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CC BY 4.0 · Int Arch Otorhinolaryngol 2024; 28(01): e148-e156
DOI: 10.1055/s-0043-1773759
Original Research

Effects of Maxillary Movements on Lips Following Orthognathic Surgery: A Retrospective Non-Randomized Clinical Trial

Soodeh Tahmasbi 
1   Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Kasra Rahimipour 
2   Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
,
Mahshid Namdari 
3   Department of Community Oral Health, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
,
Reza Tabrizi 
4   Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Fatemesadat Seyedzadeghomi 
3   Department of Community Oral Health, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
› Institutsangaben
Funding The present research received no specific grants from any funding agency in the public, commercial, or not-for-profit sectors.
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Abstract

Introduction Lips play a fundamental role in facial attractiveness and in decisions pertaining to orthognathic surgery.

Objective To assess the upper lip changes following Le Fort I osteotomy for maxillary advancement and/or impaction.

Methods In the present retrospective non-randomized clinical trial, we evaluated 3 groups of patients who underwent Le Fort I osteotomy of the maxilla. Group 1 (n = 35) underwent maxillary advancement, group 2 (n = 14), maxillary impaction, and group 3 (n = 11) was submitted to both maxillary advancement and impaction. The lip thickness of all patients was measured preoperatively, and the participants in each group were categorized into two subgroups: thin (< 12 mm) and thick (> 12 mm) lip. The primary (before orthognathic surgery) and final (after orthodontic bracket removal) lateral cephalograms of the patients were analyzed using the Dolphin software. Comparisons were made using the paired t-test and linear regression in the IBM SPSS Statistics for Windows software.

Results The length of the upper lip increased by 1 mm (p = 0.012) on average following maxillary advancement, and it decreased by 0.43 mm (p = 0.24) on average following maxillary impaction. In the maxillary advancement group, the change in angulation of the incisors predicted the incisal display (p = 0.03). In the maxillary impaction group, skeletal changes in the vertical dimension predicted changes in upper lip length (p = 0.033).

Conclusions Le Fort I osteotomy for maxillary advancement significantly increases the length of the upper lip. The assessment of lip thickness prior to surgery can help predict the postoperative results. Changing the angulation of the incisors can predict the incisal display. In maxillary impaction, skeletal changes in the vertical dimension can predict the changes in the length of the upper lip.

Keywords

Le Fort I osteotomy - maxillary advancement - maxillary impaction - upper lip

Ethical Approval

The study was conducted in accordance with the World Medical Association Declaration of Helsinki (of 1975 as revised in 2000) and was approved by the ethics committee of Shahid Beheshti University of Medical Sciences, Tehran, Iran. (Institutional Review Board: IR.SBMU.RIDS.REC.1396.575).




