Changes of lip morphology following mandibular setback surgery using 3D cone-beam computed tomography images.

BACKGROUND: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. METHODS: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program Ondemand™. Paired and independent t tests were performed for statistical analysis. RESULTS: Landmarks in the mouth corner (cheilion, Ch) moved backward and downward (p < .005, p < .01). However, cheilion width was not statistically significantly changed. Landmark in labrale superius (Ls) was not altered significantly. Upper lip prominence angle (ChRt-Ls-ChLt °) became acute. Landmarks in stomion (Stm), labrale inferius (Li) moved backward (p < .005, p < .001). Lower lip prominence angle (ChRt-Li-ChLt °) became obtuse (p < .001). Height of the upper and lower lips was not altered significantly. Length of the upper lip vermilion was increased (p =< 0.01), and length of the lower lip vermilion was decreased (p < .05). Lip area on frontal view was not statistically significantly changed, but the upper lip area on lateral view was increased and change of the lower lip area decreased (p > .05, p < .005). On lateral view, upper lip prominent point (UP) moved downward and stomion moved backward and upward and the angle of Ls-UP-Stm (°) was decreased. Lower lip prominent point (LP) moved backward and downward, and the angle of Stm-LP-Li (°) was increased. Li moved backward. Finally, landmarks in the lower incisor tip (L1) moved backward and upward, but stomion moved downward. After surgery, lower incisor tip (L1) was positioned more superiorly than stomion (p < .05). There were significant associations between horizontal soft tissue and corresponding hard tissue. The posterior movement of L1 was related to statistically significantly about backward and downward movement of cheilion. CONCLUSIONS: The lip morphology of patients with dento-skeletal class III malocclusion shows a significant improvement after orthognathic surgery. Three-dimensional lip morphology changes in class III patients after MSS exhibited that cheilion moved backward and downward, upper lip projection angle became acute, lower lip projection angle became obtuse, change of upper lip area on lateral view was increased, change of lower lip area decreased, and morphology of lower lip was protruding. L1 was concerned with the lip tissue change in statistically significant way.

Changes of lip morphology following mandibular setback surgery using 3D cone-beam computed tomography images / 대한악안면성형재건외과학회지

BACKGROUND: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. METHODS: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program Ondemand™. Paired and independent t tests were performed for statistical analysis. RESULTS: Landmarks in the mouth corner (cheilion, Ch) moved backward and downward (p .05, p < .005). On lateral view, upper lip prominent point (UP) moved downward and stomion moved backward and upward and the angle of Ls-UP-Stm (°) was decreased. Lower lip prominent point (LP) moved backward and downward, and the angle of Stm-LP-Li (°) was increased. Li moved backward. Finally, landmarks in the lower incisor tip (L1) moved backward and upward, but stomion moved downward. After surgery, lower incisor tip (L1) was positioned more superiorly than stomion (p < .05). There were significant associations between horizontal soft tissue and corresponding hard tissue. The posterior movement of L1 was related to statistically significantly about backward and downward movement of cheilion. CONCLUSIONS: The lip morphology of patients with dento-skeletal class III malocclusion shows a significant improvement after orthognathic surgery. Three-dimensional lip morphology changes in class III patients after MSS exhibited that cheilion moved backward and downward, upper lip projection angle became acute, lower lip projection angle became obtuse, change of upper lip area on lateral view was increased, change of lower lip area decreased, and morphology of lower lip was protruding. L1 was concerned with the lip tissue change in statistically significant way.

Morphometric Analysis of the Facial Artery in Perioral Region / 체질인류학회지

The facial artery is the largest and main arterial supply of the face, and the inferior and superior labial arteries supply blood to the lower and upper lips and intersect on the opposite site. The aim of this study was to provide quantitative data on the course of facial artery and the distribution of inferior and superior labial artery in perioral region. The location, distance, course, and diameter of the facial artery, inferior labial artery, and superior labial artery were measured directly on 50 hemifacial cadavers of Koreans and statistically analyzed using oneway ANOVA. The facial artery was located 18.50 mm lateral to the mouth corners (Cheilions). The inferior labial artery at its origin was located 15.11 mm inferior and 19.63 mm lateral to the Cheilions. The superior labial artery at its origin was located 5.83 mm superior and 11.28 mm lateral to the Cheilions. The diameter of facial artery, inferior labial artery, and superior labial artery was 2.19, 1.56, and 1.48 mm, respectively. The courses of the facial artery and it's branches showed no significant differences on laterality except for the diameter of the superior labial artery (p=0.026). The buccal branch of facial artery was showed in 44% of the cases in the deep layer of perioral region. In conclusion, this study provides that the data will be useful in predicting the courses of the facial artery and helpful for reconstructive surgery in perioral region.

Localization of the Mental and Infraorbital Foramen with related to the Soft-tissue Landmarks

During maxillofacial surgery, the infraorbital and mental nerves are blocked at eac foramen to induce local anesthesia. This study examined the relative locations of the infraorbital foramen (IOF) and mental foramen (MF) based on soft-tissue landmarks. Twenty-eight hemifacial cadavers were dissected to expose the IOF and MF. The distances between the bilateral IOFs, the bilateral MFs, the alae of the nose (alares), and the corners of the mouth (cheilions) were measured directly on cadavers by using a digital vernier caliper. The vertical and horizontal distances of the IOF and MF relative to the alare and cheilion were measured indirectly on digital photographs using Adobe Photoshop (Adobe, CA, USA). The distance between the bilateral IOFs (58.09 +/- 4.04 mm) was longer than the distance between the bilateral MFs (50.32 +/- 1.93 mm). The distances between the bilateral alares and cheilions were 41.22 +/- 3.44 mm and 58.43 +/- 6.62 mm, respectively. The IOF was located 12.92 +/- 3.75 mm superior and 7.88 +/- 2.56 mm lateral to the alare, and the vertical angle (Angle 1) between these structures was 31.67 +/- 13.36degrees superolaterally. The MF was located 21.83 +/- 3.26 mm inferior and 5.56 +/- 3.37 mm medial to the cheilion, and the vertical angle (Angle 2) between these structures was 14.05 +/- 10.12degrees inferomedially. In conclusion, these results provide more detailed information about the locations of the IOF and MF relative to soft-tissue landmarks.