Journal List > J Korean Assoc Oral Maxillofac Surg > v.37(6) > 1032502

J Korean Assoc Oral Maxillofac Surg. 2011 Dec;37(6):457-463. Korean.
Published online December 27, 2011.  https://doi.org/10.5125/jkaoms.2011.37.6.457
Copyright © 2011 by The Korean Association of Oral and Maxillofacial Surgeons
Soft tissue changes of upper lip and nose following posterosuperior rotation of the maxilla by Le Fort I osteotomy
Young-Wook Kwon,1 Sung-Woon Pyo,2 Won Lee,3 and Je Uk Park1
1Department of Oral and Maxillofacial Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
2Department of Oral and Maxillofacial Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea.
3Department of Oral and Maxillofacial Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea.

Corresponding author: Je Uk Park. Department of Oral and Maxillofacial Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, 137-501, Korea. TEL: +82-2-2258-6291, FAX: +82-2-237-5374, Email: jupark@catholic.ac.kr
Received June 13, 2011; Revised August 30, 2011; Accepted October 12, 2011.

Abstract

Introduction

This study evaluate the soft tissue changes to the upper lip and nose after Le Fort I maxillary posterosuperior rotational movement.

Materials and Methods

Twenty Skeletal class III patients, who had undergone bimaxillary surgery with a maxillary Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, were included in the study. The surgical plan for maxilla was posterosuperior rotational movement, with the rotation center in the anterior nasal spine (ANS) of maxilla. Soft and hard tissue changes were measured by evaluating the lateral cephalograms obtained prior to surgery and at least 6 months after surgery. For cephalometric analysis, four hard tissue landmarks ANS, posterior nasal spine [PNS], A point, U1 tip), and five soft tissue landmarks (pronasale [Pn], subnasale [Sn], A' Point, upper lip [UL], stomion superius [StmS]) were marked. A paired t test, Pearson's correlation analysis and linear regression analysis were used to evaluate the soft and hard tissue changes and assess the correlation. A P value <0.05 was considered significant.

Results

The U1 tip moved 2.52±1.54 mm posteriorly in the horizontal plane (P<0.05). Among the soft tissue landmarks, Pn moved 0.97±1.1 mm downward (P<0.05), UL moved 1.98±1.58 mm posteriorly (P<0.05) and 1.18±1.85 mm inferiorly (P<0.05), and StmS moved 1.68±1.48 mm posteriorly (P<0.05) and 1.06±1.29 mm inferiorly (P<0.05). The ratios of horizontal soft tissue movement to the hard tissue were 1:0.47 for the A point and A' point, and 1:0.74 for the U1 tip and UL. Vertically, the movement ratio between the A point and A' point was 1:0.38, between U1 tip and UL was 1:0.83, and between U1 tip and StmS was 1:0.79.

Conclusion

Posterosuperior rotational movement of the maxilla in Le Fort I osteotomy results in posterior and inferior movement of UL. In addition, nasolabial angle was increased. Nasal tip and base of the nose showed a tendency to move downward and showed significant horizontal movement. The soft tissue changes in the upper lip and nasal area are believed to be induced by posterior movement at the UL area.

Keywords: Orthognathic surgery; Le Fort osteotomy; Cephalometry; Angle class III malocclusion

Figures


Fig. 1
Cephalometric landmarks and reference planes. (ANS: anterior nasal spine, PNS, posterior nasal spine; A, A point; U1 tip, upper incisor tip; Pn, pronasale; Sn, subnasale; A', soft tissue A point; UL, upper lip; StmS, Stomion superius)
Click for larger image

Tables


Table 1
Horizontal, vertical (mm) and angular (°) changes of hard and soft tissue landmarks (T0-T1)
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Table 2
Correlations between corresponding soft to hard tissue movements and soft to hard tissue movement ratios in both horizontal and vertical planes
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Table 3
Correlations between hard tissue angular changes to soft tissue movement and their ratios
Click for larger image

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