Korean J Orthod.  2008 Apr;38(2):104-120. 10.4041/kjod.2008.38.2.104.

Soft tissue changes associated with advancement genioplasty in skeletal class III individuals receiving mandibular set-back surgery

• Kim KR
• Kim SS
• Son WS
• Park SB

• KMID: 1481498
• DOI: http://doi.org/10.4041/kjod.2008.38.2.104

Abstract

PURPOSE
The purpose of this study was to assess the hard and soft tissue changes associated with mandibular bilateral sagittal split osteotomy and genioplasty.
METHODS
This is a retrospective study of 40 patients who underwent either bilateral sagittal split osteotomy for mandibular setback (BSSO group, n = 20) or in combination with advancement genioplasty (Genio group, n = 20). Lateral radiographs, were taken before and immediately after surgery, and at least 6 months after surgery.
RESULTS
Comparing hard and soft tissue changes between the BSSO group and Genio group, there were significant differences in the lower incisor, soft tissue B point (B'), and soft tissue Pogonion (Pg') (p < 0.5). The mean ratio of hard and soft tissue changes for B/B', Pg/Pg', and Menton/soft tissue Menton after surgery in the BSSO group was 0.997, 0.965, and 1.022 respectively, and 0.824, 0.602, and 0.887 respectively in the genio group. Significant differences were found between the two groups. There were significant differences in lip thickness (B-B', Pg-Pg') in the Genioplasty group between pre and postsurgery, but not in the BSSO group. Pogonion to Labrale inferior and B' had a correlation coefficient of 0.833, 0.922, respectively for the BSSO group, and 0.775, 0.799 for the Genio group.
CONCLUSIONS
The results indicate that there is a significant difference between bilateral sagittal split osteotomy with or without genioplasty in the lower facial esthetics values. The combination of mandibular setback and genioplasty had a smaller change in soft tissue thickness of the symphysis area after surgery than that of mandibular setback only.

Keyword

Advancement genioplasty; Soft tissue change; Mandibular prognathism

MeSH Terms

Esthetics
Genioplasty
Humans
Incisor
Lip
Osteotomy
Retrospective Studies
Sitosterols
Sitosterols

Figure

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  Fig 1 Cephalometric landmarks of hard and soft tissue points and associated reference planes. 1, U1 ; 2, L1; 3, infra; 4, B; 5, Pg; 6, Me; 7, Stos; 8, Stoi; 9, Li; 10, B'; 11, Pg'; 12, Me'; 13, S; 14, Na.

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  Fig 2 Horizontal measurements of hard tissue landmarks. 1, U1; 2, L1; 3, infra; 4, B; 5, Pg; 6, Me.

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  Fig 4 Vertical measurements of hard tissue landmarks. 13, U1; 14, L1; 15, infra; 16, B; 17, Pg; 18, Me.

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  Fig 5 Vertical measurements of soft tissue landmarks. 19, Stos; 20, Stoi; 21, Li; 22, B'; 23, Pg'; 24, Me'.

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  Fig 6 Lip thickness measurements. 25, U1-Li; 26, L1-Li; 27, Infra-B'; 28, B-B'; 29, Pg-Pg'; 30, U1-Stoi; 31, L1-Stoi.

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  Fig 7 Lip length measurements. 32, Me-Me'; 33, Me'-Stoi.

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  Fig 8 Mean treatment changes (T1 - T3) in lip thickness (uint: mm).

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