Tiwari Rahul, Chakravarthi P Srinivas, Kattimani Vivekanand S, Lingamaneni Krishna Prasad
Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India.
Open Dent J. 2018 Apr 30;12:366-376. doi: 10.2174/1874210601812010366. eCollection 2018.
Facial appearance is an important factor, affects social and psychological well-being. The ideal positioning of jaws and soft tissues is crucial during orthognathic surgery for a better outcome, but the response of facial soft tissues does not always reflect the exact movements of the underlying jaws in 1:1 ratio. So, soft tissue changes following orthognathic surgery require utmost attention during surgical correction to make successful treatment.
Evaluation of perioral soft tissue changes after orthognathic surgical procedures. The objectives of the study were to assess and compare pre and post-operative perioral soft tissue changes of lip width, nasolabial and mentolabial angle using Three Dimensional Computed Tomography scan (3DCT).
The study involved ten patients for evaluation requiring orthognathic surgical procedures (maxillary or mandibular anteroposterior excess or deficiency, transverse deformities, vertical maxillary excess and facial asymmetry) presented to the department of oral and maxillofacial surgery during 2014-2016. Pre and post-operative 3DCT scan were taken after 12 months using iCT 256 slice whole body CT scanner and evaluated for changes using Dicom PMS D view.
Significant changes were observed in nasolabial angle after maxillary advancement (1.81°) and maxillary setback procedure (2.73°). The mentolabial angle was significantly increased with mandibular setback procedures (3.27°). Mandibular advancement procedures showed both increase (3.6°) and decrease (7.6°) in mentolabial angle.
3DCT showed a significant difference in perioral soft tissue changes in nasolabial and mentolabial angle but no significant change was observed in lip width. 3DCT is a reliable tool for 3D assessment. The conventional thought of changes in Nasolabial angle after surgery is changing due to the underlying factors which should be considered for prediction.
面部外观是一个重要因素，会影响社会和心理健康。在正颌手术中，颌骨和软组织的理想定位对于获得更好的手术效果至关重要，但面部软组织的反应并不总是与下方颌骨的精确移动呈1:1比例。因此，在手术矫正过程中，正颌手术后的软组织变化需要格外关注，以实现成功治疗。
评估正颌手术后口周软组织的变化。本研究的目的是使用三维计算机断层扫描（3DCT）评估和比较术前和术后口周软组织在唇宽、鼻唇角和颏唇角方面的变化。
本研究纳入了2014年至2016年间到口腔颌面外科就诊、需要进行正颌手术（上颌或下颌前后向过长或过短、横向畸形、上颌垂直过长和面部不对称）的10名患者进行评估。使用iCT 256层全身CT扫描仪在术后12个月进行术前和术后3DCT扫描，并使用Dicom PMS D视图评估变化情况。
上颌前徙术（1.81°）和上颌后退术（2.73°）后鼻唇角出现显著变化。下颌后退术后颏唇角显著增加（3.27°）。下颌前徙术显示颏唇角既有增加（3.6°）也有减少（7.6°）。
3DCT显示鼻唇角和颏唇角的口周软组织变化存在显著差异，但唇宽未观察到显著变化。3DCT是一种可靠的三维评估工具。由于存在应考虑用于预测的潜在因素，手术后鼻唇角变化的传统观念正在改变。
