de Lima Flávio Fidêncio, De Carvalho Tayná Mendes Inácio, Pulino Bianca, Cerantula Camila, Correa Mônica Grazieli, Guerra Raphael Capelli
Department of Oral and Maxillofacial Surgery, Encore Clinic, São Paulo 04545-041, Brazil.
Dental research Division, School of Dentistry, Universidade Paulista-UNIP, São Paulo 04026-002, Brazil.
Craniomaxillofac Trauma Reconstr. 2025 Sep 4;18(3):39. doi: 10.3390/cmtr18030039. eCollection 2025 Sep.
Maxillary setback in orthognathic surgery has been extensively discussed regarding its effects on bone healing and facial soft tissue profile; however, its impact on upper airway volume remains unclear.
We evaluate the influence of maxillary setback combined with counterclockwise (CCW) rotation of the occlusal plane on upper airway dimensions.
A retrospective observational case series was conducted with eight patients diagnosed with Class II malocclusion who underwent orthognathic surgery involving maxillary setback and CCW mandibular rotation. All procedures were performed by the same surgeon. Preoperative (T1) and 6-month postoperative (T2) facial CT scans were analyzed using Dolphin Imaging software11.7 to measure airway volume (VOL), surface area (SA), and linear distances D1, D2 and D3. Statistical analysis was performed using the Wilcoxon test with a 5% significance level.
Significant skeletal changes were observed, including 10.2 mm of mandibular advancement, 5.2 mm of hyoid advancement, and 4.1° of CCW rotation. Although increases in airway volume and surface area were noted, they did not reach statistical significance ( = 0.327 and = 0.050, respectively), but suggesting a favorable trend toward airway adaptation.
Maxillary setback combined with CCW rotation appears to safely correct Class II skeletal deformities without compromising upper airway space. These preliminary findings highlight the technique's potential for both functional and aesthetic outcomes, warranting further long-term studies.
正颌手术中的上颌后缩对骨愈合和面部软组织轮廓的影响已得到广泛讨论；然而，其对上气道容积的影响仍不明确。
我们评估上颌后缩联合咬合平面逆时针（CCW）旋转对上气道尺寸的影响。
对8例诊断为安氏II类错牙合畸形并接受上颌后缩和下颌逆时针旋转正颌手术的患者进行回顾性观察病例系列研究。所有手术均由同一位外科医生进行。使用Dolphin Imaging软件11.7分析术前（T1）和术后6个月（T2）的面部CT扫描，以测量气道容积（VOL）、表面积（SA）以及线性距离D1、D2和D3。采用Wilcoxon检验进行统计学分析，显著性水平为5%。
观察到明显的骨骼变化，包括下颌前移10.2mm、舌骨前移5.2mm和逆时针旋转4.1°。尽管气道容积和表面积有所增加，但未达到统计学显著性（分别为 = 0.327和 = 0.050），不过提示了气道适应的有利趋势。
上颌后缩联合逆时针旋转似乎能安全地矫正安氏II类骨骼畸形，且不影响上气道空间。这些初步研究结果凸显了该技术在功能和美学效果方面的潜力，值得进一步进行长期研究。
