Effect comparison of two maxillary segmental osteotomy methods to correct maxillary protrusion on the lip soft tissue
10.3760/cma.j.cnZHZXWKZZ-2018-1008-00411
- VernacularTitle:矫治上颌前突畸形的两种前份截骨术式对唇部软组织影响的对比
- Author:
Yanni LI
1
;
Yangyang LIN
;
Min HOU
;
Dali SONG
Author Information
1. 天津市滨海新区中医医院口腔科 300451
- Keywords:
Maxillary protrusion;
Anterior osteotomy;
Orthognathic surgery
- From:
Chinese Journal of Plastic Surgery
2020;36(4):415-422
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Using a combination of 2D and 3D methods to evaluate the difference of lip changes between two maxillary anterior segmental osteotomy methods.Methods:30 patients who visited the Department of Orthognathic Surgery of Tianjin Stomatological Hospital from January 2015 to January 2017 with maxillary protrusion [8 males and 22 females, aged (25.0 ± 0.6) years old] were divided into two groups. One group was treated with cupar maxillary anterior segmental osteotomy. One group underwent modified method. 4 osseous tissue measurements, 8 soft tissue measurements and 7 lip measurements were collected in three-dimensional model, lateral cephalometric radiographs and frontal photos at one week before surgery and one year after surgery to observe the difference between the two groups in the lip area and calculate the retreat ratio of upper incisor to upper lip.Results:The wounds of all 30 patients were healed in one stage without infection and bone necrosis. There was no recurrence of the bone protrusion at 1 year after the operation. After treatment, the bone relationship was normal and the dental arch and occlusal curve were normal. The occlusion relationship and the lip-tooth relationship were good. The shape of the lower third of the face was significantly improved, and the relationship between nose, lips and chin was coordinated. The change of the horizontal position of the lip and the position of the neck of upper incisor tooth (UJ) had a significant positive correlation. In traditional group R= 0.768 and in modified group R= 0.771. The sella-nasion-A point decreased and the nasolabial angle increased in both groups. The difference was statistically significant before and after surgery ( P<0.05). The amount of retraction of the neck point and incision point of the upper incisor and the amount of retraction of the upper lip were significantly reduced. The difference before and after surgery was statistically significant ( P<0.05). There was an increase in the thickness of the upper lip before and after surgery, a decrease in the distance between the upper and lower lip, and a decrease in the distance between the upper incisor and the upper lip. The differences were statistically significant ( P<0.05) compared with those before surgery. The increase of upper lip height in the modified group was statistically significant ( P<0.05), but not in the traditional group. Upper lip height showed a statistically significant increase in the modified procedure group. The retreat ratios of the point Pro of incisor and the upper lip were 1.19∶1 and 0.81∶1 in traditional group and modified group. In frontal view, it was observed that the midline lip thickness became more significantly smaller although the limited change amount and the upper lip line tended to be M-type. Conclusions:These two surgical procedures have obvious effects on maxillary protrusion deformity. The change of the horizontal position of the lip and the position of the neck of upper incisor tooth (UJ) had a significant positive correlation. The lip height increased in modified group compared to traditional group.
