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Zhang C, Lu T, Wang L, Wen J, Huang Z, Lin S, Zhou Y, Li G, Li H. Three-dimensional analysis of hard and soft tissue changes in skeletal class II patients with high mandibular plane angle undergoing surgery. Sci Rep 2024; 14:2519. [PMID: 38291067 PMCID: PMC10827781 DOI: 10.1038/s41598-024-51322-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
This study aimed to study 3-dimensional (3D) changes of hard and soft tissues of skeletal class II patients after 2-jaw surgery and genioplasty. 32 adult patients diagnosed with mandibular hypoplasia who underwent 2-jaw surgery of maxillary impaction, mandibular advancement and genioplasty were enrolled. Cone-beam computed tomography and 3D stereophotogrammetry was conducted 1 week before and 6 months after surgery. Dolphin imaging software was used to establish a 3D digitizing model and 3D measurement system. Paired t-test was performed to compare the values before and after surgery. Pearson's correlation test assessed the degree of correlations between hard and soft tissue change. The mean impaction of the maxilla was 2.600 ± 3.088 mm at A. The mean advancement of the mandible was 7.806 ± 2.647 mm at B. There was a significant upward and forward movement for most landmarks of the nose and lip, while a significant decrease in nasal tip height (lateral view), upper lip height, and upper and lower vermilion height. The nose's width was significantly increased. For maxillary, Sn, Ac-r, Ac-l, and Ls demonstrated a significant correlation with A and U1 in the anteroposterior axis. However, there were no significant correlations among them in the vertical axis. For mandibular, Li demonstrated a significant correlation with L1 in the anteroposterior axis specifically for the mandible. Notably, correlations between the landmarks of the chin's hard and soft tissues were observed across all axes. The utilization of 3-D analysis facilitated a quantitative comprehension of both hard and soft tissues, thereby furnishing valuable insights for the strategic formulation of orthognathic treatment plans targeting patients with skeletal class II conditions.
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Affiliation(s)
- Caixia Zhang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Tong Lu
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Lichan Wang
- Nanjing Lishui Stomatological Hospital, Nanjing, China
| | - Juan Wen
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Ziwei Huang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Shuang Lin
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yiwen Zhou
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Guifeng Li
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
| | - Huang Li
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
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Comparison Study of Extraction Accuracy of 3D Facial Anatomical Landmarks Based on Non-Rigid Registration of Face Template. Diagnostics (Basel) 2023; 13:diagnostics13061086. [PMID: 36980394 PMCID: PMC10047049 DOI: 10.3390/diagnostics13061086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/15/2023] Open
Abstract
(1) Background: Three-dimensional (3D) facial anatomical landmarks are the premise and foundation of facial morphology analysis. At present, there is no ideal automatic determination method for 3D facial anatomical landmarks. This research aims to realize the automatic determination of 3D facial anatomical landmarks based on the non-rigid registration algorithm developed by our research team and to evaluate its landmark localization accuracy. (2) Methods: A 3D facial scanner, Face Scan, was used to collect 3D facial data of 20 adult males without significant facial deformities. Using the radial basis function optimized non-rigid registration algorithm, TH-OCR, developed by our research team (experimental group: TH group) and the non-rigid registration algorithm, MeshMonk (control group: MM group), a 3D face template constructed in our previous research was deformed and registered to each participant’s data. The automatic determination of 3D facial anatomical landmarks was realized according to the index of 32 facial anatomical landmarks determined on the 3D face template. Considering these 32 facial anatomical landmarks manually selected by experts on the 3D facial data as the gold standard, the distance between the automatically determined and the corresponding manually selected facial anatomical landmarks was calculated as the “landmark localization error” to evaluate the effect and feasibility of the automatic determination method (template method). (3) Results: The mean landmark localization error of all facial anatomical landmarks in the TH and MM groups was 2.34 ± 1.76 mm and 2.16 ± 1.97 mm, respectively. The automatic determination of the anatomical landmarks in the middle face was better than that in the upper and lower face in both groups. Further, the automatic determination of anatomical landmarks in the center of the face was better than in the marginal part. (4) Conclusions: In this study, the automatic determination of 3D facial anatomical landmarks was realized based on non-rigid registration algorithms. There is no significant difference in the automatic landmark localization accuracy between the TH-OCR algorithm and the MeshMonk algorithm, and both can meet the needs of oral clinical applications to a certain extent.
