Department of Oral and Maxillofacial Surgery, Istanbul Medipol University, School of Dentistry, Istanbul, Turkey.
J Craniofac Surg. 2023 May 1;34(3):860-864. doi: 10.1097/SCS.0000000000008958. Epub 2022 Aug 24.
The cheilion (Ch), corner of the mouth, is the soft-tissue landmark where the upper and lower lips intersect. Orthognathic surgery can modify Ch position, which can affect facial esthetics. The aims were to evaluate Ch movements resulting from Le Fort I maxillary advancement with maxillary impaction or downgrafting, and with mandibular advancement or setback, and to investigate relationships between surgical movements and Ch movements. The 45 patients had undergone bilateral sagittal split ramus osteotomy with Le Fort I advancement surgery. They were divided into 4 groups according to surgical movement direction. Preoperative and postoperative photographs were calibrated. Standardized methods were used to identify and measure preoperative and postoperative Ch positions. Significant correlations were detected between extent of maxillary downgrafting and inferior movement of the Ch in group 1 ( r =0.988, P =0.001) and group 3 ( r =0.915, P =0.001). Also, significant correlations were detected between extent of mandibular advancement and anterior movement of the Ch in group 3 ( r =0.561, P =0.046) and group 4 ( r =0.661, P =0.005). The findings indicate that, in patients who undergo bilateral sagittal split ramus osteotomy/Le Fort I surgeries, mandibular advancement moves Ch anteriorly and maxillary downgrafting moves Ch inferiorly.
唇珠（Ch）是上下唇交界的软组织标志。正颌手术可以改变 Ch 的位置，从而影响面部美观。本研究旨在评估上颌骨 Le Fort I 截骨术伴上颌骨内收或向下旋转、下颌骨前徙或后退时 Ch 的运动情况，并探讨手术移动与 Ch 运动之间的关系。45 例患者均接受双侧下颌升支矢状劈开截骨术联合 Le Fort I 截骨术。根据手术移动方向将患者分为 4 组。对术前和术后照片进行校准。采用标准化方法识别和测量术前和术后 Ch 位置。第 1 组（ r =0.988，P =0.001）和第 3 组（ r =0.915，P =0.001）中，上颌骨向下旋转程度与 Ch 向下运动之间存在显著相关性；第 3 组（ r =0.561，P =0.046）和第 4 组（ r =0.661，P =0.005）中，下颌骨前徙程度与 Ch 向前运动之间存在显著相关性。结果表明，在行双侧下颌升支矢状劈开截骨术/Le Fort I 手术的患者中，下颌骨前徙可使 Ch 向前运动，上颌骨向下旋转可使 Ch 向下运动。
