Evaluation of soft tissue changes after mandibular prognathism surgery
Gaszyńska, E.; Kozakiewicz, M.
Polski Merkuriusz Lekarski Organ Polskiego Towarzystwa Lekarskiego 27(162): 474-477
2009
ISSN/ISBN: 1426-9686 PMID: 20120710 Document Number: 628559
Therapeutic goals for orthognathic surgery are not only directed towards the correction of dento-osseous deformieties but also to provide the optimal functional and esthetic effect that results in patients satisfaction. THE AIM OF THE STUDY was to evaluate soft tissue changes following surgical treatment of patients with mandibular prognathism operated with two alternative techniques: extraoral vertical ramus osteotomy or sagittal split ramus osteotomy. A sample of 37 patients with mandibular prognathism operated in Cranio-Maxillofacial Department. The patients included in the study underwent isolated surgery within mandibular rami, without any adjunctive procedures. Long-term and early outcomes of soft tissue changes following surgery were monitored by means of cephalometric analysis according to Arnett in consecutive intervals: before surgical treatment; 1 to 2 weeks after surgery; 6 months and 12 months after surgery. Study variables included age, gender and method of surgical treatment. In both groups operated with bilateral sagittal osteotomy and extraoral vertical ramus osteotomy methods increase of A'-B' value in T2, T3 i T4 comparing values in T1 was recorded. Immediately and 12 months after both surgeries increase of ULA-LLA, and 6 months after bilateral sagittal osteotomy statistically significant decrease of this parameter compareing with values before surgery was noted. Greater decrease of ULA-LLA value was found from 6 to 12 months postoperatively in female group, final change of ULA-LLA value 12 months after surgery in female group was greater. Both surgical technics of mandibular setback results in improvement in lower part of the face, although precise analysis of soft tissue profile changes reveals differences. In women skeletal changes caused greater changes within soft tissue than in men.