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Tipyanggul W, Changsiripun C, Chamnannidiadha N. Age-related perceptions of laypeople on Class II facial profile alterations. APOS TRENDS IN ORTHODONTICS 2023. [DOI: 10.25259/apos_101_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objectives:
The treatment plan for young patients with skeletal abnormalities is often selected by their parents. However, the treatment outcome should correspond with the patient’s preference to reduce the treatment need in the future. This study aimed to investigate the influence of post-treatment facial profiles in a skeletal Class II female subject on esthetic perceptions by laypeople of different age groups.
Material and Methods:
Seven digitally adjusted profile images of predetermined nasolabial angle (NLA) and facial contour angle (FCA) were obtained from a female with skeletal Class II. These profile images were evaluated by 180 laypeople and were stratified according to three age groups (12–15, 22–32, and 44–54 years) using a visual analog scale and ranking order.
Results:
The slightly convex profile with normal NLA (11° FCA and 91° NLA) was the most preferred by all age groups. The convex profile with the largest NLA (17° FCA and 115° NLA) was the least preferred by age group 12–15 and 44–54 years and the convex profile with normal NLA (17° FCA and 91° NLA) was the least preferred by age group 22–32 years. Sex was found to be significantly related to the rating score with females rated higher scores.
Conclusion:
The most attractive profile for all three age groups was a mandibular advancement-simulating profile. The least attractive profile for age groups 12–15 and 44–54 years was a most camouflage-simulating profile, while the least attractive profile for age group 22–32 years was an untreated most pronounced Class II profile.
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Affiliation(s)
- Wiwan Tipyanggul
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,
| | - Chidsanu Changsiripun
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,
| | - Niramol Chamnannidiadha
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,
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The Accuracy of Computer-Assisted Surgical Planning in Predicting Soft Tissue Responses After Le Fort I Osteotomy: Retrospective Analysis. J Craniofac Surg 2023; 34:131-138. [PMID: 36104836 DOI: 10.1097/scs.0000000000008970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 07/25/2022] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Mismatch between preoperative planning and surgical outcome in maxillofacial surgery relate to on-table replication of presurgical planning and predictive algorithm inaccuracy: software error was hereby decoupled from planning inaccuracy to assess a commercial software. The hypothesis was that soft tissue prediction error would be minimized if the surgical procedure was replicated precisely as planned and is independent of the extent of bone repositioning. MATERIALS AND METHODS Cone-beam computed tomography scans of 16 Le Fort I osteotomy patients were collected at Boston Children's Hospital. Preoperative and postoperative models of bone and soft tissue were constructed and the maxilla repositioning was replicated. Each model was subdivided into 6 regions: mouth, nose, eyes, and cheeks. Soft tissue prediction (performed using Proplan CMF-Materialise) for each patient was compared with the relative postoperative reconstruction and error was determined. P <0.05 was considered significant. RESULTS Le Fort I segment repositioning was replicated within 0.70±0.18 mm. The highest prediction error was found in the mouth (1.49±0.77 mm) followed by the cheeks (0.98±0.34 mm), nose (0.86±0.23 mm), and eyes (0.76±0.32). Prediction error on cheeks correlated significantly with mouth ( r =0.63, P < 0.01) and nose ( r =0.67, P < 0.01). Mouth prediction error correlated with total advancement ( r =0.52, P =0.04). CONCLUSIONS ProPlan CMF is a useful outcome prediction tool; however, accuracy decreases with the extent of maxillary advancement even when errors in surgical replication are minimized.
