AlOtaibi Noura M, Liu Chieh-Han, Benington Philip C M, Ayoub Ashraf F
Department Oral & Maxillofacial Surgery, Glasgow University Dental Hospital & School/ University of Glasgow, 378 Sauchiehall Street, Glasgow G23JZ, United Kingdom; Department of Oral and Maxillofacial Surgery, King Saud University, Riyadh 12372, Saudi Arabia.
Department Oral & Maxillofacial Surgery, Glasgow University Dental Hospital & School/ University of Glasgow, 378 Sauchiehall Street, Glasgow G23JZ, United Kingdom.
Br J Oral Maxillofac Surg. 2023 Dec;61(10):666-671. doi: 10.1016/j.bjoms.2023.08.213. Epub 2023 Sep 12.
Facial appearance significantly affects psychosocial wellbeing, and an improvement in facial aesthetics is considered an essential outcome of orthognathic treatment. The surgery-first approach (SFA) has emerged as a promising alternative to the conventional orthodontics-first approach (OFA) due to its potential advantages in reducing treatment duration and cost, delivering early aesthetic improvement, and increasing patient satisfaction. However, its impact on final facial aesthetics and how it compares with the OFA has, to our knowledge, not yet been investigated. This retrospective study aimed to compare the improvement in facial aesthetics after orthognathic surgery in an SFA and an OFA group. Preoperative and postoperative 3-dimensional stereophotogrammetry facial images of 40 patients were evaluated by five professional assessors using the Global Aesthetic Improvement Scale (GAIS). Similar aesthetic improvement outcomes were found in both the SFA and OFA groups. The GAIS score significantly correlated with the following facial variables: upper lip projection, chin prominence, facial proportions, paranasal hollowing, lip competence, mandibular projection, and facial profile. No significant correlation was found between a change in aesthetic score and the surgical variables. There was a positive association between overall GAIS score and the gender and experience level of the individual assessors. This study suggests that aesthetic facial improvement achieved with the SFA is satisfactory and comparable to that of the OFA.
面部外观显著影响心理社会幸福感，面部美学的改善被认为是正颌治疗的一项重要成果。手术优先方法（SFA）已成为传统正畸优先方法（OFA）的一种有前景的替代方法，因为它在缩短治疗时间和成本、实现早期美学改善以及提高患者满意度方面具有潜在优势。然而，据我们所知，其对最终面部美学的影响以及与OFA相比情况如何尚未得到研究。这项回顾性研究旨在比较SFA组和OFA组正颌手术后面部美学的改善情况。40例患者术前和术后的三维立体摄影面部图像由五名专业评估者使用全球美学改善量表（GAIS）进行评估。SFA组和OFA组均发现了相似的美学改善结果。GAIS评分与以下面部变量显著相关：上唇突度、颏部突出度、面部比例、鼻旁凹陷、唇部功能、下颌突度和面部轮廓。美学评分变化与手术变量之间未发现显著相关性。总体GAIS评分与个体评估者的性别和经验水平之间存在正相关。这项研究表明，SFA实现的面部美学改善是令人满意的，且与OFA相当。
