Nasolabial morphologic transformations after lefort-1 osteotomy — A prospective study

The present study was aimed to evaluate the morphologic changes of nose and lip after Lefort 1 osteotomy using clinical and cephalometric parameters A prospective study to evaluate soft tissue changes after Lefort 1 osteotomy which includes 30 individuals of 18-35 years of age presented with dentofacial deformities. Our Study employs the measurement of nasolabial variables using Vernier caliper and lateral cephalograms. These values were recorded and tabulated under T (pre-operative) and T(6 months Post-operative). The final soft tissue changes were analyzed with paired t- test. Our study revealed statistically highly significant (p<0.001) increase in Alar base width, Nasolabial angle, Nasal tip angle and statistically significant (p<0.05) decrease in nasal tip protrusion. Alar base widening is a definitive sequela after Lefort 1 osteotomy even after adopting techniques like alar base cinch suturing and V-Y closure. This warrants that further modifications or innovations are required for preventing these undesirable morphological changes.

[1]  L. Lo,et al.  Nasal changes after orthognathic surgery for patients with prognathism and Class III malocclusion: analysis using three-dimensional photogrammetry. , 2015, Journal of the Formosan Medical Association = Taiwan yi zhi.

[2]  P. Shivhare,et al.  Intercanine width as a tool in two dimensional reconstruction of face: An aid in forensic dentistry , 2015, Journal of forensic dental sciences.

[3]  S. Shetty,et al.  Evaluation of nasal morphology in predicting vertical and sagittal maxillary skeletal discrepancies’ , 2014, European journal of dentistry.

[4]  Dae-Seok Hwang,et al.  Effect of setback Le Fort I osteotomy on midfacial soft-tissue changes as evaluated by cone-beam computed tomography superimposition for cases of skeletal Class III malocclusion. , 2013, International journal of oral and maxillofacial surgery.

[5]  A. Wahab,et al.  Comparison between the classical and a modified trans-septal technique of alar cinching for Le Fort I osteotomies: a prospective randomized controlled trial. , 2013, International journal of oral and maxillofacial surgery.

[6]  Ranjith Raveendran,et al.  Soft Tissue Cephalometric Norms of Malabar Population in Northern Kerala: An Epidemiologic Study , 2012 .

[7]  S. Ruf,et al.  Advancement genioplasty in Class I patients: predictability and stability of facial profile changes. , 2011, International journal of oral and maxillofacial surgery.

[8]  M. de Moraes,et al.  Comparative analysis of two different alar base sutures after Le Fort I osteotomy: randomized double-blind controlled trial. , 2011, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[9]  A. Datarkar,et al.  Cephalometric norms for Central Indian population using Burstone and Legan analysis. , 2011, Indian journal of dental research : official publication of Indian Society for Dental Research.

[10]  L. Cheung,et al.  Facial soft tissue response to anterior segmental osteotomies: a systematic review. , 2010, International journal of oral and maxillofacial surgery.

[11]  S. Varlık,et al.  Influence of lower facial height changes on frontal facial attractiveness and perception of treatment need by lay people. , 2010, The Angle orthodontist.

[12]  M. Santagata,et al.  Comparison of two techniques of cinch suturing to avoid widening of the base of the nose after Le Fort I osteotomy. , 2010, The British journal of oral & maxillofacial surgery.

[13]  B. Melsen,et al.  Comparison of soft and hard tissue profiles of orthognathic surgery patients treated recently and 20 years earlier. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[14]  Eyas Abuhijleh,et al.  Facial soft tissue values in Persian adults with normal occlusion and well-balanced faces. , 2009, The Angle orthodontist.

[15]  Yu-Ray Chen,et al.  Bimaxillary protrusion: an overview of the surgical-orthodontic treatment. , 2009, Seminars in plastic surgery.

[16]  Mladen Slaj,et al.  Analysis of the soft tissue facial profile by means of angular measurements. , 2008, European journal of orthodontics.

[17]  M. Chew,et al.  Outcome of Orthognathic Surgery in Chinese Patients , 2007 .

[18]  L. Farkas,et al.  A study of anthropometric measures before and after external septoplasty in children: a preliminary study. , 2001, Archives of otolaryngology--head & neck surgery.

[19]  L. Farkas,et al.  Anthropometric Anatomical and Morphological Nose Widths in Canadian Caucasian Adults , 1998 .

[20]  S. Schendel,et al.  Nasal considerations in orthognathic surgery. , 1991, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[21]  A. Westermark,et al.  Nasolabial morphology after Le Fort I osteotomies. Effect of alar base suture. , 1991, International journal of oral and maxillofacial surgery.

[22]  J. V. Van Sickels,et al.  A lateral cephalometric analysis of nasal morphology following Le Fort I osteotomy applying photometric analysis techniques. , 1989, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[23]  H. Rosen Lip-nasal aesthetics following Le Fort I osteotomy. , 1988, Plastic and reconstructive surgery.

[24]  P. G. Nadkarni Soft tissue profile changes associated with orthognathic surgery for bimaxillary protrusion. , 1986, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[25]  S. Schendel,et al.  Muscle reorientation following superior repositioning of the maxilla. , 1983, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[26]  R. Kaminishi,et al.  Improved maxillary stability with modified Lefort I technique. , 1983, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[27]  B. Epker,et al.  The alar base cinch: a technique for prevention of alar base flaring secondary to maxillary surgery. , 1982, Oral surgery, oral medicine, and oral pathology.

[28]  L. J. Radney,et al.  Soft-tissue changes associated with surgical total maxillary intrusion. , 1981, American journal of orthodontics.

[29]  Millard Dr The alar cinch in the flat, flaring nose. , 1980 .

[30]  P. Lines,et al.  Profilemetrics and facial esthetics. , 1978, American journal of orthodontics.

[31]  L. A. Bloom Perioral profile changes in orthodontic treatment , 1961 .

[32]  Richard A. Riedel,et al.  An analysis of dentofacial relationships , 1957 .