Clinical and Radiographic Evaluation of Maxillary Central Incisors Exposure in Patients Undergoing Maxillary Advancement

Overview

Journal Dental Press J Orthod

Specialty Dentistry

Date 2015 Dec 23

PMID 26691970

Authors

Guilherme Dos Santos Trento

Felipe Bueno Rosettti Bernabe

Delson Joao da Costa

Nelson Luis Barbosa Rebellato

Leandro Eduardo Kluppel

Rafaela Scariot

Affiliations

Soon will be listed here.

Abstract

Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics.

Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement.

Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%).

Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002).

Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness.

References

Mobarak K, Krogstad O, Espeland L, Lyberg T . Factors influencing the predictability of soft tissue profile changes following mandibular setback surgery. Angle Orthod. 2001; 71(3):216-27. DOI: 10.1043/0003-3219(2001)071<0216:FITPOS>2.0.CO;2. View

Fudalej P . Long-term changes of the upper lip position relative to the incisal edge. Am J Orthod Dentofacial Orthop. 2008; 133(2):204-9. DOI: 10.1016/j.ajodo.2006.04.040. View

Bell W . Le Forte I osteotomy for correction of maxillary deformities. J Oral Surg. 1975; 33(6):412-26. View

Bell W, Dann 3rd J . President's page. Am J Orthod. 1973; 64(2):162-87. DOI: 10.1016/s0002-9416(73)90308-4. View

Louis P, Austin R, Waite P, Mathews C . Soft tissue changes of the upper lip associated with maxillary advancement in obstructive sleep apnea patients. J Oral Maxillofac Surg. 2001; 59(2):151-6. DOI: 10.1053/joms.2001.20485. View

Freihofer Jr H . The lip profile after correction of retromaxillism in cleft and non-cleft patients. J Maxillofac Surg. 1976; 4(3):136-41. View

Chew M, Sandham A, Wong H . Evaluation of the linearity of soft- to hard-tissue movement after orthognathic surgery. Am J Orthod Dentofacial Orthop. 2008; 134(5):665-70. DOI: 10.1016/j.ajodo.2006.12.017. View

Van Butsele B, Mommaerts M, Abeloos J, De Clercq C, Neyt L . Creating lip seal by maxillo-facial osteotomies. A retrospective cephalometric study. J Craniomaxillofac Surg. 1995; 23(3):165-74. DOI: 10.1016/s1010-5182(05)80006-x. View

Altug-Atac A, Bolatoglu H, Memikoglu U . Facial soft tissue profile following bimaxillary orthognathic surgery. Angle Orthod. 2008; 78(1):50-7. DOI: 10.2319/122206-525.1. View

10.

Kretschmer W, Zoder W, Baciut G, Bacuit M, Wangerin K . Accuracy of maxillary positioning in bimaxillary surgery. Br J Oral Maxillofac Surg. 2009; 47(6):446-9. DOI: 10.1016/j.bjoms.2009.06.004. View

11.

Hui E, Hagg E, Tideman H . Soft tissue changes following maxillary osteotomies in cleft lip and palate and non-cleft patients. J Craniomaxillofac Surg. 1994; 22(3):182-6. DOI: 10.1016/s1010-5182(05)80386-5. View

12.

Marsan G, Cura N, Emekli U . Soft and hard tissue changes after bimaxillary surgery in Turkish female Class III patients. J Craniomaxillofac Surg. 2008; 37(1):8-17. DOI: 10.1016/j.jcms.2008.07.004. View

13.

Radney L, Jacobs J . Soft-tissue changes associated with surgical total maxillary intrusion. Am J Orthod. 1981; 80(2):191-212. DOI: 10.1016/0002-9416(81)90218-9. View

14.

Bundgaard M, Melsen B, Terp S . Changes during and following total maxillary osteotomy (le Fort I procedure): a cephalometric study. Eur J Orthod. 1986; 8(1):21-9. DOI: 10.1093/ejo/8.1.21. View

15.

Lines P, Steinhauser E . Diagnosis and treatment planning in surgical orthodontic therapy. Am J Orthod. 1974; 66(4):378-97. DOI: 10.1016/0002-9416(74)90048-7. View

16.

Stella J, Streater M, EPKER B, Sinn D . Predictability of upper lip soft tissue changes with maxillary advancement. J Oral Maxillofac Surg. 1989; 47(7):697-703. DOI: 10.1016/s0278-2391(89)80008-4. View

17.

Lee D, Bailey L, Proffit W . Soft tissue changes after superior repositioning of the maxilla with Le Fort I osteotomy: 5-year follow-up. Int J Adult Orthodon Orthognath Surg. 1996; 11(4):301-11. View

18.

Mansour S, Burstone C, Legan H . An evaluation of soft-tissue changes resulting from Le Fort I maxillary surgery. Am J Orthod. 1983; 84(1):37-47. DOI: 10.1016/0002-9416(83)90146-x. View

19.

ROSEN H . Lip-nasal aesthetics following Le Fort I osteotomy. Plast Reconstr Surg. 1988; 81(2):171-82. DOI: 10.1097/00006534-198802000-00005. View

20.

Carlotti Jr A, Aschaffenburg P, Schendel S . Facial changes associated with surgical advancement of the lip and maxilla. J Oral Maxillofac Surg. 1986; 44(8):593-6. DOI: 10.1016/s0278-2391(86)80068-4. View