Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, SP ZIP 14049-900, Brazil; Craniofacial Research Support Center, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, SP ZIP 14049-900, Brazil.
Arch Oral Biol. 2025 Jan;169:106103. doi: 10.1016/j.archoralbio.2024.106103. Epub 2024 Oct 9.
Dentofacial deformities (DFD) require orthodontic treatment, orthognathic surgery, and speech therapy for aesthetic and functional problems. This longitudinal study analyzed changes in masticatory function and three-dimensional (3D) facial soft tissue in patients with Class II and Class III DFD after orthognathic surgery. In addition, the study investigated the relationship between facial measurements, maximum bite force (MBF), and orofacial myofunctional status (OMS).
The sample consisted of 46 participants, including 10 patients with Class II DFD, and 11 patients with Class III DFD. These groups were assessed before (T0) and 6 months (T1) after surgery. Twelve patients who completed the treatment protocol were evaluated 12 months post-surgery (T2). The patient groups were compared with each other and with a control group (CG) of 25 healthy subjects. The participants underwent MBF and clinical evaluation of OMS, including masticatory behavior, using a validated protocol. The 3D facial soft tissue was assessed using laser scanning.
Compared to the CG, DFD patients showed reduced MBF, masticatory behavior, and OMS scores at T0. At T2, there was an improvement in MBF, masticatory, and OMS scores, but differences were observed compared to the CG. Changes in facial soft tissue followed the underlying hard tissue movement resulting from surgery, and reduction of vertical measurements contributed to improvements in masticatory function.
These findings indicated that combined surgery, orthodontic treatment, and speech therapy can lead to a significant improvement in masticatory function and facial soft tissue in DFD patients, although not completely 12 months post-surgery.
牙颌面畸形（DFD）需要正畸治疗、正颌手术和言语治疗，以解决美观和功能问题。本纵向研究分析了正颌手术后 II 类和 III 类 DFD 患者咀嚼功能和三维（3D）面部软组织的变化。此外，该研究还调查了面部测量、最大咬合力（MBF）和口面肌功能状态（OMS）之间的关系。
样本包括 46 名参与者，其中 10 名 II 类 DFD 患者和 11 名 III 类 DFD 患者。这些组在手术前（T0）和术后 6 个月（T1）进行评估。12 名完成治疗方案的患者在术后 12 个月（T2）进行评估。将患者组与对照组（CG）的 25 名健康受试者进行比较。参与者接受了 MBF 和 OMS 的临床评估，包括使用经过验证的方案评估咀嚼行为。使用激光扫描评估 3D 面部软组织。
与 CG 相比，DFD 患者在 T0 时表现出较低的 MBF、咀嚼行为和 OMS 评分。在 T2 时，MBF、咀嚼和 OMS 评分有所改善，但与 CG 相比仍存在差异。面部软组织的变化遵循手术引起的基础硬组织运动，垂直测量值的减少有助于咀嚼功能的改善。
这些发现表明，联合手术、正畸治疗和言语治疗可以显著改善 DFD 患者的咀嚼功能和面部软组织，但在术后 12 个月内并非完全恢复。
