinese Class III patients. Angle Orthod 2005;75:959-963.
  • 7. Altug-Atac AT, Bolatoglu H, Memikoglu UT. Facial soft tissue profile following bimaxillary orthognathic surgery. Angle Orthod 2008;78:50-57.
  • 8. Aydil B, Ozer N, Marsan G. Bimaxillary surgery in Class III malocclusion: soft and hard tissue changes. J Craniomaxillofac Surg 2013;41:254-257.
  • 9. Catherine Z, Scolozzi P. Modified Le Fort I step osteotomy for improvement of paranasal flatness in maxillary deficiency: Technical note and series of 24 cases. J Stomatol Oral Maxillofac Surg 2019;120:559-565.
  • 10. Keller EE, Sather AH. Intraoral quadrangular Le Fort II osteotomy. J Oral Maxillofac Surg 1987;45:223-232.
  • 11. Obwegeser HL. Surgical correction of small or retrodisplaced maxillae. The "dish-face" deformity. Plast Reconstr Surg 1969;43:351-365.
  • 12. Kufner J. Four-year experience with major maxillary osteotomy for retrusion. J Oral Surg 1971;29:549-553.
  • 13. Kaminishi RM, Davis WH, Hochwald DA, Nelson N. Improved maxillary stability with modified Lefort I technique. J Oral Maxillofac Surg 1983;41:203-205.
  • 14. Bennett MA, Wolford LM. The maxillary step osteotomy and Steinmann pin stabilization. J Oral Maxillofac Surg 1985;43:307-311.
  • 15. Stringer DE, Boyne PJ. Modification of the maxillary step osteotomy and stabilization with titanium mesh. J Oral Maxillofac Surg 1986;44:487-488.
  • 16. Olate S, Zaror C, Blythe JN, Mommaerts MY. A systematic review of soft-to-hard tissue ratios in orthognathic surgery. Part III: Double jaw surgery procedures. J Craniomaxillofac Surg 2016;44:1599-1606.
  • 17. Shoji T, Muto T, Takahashi M, Akizuki K, Tsuchida Y. The stability of an alar cinch suture after Le Fort I and mandibular osteotomies in Japanese patients with Class III malocclusions. Br J Oral Maxillofac Surg 2012;50:361-364.
  • 18. Schendel SA, Williamson LW. Muscle reorientation following superior repositioning of the maxilla. J Oral Maxillofac Surg 1983;41:235-240.
  • 19. Legan HL, Burstone CJ. Soft tissue cephalometric analysis for orthognathic surgery. Journal of oral surgery (American Dental Association: 1965) 1980;38:744-751.
  • 20. Lew K, Loh F, Yeo J, Loh H. Evaluation of soft tissue profile following intraoral ramus osteotomy in Chinese adults with mandibular prognathism. The International journal of adult orthodontics and orthognathic surgery 1990;5:189-197.
  • 21. Dahlberg G. Statistical methods for medical and biological students. Statistical methods for medical and biological students. 1940.
  • 22. Louis PJ, Austin RB, Waite PD, Mathews CS. Soft tissue changes of the upper lip associated with maxillary advancement in obstructive sleep apnea patients. J Oral Maxillofac Surg 2001;59:151-156.
  • 23. Soncul M, Bamber MA. Evaluation of facial soft tissue changes with optical surface scan after surgical correction of Class III deformities. J Oral Maxillofac Surg 2004;62:1331-1340.
  • 24. Davidson E, Kumar AR. A Preliminary Three-Dimensional Analysis of Nasal Aesthetics Following Le Fort I Advancement in Patients With Cleft Lip and Palate. J Craniofac Surg 2015;26:e629-633.
  • 25. Kaklamanos EG, Kolokitha O-E. Relation between soft tissue and skeletal changes after mandibular setback surgery: a systematic review and meta-analysis. Journal of Cranio-Maxillofacial Surgery 2016;44:427-435.
  • 26. Lin SS, Kerr WJ. Soft and hard tissue changes in Class III patients treated by bimaxillary surgery. Eur J Orthod 1998;20:25-33.
  • 27. Jensen AC, Sinclair PM, Wolford LM. Soft tissue changes associated with double jaw surgery. Am J Orthod Dentofacial Orthop 1992;101:266-275.
  • 28. Becker OE, Avelar RL, Dolzan Ado N, Haas OL, Jr., Scolari N, Oliveira RB. Soft and hard tissue changes in skeletal Class III patients treated with double-jaw orthognathic surgery-maxillary advancement and mandibular setback. Int J Oral Maxillofac Surg 2014;43:204-212.
There are 28 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research Articles
Authors

Neslihan İzgi 0000-0002-1469-9161

Sibel Akbulut 0000-0003-3007-1179

Nihat Akbulut 0000-0001-6950-8214

Project Number 19-KAEK-111
Publication Date May 31, 2021
Submission Date October 14, 2020
Published in Issue Year 2021Volume: 24 Issue: 2

Cite

EndNote İzgi N, Akbulut S, Akbulut N (May 1, 2021) Soft Tissue Response after Maxillary Step Surgery with or without ANS Reduction. Cumhuriyet Dental Journal 24 2 121–128.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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