Maxillofacial Plastic and Reconstructive Surgery

  • Volume 41
  • /
  • Pages.48.1-48.7
  • /
  • 2019
  • /
  • 2288-8101(pISSN)
  • /
  • 2288-8586(eISSN)
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지
DOI QR코드

DOI QR Code

Horizontal change of philtrum after orthognathic surgery in patients with facial asymmetry

  • Joh, Yewon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Park, Hyun Soo (Seoul Leaders Dental Clinic) ;
  • Yang, Hoon Joo (Orthognathic Surgery Center, Seoul National University Dental Hospital) ;
  • Hwang, Soon Jung (HSJ Dental Clinic for Oral and Maxillofacial Surgery)
  • Received : 2019.09.18
  • Accepted : 2019.10.09
  • Published : 2019.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods: Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results: Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion: The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

Keywords

References

  1. Yang HJ, Hwang SJ (2014) Change in condylar position in posterior bending osteotomy minimizing condylar torque in BSSRO for facial asymmetry. J Craniomaxillofac Surg 42:325-332 https://doi.org/10.1016/j.jcms.2013.05.021
  2. Cheong YW, Lo LJ (2011) Facial asymmetry: etiology, evaluation, and management. Chang Gung Med J 34:341-351
  3. Aoyama I, Oikawa T, Nakaoka K et al (2018) Lip morphology in patients with facial asymmetry can be corrected by 2-jaw surgery. J Oral Maxillofac Surg 76:2404-2410 https://doi.org/10.1016/j.joms.2018.04.017
  4. Kang DH, Park KR, Chung KJ et al (2015) The relationship between facial asymmetry and nasal septal deviation. J Craniofac Surg 26:1273-1276 https://doi.org/10.1097/SCS.0000000000001549
  5. Suzuki-Okamura E, Higashihori N, Kawamoto T et al (2015) Threedimensional analysis of hard and soft tissue changes in patients with facial asymmetry undergoing 2-jaw surgery. Oral Surg Oral Med Oral Pathol Oral Radiol 120:299-306 https://doi.org/10.1016/j.oooo.2015.05.020
  6. Freudlsperger C, Ruckschloss T, Ristow O et al (2017) Effect of occlusal plane correction on lip cant in two-jaw orthognathic surgery - a threedimensional analysis. J Craniomaxillofac Surg 45:1026-1030 https://doi.org/10.1016/j.jcms.2017.03.014
  7. Hajeer MY, Ayoub AF, Millett DT (2004) Three-dimensional assessment of facial soft-tissue asymmetry before and after orthognathic surgery. Br J Oral Maxillofac Surg 42:396-404 https://doi.org/10.1016/j.bjoms.2004.05.006
  8. Kim YH, Jeon J, Rhee JT et al (2010) Change of lip cant after bimaxillary orthognathic surgery. J Oral Maxillofac Surg 68:1106-1111 https://doi.org/10.1016/j.joms.2009.07.030
  9. Ko EW, Huang CS, Chen YR (2009) Characteristics and corrective outcome of face asymmetry by orthognathic surgery. J Oral Maxillofac Surg 67:2201-2209 https://doi.org/10.1016/j.joms.2009.04.039
  10. Fujita T, Shirakura M, Koh M et al (2013) Changes in the lip-line in asymmetrical cases treated with isolated mandibular surgery. J Orthod 40:313-317 https://doi.org/10.1179/1465313313Y.0000000056
  11. Hwang HS, Min YS, Lee SC et al (2009) Change of lip-line cant after 1-jaw orthognathic surgery in patients with mandibular asymmetry. Am J Orthod Dentofac Orthop 136:564-569 https://doi.org/10.1016/j.ajodo.2007.10.060
  12. Jeon EG, Lee ST, Kwon TG (2017) Perioral soft tissue change after isolated mandibular surgery for asymmetry patients. J Craniomaxillofac Surg 45:962-968 https://doi.org/10.1016/j.jcms.2017.01.039
  13. Yamashita Y, Nakamura Y, Shimada T et al (2009) Asymmetry of the lips of orthognathic surgery patients. Am J Orthod Dentofac Orthop 136:559-563 https://doi.org/10.1016/j.ajodo.2007.10.057
