• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.3
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• pp.250-259
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• 1997

The purpose of this study was to evaluate the interrelationship of the soft and hard tissue changes after both maxillary and mandibular anterior segmental surgery in bimaxillary protrusion patients. 11 patients had received both maxillary and mandibular anterior segmental surgery and were investigated radiologically with lateral cephalogram. The results were as follows : 1. The correlation of maxillary hard and soft tissue horizontal changes were relative high. : Coefficient between UIE and Stms was 0.89 (p<0.001). 2. The correlation of mandibular hard and soft tissue horizontal changes were very high, especially at the chin. : Coefficients were over 0.90 (p<0.001) 3. All points were moved superiorly except SLS, LS, Stms. 4. Upper and lower lip convexity to the E-Line were decreased (p<0.001) and postsurgical facial profiles were changed very esthetically.

• The korean journal of orthodontics
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• v.23 no.4 s.43
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• pp.707-724
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• 1993

The purpose of the study is to estimate hard and soft tissue changes after orthognathic surgery for the correction of the mandibular prognathism and to describe interrelationship and ratios of soft and hard tissue changes. The presurgical and postsurgical lateral cephalograms of 31 treated patients(17 males and 14 females) was used ; these patients had received combined orthodontic-surgical treatment by means of a bilateral sagittal split ramus osteotomy. Their ages ranged from 16 to 31 years and mean age was 21.4 years. A computerized cephalometric appraisal was developed and used to analyse linear and angular changes of skeletal and soft tissue profile. The statistical elaboration of the data was made by means of $SPSS/PC^+$. The results of the study were as follows : 1. The correlations of soft and hard tissue horizontal changes were significantly high and the ratios were $97\%$ at LI, $107\%$ at ILS, and $93\%$ at Pog'. 2. The correlations of vertical changes at Stm, LI and horizontal changes at Pog were high$(26\%)$ and at the other areas were not statistically high. 3. The correlations of soft ad hard tissue vertical changes were not significantly high in all areas except Gn' $(30\%)$ and Me' $(56\%)$. 4. The soft tissue thickness was significantly decreased in upper lip and increased in lower lip, and the amount of changes after surgery was reversely correlated with initial thickness. 5. The facial convexity was increased and relative protrusion of upper lip was increased and that of lower lip was decreased. 6. The upper to lower facial height(Gl-Sn/Sn-Me') was increased and upper to lower jaw height(Sn-Stms/Stmi-Me') was increased.

• The korean journal of orthodontics
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• v.38 no.4
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• pp.252-264
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• 2008

Objective: To aid the development of a frontal image simulating program, we evaluated the soft tissue frontal changes in relationship to movement of hard tissue with orthognathic surgery of facial asymmetry patients. Methods: Preoperative and postoperative frontal cephalograms and frontal view photographs of 45 mandibular surgery patients with facial asymmetry were obtained in a standardized manner. Vertical and horizontal changes of hard tissue and soft tissue were measured from cephalograms and photographs, respectively. Soft tissue change in result to hard tissue change was then analyzed. Results: Both vertical and horizontal correlation analysis showed a weak relationship between the changes. Hard tissue points that were picked for 1 : 1 mean ratio with soft tissue points did not show any significant relevance. For each soft tissue change, regressive equation was formulated by stepwise multiple regression analysis, and the equation for soft tissue Menton was most reliable in predicting changes. Both vertical and horizontal hard tissue changes were used together in prediction of vertical or horizontal soft tissue change. Conclusions: The results suggest that computerized image simulation using regression analysis may be of help for prediction of soft tissue change, while 1:1 mean ratio method is not useful.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.3
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• pp.49-56
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• 1990

