Mandrekar Pooja Narendra, Dhupar Vikas, Akkara Francis
Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India.
Ann Maxillofac Surg. 2021 Jan-Jun;11(1):32-36. doi: 10.4103/ams.ams_138_20. Epub 2021 Jul 24.
Orthognathic surgery is carried out in the hard tissues; however, the patient perceives change in the soft tissue. It is important to accurately predict postoperative facial changes associated with each surgical procedure. This study aims to evaluate the changes in the soft tissues resulting from the movement of the hard tissue following single and bi-jaw surgeries.
An evaluative clinical study was carried out on a total of 34 subjects which consisted of 52 jaw surgeries. Maxilla and mandible were considered as a separate entity even in bi-jaw cases for evaluation. Surgical procedures performed were either bilateral sagittal split osteotomy, Le Fort I osteotomy or both. Pre- and post-surgical lateral cephalograms were compared to assess the soft-tissue change at various soft-tissue points and were labeled T1 and T2, respectively. The points on maxilla were Point A and PrS on upper lip. The points on mandible were PrI and Point B on lower lip and Pog and Gn on chin.
All the points on the maxilla and mandible had a strong correlation between the hard and soft-tissue points except point PrS on upper lip.
Facial appearance is an important parameter in the present times which influences the social and psychological development of an individual. What patient sees is the external soft-tissue drape whereas orthognathic surgery is carried out on bony components of the face. Thus prediction of soft-tissue changes following surgery is an important part of treatment planning.
正颌外科手术作用于硬组织;然而,患者感受到的是软组织的变化。准确预测与每种外科手术相关的术后面部变化非常重要。本研究旨在评估单颌和双颌手术后硬组织移动所导致的软组织变化。
对总共34名受试者进行了一项评估性临床研究,其中包括52例颌骨手术。即使在双颌病例中,上颌骨和下颌骨在评估时也被视为独立的个体。所进行的外科手术为双侧矢状劈开截骨术、Le Fort I 截骨术或两者皆有。比较手术前后的头颅侧位片,以评估各个软组织点的软组织变化,分别标记为T1和T2。上颌骨上的点为上唇的A点和PrS点。下颌骨上的点为下唇的PrI点和B点以及下巴的Pog点和Gn点。
除上唇的PrS点外,上颌骨和下颌骨上的所有点在硬组织点和软组织点之间都有很强的相关性。
面部外观是当今影响个体社会和心理发展的一个重要参数。患者看到的是外部软组织覆盖物,而正颌外科手术是在面部的骨成分上进行的。因此,预测手术后的软组织变化是治疗计划的重要组成部分。