  14. Bidra AS, Uribe F, Taylor TD et al (2009) The relationship of facial anatomic landmarks with midlines of the face and mouth. J Prosthet Dent 102:94-103 https://doi.org/10.1016/S0022-3913(09)60117-7
  15. Bishara SE, Burkey PS, Kharouf JG (1994) Dental and facial asymmetries: a review. Angle Orthod 64:89-98
  16. Miller EL, Bodden WR Jr, Jamison HC (1979) A study of the relationship of the dental midline to the facial median line. J Prosthet Dent 41:657-660 https://doi.org/10.1016/0022-3913(79)90065-9
  17. Nanda R, Margolis MJ (1996) Treatment strategies for midline discrepancies. Semin Orthod 2:84-89 https://doi.org/10.1016/S1073-8746(96)80046-6
  18. Alarabi AM, Revie GF, Bearn DR (2019) Quantification of maxillary dental midline deviation in 2D photographs: methodology trial. Int Orthod 17:312-323 https://doi.org/10.1016/j.ortho.2019.03.014
  19. Arnett GW, Bergman RT (1993) Facial keys to orthodontic diagnosis and treatment planning--part II. Am J Orthod Dentofac Orthop 103:395-411 https://doi.org/10.1016/S0889-5406(05)81791-3
  20. Kim HY (2013) Statistical notes for clinical researchers: evaluation of measurement error 2: Dahlberg's error, Bland-Altman method, and Kappa coefficient. Restor Dent Endod 38:182-185 https://doi.org/10.5395/rde.2013.38.3.182
  21. Baek C, Paeng JY, Lee JS et al (2012) Morphologic evaluation and classification of facial asymmetry using 3-dimensional computed tomography. J Oral Maxillofac Surg 70:1161-1169 https://doi.org/10.1016/j.joms.2011.02.135
  22. Cho JH, Kim EJ, Kim BC et al (2007) Correlations of frontal lip-line canting with craniofacial morphology and muscular activity. Am J Orthod Dentofac Orthop 132(278):e277-e214 https://doi.org/10.1016/j.ajodo.2007.01.015
  23. Sarver DM, Ackerman MB (2003) Dynamic smile visualization and quantification: part 1. Evolution of the concept and dynamic records for smile capture. Am J Orthod Dentofac Orthop 124:4-12 https://doi.org/10.1016/S0889-5406(03)00306-8
  24. Norton NS, Netter FH (2017) Netter's head and neck anatomy for dentistry. Elsevier, Philadelphia
  25. Latham RA, Deaton TG (1976) The structural basis of the philtrum and the contour of the vermilion border: a study of the musculature of the upper lip. J Anat 121:151-160
  26. Hur MS, Kim HJ, Choi BY et al (2013) Morphology of the mentalis muscle and its relationship with the orbicularis oris and incisivus labii inferioris muscles. J Craniofac Surg 24:602-604 https://doi.org/10.1097/SCS.0b013e318267bcc5
  27. Iwanaga J, He P, Watanabe K et al (2017) Intraoral observation of the mentalis and incisivus labii inferioris muscles. J Craniofac Surg 28:2159-2161 https://doi.org/10.1097/SCS.0000000000004043
  28. Almukhtar A, Khambay B, Ju X et al (2018) Comprehensive analysis of soft tissue changes in response to orthognathic surgery: mandibular versus bimaxillary advancement. Int J Oral Maxillofac Surg 47:732-737 https://doi.org/10.1016/j.ijom.2017.11.014
  29. Lo LJ, Weng JL, Ho CT et al (2018) Three-dimensional region-based study on the relationship between soft and hard tissue changes after orthognathic surgery in patients with prognathism. PLoS One 13:e0200589 https://doi.org/10.1371/journal.pone.0200589
  30. Jung J, Lee CH, Lee JW et al (2018) Three dimensional evaluation of soft tissue after orthognathic surgery. Head Face Med 14:21 https://doi.org/10.1186/s13005-018-0179-z
  31. Wermker K, Kleinheinz J, Jung S et al (2014) Soft tissue response and facial symmetry after orthognathic surgery. J Craniomaxillofac Surg 42:e339-e345 https://doi.org/10.1016/j.jcms.2014.01.032

Cited by

  1. Surgical Orthodontic Treatment for Skeletal Class I with Facial Asymmetry and Occlusal Cant: A Case Report vol.15, pp.1, 2019, https://doi.org/10.2174/1874210602115010644