Haas O L, Pessoa Neto J V, Sousa Gil A P, Mello da Rosa B, Bastos R M, Giralt-Hernando M, Valls-Ontañón A, Hernández-Alfaro F, de Oliveira R B
Private Practice / Belle & Haas Center of OrthoFacial Surgery, Oral and Maxillofacial Surgery, Hospital São Lucas, Porto Alegre, Brazil.
Department of Oral and Maxillofacial Surgery, General Hospital of Fortaleza, Brazil.
J Stomatol Oral Maxillofac Surg. 2025 Jun;126(3):102103. doi: 10.1016/j.jormas.2024.102103. Epub 2024 Oct 5.
The aim of this study was to conduct a three-dimensional analysis of the effects on mentolabial soft tissues of three different orthognathic surgery protocols: bimaxillary surgery without genioplasty, bimaxillary surgery with conventional or minimally invasive genioplasty (MIS).
Pre-operative and post-operative CBCT were superimposed to quantify and ascertain the direction of mandibular movements, and soft tissue were analyzed to evaluate the hard to soft tissue ratio. Data from 97 consecutive patients were evaluated: 30 conventional genioplasty, 36 MIS and 31 no genioplasty.
The impact of the surgical movements on the overlying soft tissues can be consider with stronger correlation in the group No Genioplasty in the whole mentolabial region, stronger correlation in labial and pogonion region in the MIS group and no stronger correlation in the conventional group.
Sutures in the mentolabial region directly interfere with the postoperative impact of orthognathic surgery on soft tissues in mentolabial area, in both the vertical and horizontal directions. A smaller incision - consequently involving less detachment of soft tissues in the region - may promote a lower risk of chin ptosis, in addition to greater suspension of the musculature.
本研究的目的是对三种不同正颌外科手术方案对颏唇软组织的影响进行三维分析：不进行颏成形术的双颌手术、采用传统或微创颏成形术（MIS）的双颌手术。
将术前和术后的锥形束计算机断层扫描（CBCT）进行叠加，以量化和确定下颌运动的方向，并对软组织进行分析，以评估硬组织与软组织的比例。对97例连续患者的数据进行了评估：30例行传统颏成形术，36例行微创颏成形术，31例未行颏成形术。
在整个颏唇区域，无颏成形术组手术移动对上覆软组织的影响具有更强的相关性；在微创颏成形术组的唇部和颏部区域相关性更强；在传统组则无更强的相关性。
颏唇区域的缝合直接干扰正颌手术对颏唇区域软组织的术后影响，在垂直和水平方向均如此。较小的切口——因此该区域软组织分离较少——除了能更好地悬吊肌肉组织外，还可能降低颏部下垂的风险。