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Comparison of soft tissue simulations between two planning software programs for orthognathic surgery. Sci Rep 2022; 12:5013. [PMID: 35322115 PMCID: PMC8943157 DOI: 10.1038/s41598-022-08991-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/04/2022] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to compare the soft tissue predicative abilities of two established programs depending on the surgical technique and amount of displacement. On the basis of 50 computed tomography images, 11 orthognathic operations with differences in displacement distances and technique (maxillary advancement, MxA; maxillary impaction, MxI; mandibular setback, MnS; mandibular advancement, MnA bimaxillary displacement, MxA/MnS) as well as corresponding soft tissue predictions were simulated using the programs Dolphin (D) and ProPlan (PP). For all the soft tissue predictions by the two programs, eight linear and two angular measurements were performed and compared. The simulation of maxillary impaction showed a similar soft tissue behaviour between the two programs. However, differences or divergent behaviours were observed for other procedures. In the middle third of the face these significant differences concerned in particular the nasolabial angle (Ns-Sn-Ls)(5 mm-MA, D: 119.9 ± 8.6° vs. PP: 129.5 ± 8.4°; 7 mm-MnS: D: 128.5 ± 8.2° vs. PP: 129.6 ± 8.1°; 10 mm-MnA D: 126.0 ± 8.0° vs. PP: 124.9 ± 8.4°; 5 mm-MxA/4 mm-MnS, D: 120.2 ± 8.7° vs. PP: 129.9 ± 8.3°; all p < 0.001) and in the lower third the mentolabial angle (Pog´-B´-Li) (5 mm-MA, D: 133.2 ± 11.4° vs. PP: 126.8 ± 11.6°; 7 mm-MnS: D: 133.1 ± 11.3° vs. PP: 124.6 ± 11.9°; 10 mm-MnA D: 133.3 ± 11.5° vs. PP: 146.3 ± 11.1°; bignathic 5 mm-MxA/4 mm-MnS, D: 133.1 ± 11.4° vs. PP: 122.7 ± 11.9°; all p < 0.001) and the distance of the inferior lip to the aesthetic Line (E-Line-Li) (5 mm-MA, D: 3.7 ± 2.3 mm vs. PP: 2.8 ± 2.5 mm; 7 mm-MnS: D: 5.1 ± 3.0 mm vs. PP: 3.3 ± 2.3 mm; 10 mm-MnA D: 2.5 ± 1.6 mm vs. PP: 3.9 ± 2.8 mm; bignathic 5 mm-MxA/4 mm-MnS, D: 4.8 ± 3.0 mm vs. PP: 2.9 ± 2.0 mm; all p < 0.001). The soft tissue predictions by the tested programs differed in simulation outcome, which led to the different, even divergent, results. However, the significant differences are often below a clinically relevant level. Consequently, soft tissue prediction must be viewed critically, and its actual benefit must be clarified.
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Mandrekar PN, Dhupar V, Akkara F. Prediction of Soft-Tissue Changes Following Single and Bi-Jaw Surgery: An Evaluative Study. Ann Maxillofac Surg 2021; 11:32-36. [PMID: 34522651 PMCID: PMC8407611 DOI: 10.4103/ams.ams_138_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 02/24/2021] [Accepted: 03/16/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction: Orthognathic surgery is carried out in the hard tissues; however, the patient perceives change in the soft tissue. It is important to accurately predict postoperative facial changes associated with each surgical procedure. This study aims to evaluate the changes in the soft tissues resulting from the movement of the hard tissue following single and bi-jaw surgeries. Materials and Methods: An evaluative clinical study was carried out on a total of 34 subjects which consisted of 52 jaw surgeries. Maxilla and mandible were considered as a separate entity even in bi-jaw cases for evaluation. Surgical procedures performed were either bilateral sagittal split osteotomy, Le Fort I osteotomy or both. Pre- and post-surgical lateral cephalograms were compared to assess the soft-tissue change at various soft-tissue points and were labeled T1 and T2, respectively. The points on maxilla were Point A and PrS on upper lip. The points on mandible were PrI and Point B on lower lip and Pog and Gn on chin. Results: All the points on the maxilla and mandible had a strong correlation between the hard and soft-tissue points except point PrS on upper lip. Discussion: Facial appearance is an important parameter in the present times which influences the social and psychological development of an individual. What patient sees is the external soft-tissue drape whereas orthognathic surgery is carried out on bony components of the face. Thus prediction of soft-tissue changes following surgery is an important part of treatment planning.
