Evaluation of long-term soft tissue changes after bimaxillary orthognathic surgery in Class III patients.

OBJECTIVE: To assess soft tissues in the short and long term after bimaxillary surgery in Class III patients by comparing the hard tissue changes and results between time periods. MATERIALS AND METHODS: Twenty-six Class III adult patients treated with bimaxillary surgery were included in the study. Cephalometric records were taken before surgery (T1) and 5 months (T2), 1.4 years (T3), 3 years (T4), and 5 years (T5) after surgery. RESULTS: There was no significant relapse in skeletal parameters. Overjet was significantly reduced between T4-T3 time intervals (P < .01). There were significant increases in Sn-HR, ULA-HR, LLA-HR, B-B(∧) (P < .01), and B(∧)-HR (P < .05) between T4-T3 time intervals. There was no significant change in the soft tissue parameters between T5-T4 time intervals. CONCLUSION: Soft tissue vertical relapse occurs in skeletally stabile Class III bimaxillary surgery patients in the first 3 years after surgery.

Three-dimensional craniofacial morphology in unilateral cleft lip and palate.

Craniofacial morphology and asymmetry were compared before, during, and after puberty within and between patients with unilateral complete cleft lip and palate (UCCLP) and a non-cleft group. In the UCCLP group, the posterior cranial base and total cranial base were significantly shorter at all skeletal periods, the maxilla was significantly retruded and posteriorly rotated, and the mandible was significantly smaller and inferoposteriorly rotated. The angle between the nasal and mandibular plane and lower anterior facial height were significantly higher, and upper posterior facial height and total posterior height were significantly lower, in the UCCLP group. Except for an increase in the nasal cavity, no significant differences were detected in facial width. For all measurements, asymmetry on the horizontal plane was more significant than that on the vertical plane. Asymmetries in the UCCLP group were mostly detected during puberty. The UCCLP group had no distinctive mandibular asymmetry, as compared with the Class I group. In UCCLP patients, the cranial base, maxilla, and mandible were affected on the sagittal plane during all growth periods. However, horizontal asymmetries were mostly detected before and during puberty. Vertical asymmetries were less severe, and there was no distinctive mandibular asymmetry as compared with the Class I group. (J Oral Sci 56, 165-172, 2014).

Pharyngeal airway space, hyoid bone position, and head posture after bimaxillary orthognathic surgery in Class III patients: long-term evaluation.

OBJECTIVE: (1) To determine the effect of bimaxillary orthognathic surgery on pharyngeal airway, hyoid bone, and craniocervical posture in Class III bimaxillary surgery patients. (2) To evaluate short-term and long-term results. (3) To compare short- and long-term values. MATERIALS AND METHODS: Twenty-six Class III adult patients treated with bimaxillary surgery were included in the study. Cephalometric records were taken before treatment (T1), before surgery (T2), and 5 months (T3), 1.4 years (T4), 3 years (T5), and 5 years (T6) postsurgery. RESULTS: No significant differences were identified in craniocervical angulation between time intervals. There was a significant superior movement of hyoid bone at postsurgery (T3; P < .05); however, adaptation occurred to the normal position in the long term. A nonsignificant decrease occurred at the oropharyngeal middle pharyngeal distance parameter; however, this was compensated with a significant increase between T5 and T6 (P < .001). A significant decrease was observed in the hypopharyngeal Go-P parameter between T3 and T1 (P < .01), but it recovered with a nonsignificant increase in the long term. A significant increase in nasopharyngeal area was observed between T3 and T1 (P < .05). The hypopharyngeal area significantly increased between T5 and T6, and PNS-R significantly increased between T3 and T1 (P < .05). CONCLUSION: The pharyngeal areas adversely affected after surgery recover at long-term follow-up; thus, adaptation occurs after bimaxillary surgery.

Three-dimensional tooth crown size symmetry in cleft lip and cleft palate.

OBJECTIVE: To evaluate and compare three-dimensional tooth size symmetry in the right and left sides of upper and lower dental arches in cleft lip and palate (CLP) patients and to compare it with an Angle Class I normal occlusion control group. MATERIALS AND METHODS: Dental casts of 72 individuals with CLP (20 bilateral [BCLP], 34 unilateral left [ULCLP], and 18 unilateral right [URCLP]) and 53 individuals with Class I occlusion, all with permanent dentition, were randomly selected. Mesiodistal (MD), labiolingual (LL), and occlusogingival (OG) measurements of upper and lower teeth were recorded with a digital caliper. Descriptive statistics and paired t-test were used for statistical analysis. RESULTS: Significant asymmetries were found between the right and left sides of the dental arches in CLP as follows: MD dimension: mandibular first premolar (ULCLP, P < .01); LL dimension: mandibular first premolar (URCLP, P < .05); OG dimension: maxillary central incisor and first premolar (ULCLP, P < .05 and P < .01, respectively), central incisor (BLCLP, P < .01), mandibular canine and first premolar (ULCLP, P < .01), and first molar (ULCLP, P < .05). Tooth crown size asymmetries were also recorded in the Class I group. CONCLUSIONS: Significant three-dimensional tooth size asymmetries were found in CLP subjects; however, such asymmetries were also present on the Class I control group.

Pharyngeal airway space, hyoid bone position and head posture after orthognathic surgery in Class III patients.

OBJECTIVE: To determine the effect of orthognathic surgery on pharyngeal airway in Class III patients and to (1) compare the results of different surgical techniques, (2) determine the change at the position of the hyoid bone, and (3) evaluate the craniocervical posture changes related to pharyngeal airway change. MATERIALS AND METHODS: Forty-eight Class III adult patients were included in the study to assess airway space after orthognathic surgery. Nine patients were treated with maxillary advancement, seven patients were treated with mandibular set back, and 32 patients were treated with bimaxillary surgery. Cephalometric records were taken before treatment, after surgery, and about 1 year after surgery (at the end of the treatment). RESULTS: No differences were determined at the position of hyoid bone and craniocervical posture. Nasopharyngeal area was significantly increased in all groups (P < .05). Oropharyngeal area and SPSS and IPS parameters were significantly decreased after mandibular set back operation (P < .05). In bimaxillary and maxillary advancement groups, PPS parameter was significantly increased (P < .01), and IPS parameter was significantly decreased (P < .05). No differences were detected at oropharyngeal and hypopharyngeal areas in bimaxillary and maxillary advancement groups. CONCLUSION: Different surgical procedures have different effects on pharyngeal airway space.