Publikationsverlauf

Eingereicht: 26. Mai 2021

Angenommen: 18. September 2022

Artikel online veröffentlicht:
05. Februar 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Khosravanifard B, Rakhshan V, Raeesi E. Factors influencing attractiveness of soft tissue profile. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115 (01) 29-37
    CrossrefPubMedSuche in Google Scholar
  • 2 Oh K-M, Seo S-K, Park J-E. et al. Post-operative soft tissue changes in patients with mandibular prognathism after bimaxillary surgery. J Craniomaxillofac Surg 2013; 41 (03) 204-211
    CrossrefPubMedSuche in Google Scholar
  • 3 DeSesa CR, Metzler P, Sawh-Martinez R, Steinbacher DM. Three-dimensional Nasolabial Morphologic Alterations Following Le Fort I. Plast Reconstr Surg Glob Open 2016; 4 (08) e848
    CrossrefPubMedSuche in Google Scholar
  • 4 Metzler P, Geiger EJ, Chang CC, Sirisoontorn I, Steinbacher DM. Assessment of three-dimensional nasolabial response to Le Fort I advancement. J Plast Reconstr Aesthet Surg 2014; 67 (06) 756-763
    CrossrefPubMedSuche in Google Scholar
  • 5 Tahmasbi S, Meshkini M, Rahimipour K, Namdari M, Mousavi R. Changes in scleral exposure following Le Fort I maxillary advancement or impaction. Oral Maxillofac Surg Cases 2019; 5 (04) 100108
    CrossrefSuche in Google Scholar
  • 6 Suh H-Y, Lee H-J, Lee Y-S, Eo S-H, Donatelli RE, Lee S-J. Predicting soft tissue changes after orthognathic surgery: The sparse partial least squares method . Angle Orthod 2019; 89 (06) 910-916
    CrossrefPubMedSuche in Google Scholar
  • 7 Eslami S, Faber J, Fateh A, Sheikholaemmeh F, Grassia V, Jamilian A. Treatment decision in adult patients with class III malocclusion: surgery versus orthodontics. Prog Orthod 2018; 19 (01) 28
    CrossrefPubMedSuche in Google Scholar
  • 8 Ribeiro HT, Faria AC, Terreri AL, de Mello-Filho FV. A cephalometric analysis for evaluation of changes in soft tissues in the regions of the upper and lower lips and chin due to orthognathic maxillary advancement surgery. Int Arch Otorhinolaryngol 2014; 18 (01) 57-62
    Thieme ConnectPubMedSuche in Google Scholar
  • 9 Betts NJ, Vig KW, Vig P, Spalding P, Fonseca RJ. Changes in the nasal and labial soft tissues after surgical repositioning of the maxilla. Int J Adult Orthodon Orthognath Surg 1993; 8 (01) 7-23
    PubMedSuche in Google Scholar
  • 10 Üstün GG, Konaş E, El H. et al. The Effects of Maxillary Movements on Nasal Aesthetics Following Orthognathic Surgery. J Craniofac Surg 2020; 31 (03) 796-800
    CrossrefPubMedSuche in Google Scholar
  • 11 van Loon B, van Heerbeek N, Bierenbroodspot F. et al. Three-dimensional changes in nose and upper lip volume after orthognathic surgery. Int J Oral Maxillofac Implants 2015; 44 (01) 83-89
    CrossrefPubMedSuche in Google Scholar
  • 12 Khamashta-Ledezma L, Naini FB. Systematic review of changes in maxillary incisor exposure and upper lip position with Le Fort I type osteotomies with or without cinch sutures and/or VY closures. Int J Oral Maxillofac Implants 2014; 43 (01) 46-61
    CrossrefPubMedSuche in Google Scholar
  • 13 Jung J, Lee C-H, Lee J-W, Choi B-J. Three dimensional evaluation of soft tissue after orthognathic surgery. Head Face Med 2018; 14 (01) 1-8
    CrossrefPubMedSuche in Google Scholar
  • 14 Altug-Atac AT, Bolatoglu H, Memikoglu UT. Facial soft tissue profile following bimaxillary orthognathic surgery. Angle Orthod 2008; 78 (01) 50-57
    CrossrefPubMedSuche in Google Scholar
  • 15 Hulley SB. Designing clinical research: Lippincott Williams & Wilkins; 2007
    PubMed
  • 16 Proffit WR, Fields H, Sarver D. Contemporary orthodontics. Mosby. Elsevier, St Louis 2007;160:207–217.
  • 17 Stella JP, Streater MR, Epker BN, Sinn DP. Predictability of upper lip soft tissue changes with maxillary advancement. J Oral Maxillofac Surg 1989; 47 (07) 697-703
    CrossrefPubMedSuche in Google Scholar
  • 18 Bailey LJ, Collie FM, White Jr RP. Long-term soft tissue changes after orthognathic surgery. Int J Adult Orthodon Orthognath Surg 1996; 11 (01) 7-18
    PubMedSuche in Google Scholar
  • 19 Pittayapat P, Limchaichana-Bolstad N, Willems G, Jacobs R. Three-dimensional cephalometric analysis in orthodontics: a systematic review. Orthod Craniofac Res 2014; 17 (02) 69-91
    CrossrefPubMedSuche in Google Scholar
  • 20 Olszewski R, Reychler H, Cosnard G, Denis JM, Vynckier S, Zech F. Accuracy of three-dimensional (3D) craniofacial cephalometric landmarks on a low-dose 3D computed tomograph. Dentomaxillofac Radiol 2008; 37 (05) 261-267
    CrossrefPubMedSuche in Google Scholar
  • 21 Aydil B, Özer N, Marşan G. Facial soft tissue changes after maxillary impaction and mandibular advancement in high angle class II cases. Int J Med Sci 2012; 9 (04) 316-321
    CrossrefPubMedSuche in Google Scholar
  • 22 Jensen AC, Sinclair PM, Wolford LM. Soft tissue changes associated with double jaw surgery. Am J Orthod Dentofacial Orthop 1992; 101 (03) 266-275
    CrossrefPubMedSuche in Google Scholar
  • 23 Rupperti S, Winterhalder P, Rudzki I, Mast G, Holberg C. Changes in the facial soft-tissue profile after mandibular orthognathic surgery. Clin Oral Investig 2019; 23 (04) 1771-1776
    CrossrefPubMedSuche in Google Scholar
  • 24 Alkadhi RM, Finkelman MD, Trotman CA, Kanavakis G. The role of lip thickness in upper lip response to sagittal change of incisor position. Orthod Craniofac Res 2019; 22 (01) 53-57
    CrossrefPubMedSuche in Google Scholar
  • 25 Bays RA, Timmis D, Hegtvedt A. Maxillary orthognathic surgery. Principles of oral and maxillofacial surgery. 3: Lippincott Philadelphia; 1992:1374–1375.
  • 26 Möhlhenrich SC, Kötter F, Peters F. et al. Effects of different surgical techniques and displacement distances on the soft tissue profile via orthodontic-orthognathic treatment of class II and class III malocclusions. Head Face Med 2021; 17 (01) 13
    CrossrefPubMedSuche in Google Scholar
  • 27 Chalipa J, Roochi MM, Mortazavi M. et al. Cephalometric Evaluation of Facial Soft Tissue Changes after Orthodontics and Bimaxillary Orthognathic Surgery Treatment in Patients with Skeletal Class III Discrepancy. Iran J Orthod 2018; 13 (01) e8345
    Suche in Google Scholar
  • 28 Shmuly T, Chaushu G, Allon DM. Does Maxillary Advancement Influence the Nasolabial Angle?. J Craniofac Surg 2019; 30 (05) e408-e411
    CrossrefPubMedSuche in Google Scholar
  • 29 Khamashta-Ledezma L, Naini FB. Prospective assessment of maxillary advancement effects: maxillary incisor exposure, and upper lip and nasal changes. Am J Orthod Dentofacial Orthop 2015; 147 (04) 454-464
    CrossrefPubMedSuche in Google Scholar