Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Soft tissue changes of upper lip and nose following posterosuperior rotation of the maxilla by Le Fort I osteotomy

Le Fort I 골절단술을 통한 상악의 후상방 회전에 따른 상순과 비부의 연조직 변화

  • Kwon, Young-Wook (Department of Oral and Maxillofacial Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Pyo, Sung-Woon (Department of Oral and Maxillofacial Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Lee, Won (Department of Oral and Maxillofacial Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea) ;
  • Park, Je-Uk (Department of Oral and Maxillofacial Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • 권영욱 (가톨릭대학교 서울성모병원) ;
  • 표성운 (가톨릭대학교 부천성모병원) ;
  • 이원 (가톨릭대학교 의정부성모병원 구강악안면외과) ;
  • 박재억 (가톨릭대학교 서울성모병원)
  • Received : 2011.06.13
  • Accepted : 2011.10.12
  • Published : 2011.12.31
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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 $2.52{\pm}1.54$ mm posteriorly in the horizontal plane (P<0.05). Among the soft tissue landmarks, Pn moved $0.97{\pm}1.1$ mm downward (P<0.05), UL moved $1.98{\pm}1.58$ mm posteriorly (P<0.05) and $1.18{\pm}1.85$ mm inferiorly (P<0.05), and StmS moved $1.68{\pm}1.48$ mm posteriorly (P<0.05) and $1.06{\pm}1.29$ 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

References

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