Facial balance is the primary detevminant of good facial esthetics and is expressed externally by the shape of facial soft tissues. Balance of the facial skeleton is most important in prediction of orthognathic surgery, however, it is not alwags coincided to soft tissue balance because the soft tissue drapes overlying hard tissue varies in thickness and tones from case to case. So, soft tissue facial balance and esthetics also should always be considered in prediction of hard tissue changes preoperatively. The chin has a paramount importance in the overall appearance of the face and facial profile because it may express individual charactor or image. Therefore positional change of the chin must be considered in any cases as the last and important option to give an overall soft tissue balance. Two cases were referred from orthodontists only for anterior segmental of teortomuy of the chin. Pre-operative evaluation showed poor soft tissue chin profiles which were not coincided to hard tissue chin balance. We altered surgical plans to fulfill balancing soft tissue profile and then could improve overall esthetics after surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.6
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• pp.509-514
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• 2005

Purpose: In order to clarify the clinical utility of the vertical height augmentation (VHA) genioplasty using autogenous iliac bone graft (IBG), this study examined the postsurgical changes in hard and soft tissues of the chin and the stability of the grafted bone. Patients and Methods: Twenty-three patients who had undergone VHA genioplasty using autogenous IBG were evaluated radiographically and clinically. A comparison study of the changes in hard to soft tissues after surgery in all 23 patients was performed with preoperative, 1-month, 3-months, 6-months, and/or 1-year postoperative lateral cephalograms by tracing. Stability, bone healing, and complication of the grafted bone was evaluated by follow-up roentgenograms and clinical observation. Results: Between the preoperative and 6-month postoperative tracings, an average vertical augmentation of the osseous segment was 4.2 mm at menton and that of the soft tissue menton was 4.0 mm. There was a high predictability of 1: 0.94 between the amounts of hard versus soft tissue changes with surgery in the vertical plane. The position of the genial bone segment was stable immediately after surgery and soft tissue was not changed significantly from 1 month to 1 year after operation. Clinical and radiological follow-up results of the iliac bone graft showed normal bony union and were generally stable. Conclusions: VHA genioplasty using IBG is a reliable method for predicting hard and soft tissue changes and for maintaining postoperative soft tissue of the chin after surgery.

• The korean journal of orthodontics
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• v.24 no.3 s.46
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• pp.547-554
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• 1994

This study was carried out in order to find out the soft tissue profile changes associated with maxillary incisor retraction in Angle's class I malocclusion patients. For this study fifty two female adult patients (Maximum Retraction Group 23, Minimum Retraction Group 29) who received orthodontic treatment were chosen. Following conclusions were obtained by analysing the changes of soft tissue and hard tissue before and after treatment. 1. When considering the mean changes of soft tissue and hard tissue, UP, LIP, Ls, Li (p<0.001), Point B, Si (p<0.01), Point A, Ss (p<0.05) were significant posterior movement in Maximum Retraction Group and UIP (p<0.001), LIP, Ls, Li (p<0.01), Point B, Si (p<0.05) were significant posterior movement in Minimum Retraction Group. 2. When considering the correlations between hard tissue and soft tissue changes, greater correlations were found in Minimum Retraction Group between UIP and Ls (p<0.01), Point A and Ss, UIP and Li, Point B and Si (p<0.05) than Minimum Retraction Group. 3. Correlations (p<0.01) were found between upper incisor retraction and posterior movement of the upper and lower lip in Thin Lip-Thickness Group, whereas no significant correlations were found in Thick Lip-Thickness Group. 4. Mean changes of the soft tissue thickness subsequent to incisor retraction were increased (p<0.01) in upper lip (Ls-Ls'), whereas no changes were found in lower lip.

