Private Practitioner in OMS and Oral Medicine, Kirkland, WA; Faculty, University of Washington, Seattle, WA; Orthognathic Surgery Fellow, Institute of Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain; PhD Candidate, Department of Oral and Maxillofacial Surgery, Universitat International de Catalunya, Barcelona, Spain.
Private Practitioner, Institute of Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain; Faculty Member of the Department of Oral and Maxillofacial Surgery, Universitat International de Catalunya, Barcelona, Spain.
J Oral Maxillofac Surg. 2024 Nov;82(11):1386-1401. doi: 10.1016/j.joms.2024.07.010. Epub 2024 Jul 20.
Retrusive profiles show an appearance of aging with an under-projected vermilion and pronounced nasolabial folds due to deficient bone support.
A study was made of the association between orthognathic surgery and changes in the nasolabial and vermilion areas in patients with retrusive profiles.
STUDY DESIGN, SETTING, SAMPLE: A retrospective cohort study evaluated patients subjected to bimaxillary surgery according to the Barcelona Line (BL) protocol during 2021 at Teknon Medical Center (Barcelona, Spain). Subjects with craniofacial syndromes, facial esthetic procedures, and dental rehabilitations involving lip changes, were excluded.
The predictor variable was the timing of cephalometric measures, reported as T0 (preoperatively), T1 (1 month after surgery), and T2 (after 1 year of follow-up).
The outcome variable corresponded to the soft tissue changes of the nasolabial and vermilion area, reported as the nasolabial fold length and angle, nasolabial angle, upper lip concavity, vermilion length, and upper lip sagittal distance from BL.
The covariates comprised patient demographic data, the surgical-orthodontic protocol, and the magnitude and direction of the skeletal movements.
Descriptive and inferential analyses were performed based on analysis of variance, the Bonferroni test, Pearson's linear coefficient, the nonparametric Mann-Whitney U-test, Kruskal-Wallis test, and multiple linear regression models. Statistical significance was considered for P < .05.
The sample comprised 27 subjects with a mean age of 32.5 ± 11.2 years. A mean decrease in nasolabial angle of 5.5 ± 6° was recorded (P < .001), with a shortening of the nasolabial fold length of 4.4 ± 7.6 mm (P = .019). An increase in upper lip concavity angle of 14.4 ± 12° was recorded (P < .001), along with a vermilion lengthening of 1.6 ± 1.3 mm (P < .001) and an increase in upper lip sagittal distance to BL of 5.7 ± 7.3 mm (P = .001), indicating a more projected and everted upper vermilion.
When adequate dentoskeletal support is provided by specific positional changes of the jaws planned through orthognathic surgery, the length of the nasolabial fold decreases, and the upper vermilion lengthens and becomes slightly everted.
退缩型面型的患者由于骨支持不足，表现出衰老的外观，红唇显露不足，鼻唇沟明显。
研究正颌手术对退缩型面型患者鼻唇区和红唇区的影响。
研究设计、地点和样本：回顾性队列研究评估了 2021 年在西班牙巴塞罗那 Teknon 医疗中心按照巴塞罗那线（BL）方案接受双颌手术的患者。排除颅面综合征、面部美容手术以及涉及唇部变化的牙列修复的患者。
预测变量是头影测量的时间，报告为 T0（术前）、T1（术后 1 个月）和 T2（随访 1 年后）。
结局变量是鼻唇区和红唇区软组织的变化，表现为鼻唇沟长度和角度、鼻唇角、上唇凹陷、红唇长度和上唇从 BL 的矢状距离。
协变量包括患者的人口统计学数据、手术-正畸方案以及骨骼运动的幅度和方向。
基于方差分析、Bonferroni 检验、Pearson 线性系数、非参数 Mann-Whitney U 检验、Kruskal-Wallis 检验和多元线性回归模型进行描述性和推断性分析。P<.05 为统计学显著。
样本包括 27 名平均年龄为 32.5±11.2 岁的患者。记录到鼻唇角平均减少 5.5±6°（P<.001），鼻唇沟长度平均缩短 4.4±7.6mm（P=.019）。上唇凹陷角度平均增加 14.4±12°（P<.001），同时红唇长度增加 1.6±1.3mm（P<.001），上唇从 BL 的矢状距离增加 5.7±7.3mm（P=.001），表明上唇更突出和外翻。
通过正颌手术计划的特定颌骨位置变化提供足够的牙颌骨支持时，鼻唇沟长度减小，上唇长度增加且略微外翻。