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Affiliation(s)
- Pooja Narendra Mandrekar
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Vikas Dhupar
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Francis Akkara
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
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Choi SH, Lee H, Hwang JJ, Jung HD, Hwang CJ, Cha JY. Differences in soft-tissue thickness changes after bimaxillary surgery between patients with vertically high angle and normal angle. Am J Orthod Dentofacial Orthop 2020; 159:30-40. [PMID: 33127204 DOI: 10.1016/j.ajodo.2019.10.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 01/14/2023]
Abstract
INTRODUCTION We evaluated soft-tissue thickness changes after bimaxillary surgery according to vertical facial patterns in patients with skeletal Class III malocclusion with mandibular prognathism. METHODS Forty-three Korean patients (16 men and 27 women; mean age, 22.6 ± 4.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into 2 groups: normal-angle group (N group) and high-angle group (H group), on the basis of the presurgical angle of the mandibular plane relative to the sella-nasion plane (SN-MP). Changes in hard-tissue landmarks and soft-tissue thickness before and after surgery were analyzed from reconstructed 3-dimensional cone-beam computed tomography images. Postoperative soft-tissue thickness in both groups was compared with that in 40 patients with normal skeletal Class I malocclusion in the reference group. RESULTS Group N (27°-37°) and group H (>37°) did not differ significantly in terms of sex and age before surgery. Preoperative pogonion (Pog) thickness was significantly less in group H (9.7 ± 1.6 mm) than in group N (10.8 ± 1.9 mm) (P = 0.042). Adjusted multiple linear regression analysis showed a weak positive linear relationship between the SN-MP before surgery and soft-tissue Pog thickness change (R2 of 0.361; P = 0.001) after surgery, but the area below the lower lips was not completely normalized despite surgery. CONCLUSIONS The thickness of the soft-tissue Pog may increase slightly after surgery in patients with skeletal Class III malocclusion with a higher preoperative mandibular plane angle, but normalization in the area cannot be completely achieved despite surgery.
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Affiliation(s)
- Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, and BK21 PLUS Project, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea
| | - Hyemin Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jae Joon Hwang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Hwi-Dong Jung
- Department of Oral and Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jung-Yul Cha
- Department of Orthodontics, Institute of Craniofacial Deformity, and BK21 PLUS Project, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea.
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Torgersbråten N, Stenvik A, Espeland L. Bimaxillary surgery to correct high-angle class II malocclusion: does a simultaneous genioplasty affect long-term stability? Eur J Orthod 2020; 42:426-433. [PMID: 31369666 DOI: 10.1093/ejo/cjz055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND OBJECTIVES High-angle skeletal Class II malocclusion is one of the most challenging dentofacial deviations to treat and, in adults, a combination of orthodontic treatment and bimaxillary orthognathic surgery is often indicated. This study examines the rate of clinically significant relapse and whether a genioplasty affects the treatment outcome of high-angle Class II malocclusions. MATERIAL AND METHODS Cephalometric tracings of 36 consecutively treated high-angle Class II patients were evaluated from pre-surgery to 3 years post-surgery. All patients had undergone bimaxillary surgery (Le Fort I and BSSO), 13 of them had in addition a genioplasty. RESULTS The maxilla remained stable, whereas relapse (greater than or equal to 2 mm) of the mandibular advancement was seen in 40 per cent of the patients. Advancement greater than 10 mm increased the risk for horizontal relapse. The overjet was normalized and remained stable despite mandibular relapse. Half of the patients had an anterior open bite 3 years post-surgery. A supplemental genioplasty did not affect the relapse rate. CONCLUSIONS AND IMPLICATIONS Overjet was normalized and remained stable long term; there was an open bite in half of the patients. Combined orthodontic and bimaxillary surgical treatment of high-angle Class II patients showed skeletal relapse (greater than or equal to 2 mm) of the mandible in 40 per cent of patients. Mandibular advancement greater than 10 mm increased the risk for relapse. There was no increased risk for dental or skeletal instability associated with a genioplasty in combination with maxillary and mandibular surgery in the treatment of high-angle skeletal Class II malocclusion.
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Affiliation(s)
| | - Arild Stenvik
- Department of Orthodontics, University of Oslo, Norway
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Lo LJ, Weng JL, Ho CT, Lin HH. Three-dimensional region-based study on the relationship between soft and hard tissue changes after orthognathic surgery in patients with prognathism. PLoS One 2018; 13:e0200589. [PMID: 30067766 PMCID: PMC6070212 DOI: 10.1371/journal.pone.0200589] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/01/2018] [Indexed: 01/27/2023] Open
Abstract
Both deep understanding and reliable prediction of postoperative soft tissue changes are crucial for planning orthognathic surgery. Instead of estimating soft tissue responses by measuring individual landmark changes, this study aimed to investigate the relationship (ratio) between soft and hard tissue movements in different facial regions through three-dimensional cone-beam computed tomography (CBCT). Preoperative and postoperative CBCT images were superimposed using the surface registration method on the basis of the cranial base, and 10 facial regions of interest were defined. Region-based volumetric subtractions between the preoperative and postoperative segments were performed. The volumetric differences and surface of each region were used to estimate the average movement. Correlation and regression analyses were performed to examine the relationships between the corresponding soft and hard tissue movements. An overall pattern of facial soft tissue movement was observed in patients with prognathism who underwent orthognathic surgery. The experiment results have shown that mean ratios for the average soft-to-hard tissue movements in the facial regions varied, which may not exactly be similar to the published reports because of the population biocharacteristics and study methods, but the trend is in agreement with the previous studies. Additionally, the prediction capability of the regression model was significantly high, ranging from 0.786 to 0.857, in upper lip, upper vermilion, and chin regions, thus demonstrating that the skin outline changes in these critical regions could be reliably predicted from the underlying bone movements. These results could likely be applied in future soft tissue simulation in orthognathic surgery.
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Affiliation(s)
- Lun-Jou Lo
- Department of Plastic and Reconstructive Surgery, and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Jing-Ling Weng
- Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Ting Ho
- Department of Craniofacial Orthodontics, Department of Dentistry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hsiu-Hsia Lin
- Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
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Storms AS, Vansant L, Shaheen E, Coucke W, de Llano-Pérula MC, Jacobs R, Politis C, Willems G. Three-dimensional aesthetic assessment of class II patients before and after orthognathic surgery and its association with quantitative surgical changes. Int J Oral Maxillofac Surg 2017; 46:1664-1671. [PMID: 28751183 DOI: 10.1016/j.ijom.2017.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 04/25/2017] [Accepted: 07/04/2017] [Indexed: 10/19/2022]
Abstract
The aim of this study was to compare evaluations of the aesthetic outcome of class II orthognathic patients, as performed by observers with varying expertise using three-dimensional (3D) facial images, and to examine the relationship of aesthetic ratings in relation to quantitative surgical changes. Pre- and postoperative 3D facial images of 20 surgically treated class II patients (13 female, 7 male) were assessed for aesthetics by orthodontists, maxillofacial surgeons, and laypeople. Attractiveness ratings for the lips, chin, and overall facial aesthetics were evaluated on a 5-point Likert scale. Correlation between the aesthetic scores was obtained and quantitative surgical changes were examined. For all groups of observers, significant improvements in attractiveness scores were found, especially for the chin assessment. Orthodontists perceived the greatest improvement and laypeople the smallest. Overall, laypeople scored higher with less variability, but with lower intra- and inter-observer agreement. No significant correlation was found between the aesthetic improvement and soft tissue surgical changes. To avoid patient dissatisfaction, it is important to bear in mind that the demands and perception of aesthetic improvement after orthognathic surgery are higher for clinicians than for the general public.
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Affiliation(s)
- A S Storms
- Department of Oral Health Sciences - Orthodontics, KU Leuven, and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - L Vansant
- Department of Oral Health Sciences - Orthodontics, KU Leuven, and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - E Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - W Coucke
- Department of Clinical Biology, Scientific Institute of Public Health, Brussels, Belgium
| | - M Cadenas de Llano-Pérula
- Department of Oral Health Sciences - Orthodontics, KU Leuven, and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - R Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - C Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - G Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven, and Dentistry, University Hospitals Leuven, Leuven, Belgium.
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