• The korean journal of orthodontics
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• v.27 no.1
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• pp.65-78
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• 1997

This study was carried out in order to determine soft tissue response to incisor movement and mandibular repositioning and to determine feasibility of predicting vertical and horizontal changes in soft tissue with hard tissue movement. For this study, cephalometric records of 41 orthodontically treated adult females who had Angle's Class II division 1 malocclusion were selected and stepwise multiple regression analysis was employed. Following conclusions were obtained by analysing the changes of soft tissue and hard tissue before and after treatment. 1. Hard tissue measurements that showed significant changes before and after treatment were horizontal and angular changes of maxillary incisor, horizontal,vertical and angular changes of mandibular incisor, overjet, overbite, interincisal angle, mandibular repositioning, A,B, skeletal convexity and soft tissue measurements that showed significant changes were horizontal, thickness and angular changes of upper lip, horizontal and angular changes of lower lip, interlabial angle, nasolabial angle labiomental angle, Sri, Ss, Si and soft tissue convexity(P<0.05). 2. All Soft tissue measurements changed significantly before and after treatment had between one and four hard tissue independent variables at statistically significant level, indicating that all soft tissue changes were direct relationship with hard tissue changes 3. Ova jet, horizontal change of maxillary incisor, horizontal change of maxillary root apex and horizontal change of pogonion entered into prediction equations most frequentely indicating that they were more significant variables in prediction of vertical and horizontal changes in the soft tissue with treatment, but vertical changes of mandibular incisor not entered any prediction equations, indicating that it was not considered a good predictor for soft tissue changes with maxillary incisor retraction. 4. Horizontal and vertical changes in subnasale were found to have most independent variables, significant at the 0.05 level in prediction-equations(${\Delta}$Sn(H):Ur, Is(H), Pg(H), UIA,${\Delta}$Sn(V): Is(H), Pg(H), overjet, A), indicating that subnasale changes are influenced by complex hard tissue interaction. 5. Multiple correlation coefficient($R^2$) of the soft tissue prediction equations ranges from 0.2-0.6.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.447-452
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• 2006

Purpose: In order to clarify the correlation of mandibular setback using bilateral intraoral vertical ramus osteotomy (BIVRO) and post-surgical transverse mandibular width (TMW), this study examined the pre- and postsurgical changes in hard and soft tissues of TMW and the relationship of TMW and the amount of mandibular setback. Patients and Methods: One-hundred seven patients who had undergone BIVRO were evaluated radiographically and clinically. A comparison study of the changes in hard and soft tissue after surgery in all 107 patients was performed with preoperative, 1 month, 3 month, 6 month and 1 year postoperative posteroanterio cephalograms and clinical photographs by tracing. And this changes were evaluated in parts to amounts of mandibular setback. Results: Statistically significant increases of TMW in hard and soft tissue from preoperative to postoperative 1 month were seen. TMW in hard tissue from 1 month to 1 year postopertive were gradually decreased. TMW in soft tissue was not changed uniformly but almost equal to pre-operative width. And there was no significant correlation between TMW and amount of mandibular setback. Conclusions: The results show that mandibular setback using BIVRO did not significantly influence increasing of TMW in soft tissue.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.413-420
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• 2012

Purpose: The purpose of this setback genioplasty study is to develop a prediction method for the calculated osteotomy angle using horizontal and vertical changes as well as to evaluate the proportion of hard and soft tissue changes. Methods: Twelve patients who had received setback genioplasty with other maxillofacial surgery were examined. Three lateral cephalograms were taken just before surgery, immediately after surgery, and 3 months later surgery. A reference line was established to the reference point of the inner most point of the lingual symphysis cortex, incisor tip, and 2nd molar cusp tip. Measuring was conducted from pogonion (Pg), menton (Me), labrale inferius (Li), Mentolabial fold, soft tissue pogonion (Pg'), and soft tissue menton (Me') to the reference lines. Results: In setback genioplasty, the skeletal Pg moved posteriorly 5.07 mm. The ratios of soft tissue to hard tissue movement were 36% posteriorly and 62% inferiorly at Pg', 67% posteriorly and 104% inferiorly at Me', and 34% anteriorly and 164% posteriorly at Li. In reduction & setback genioplasty, skeletal Pg moved posteriorly 4.63 mm and skeletal Me moved superiorly 3.63 mm. The ratios of soft tissue to hard tissue movement were 76% posteriorly and 18% superiorly at Pg', 68% posteriorly and 42% superiorly at Me', and 44% anteriorly, 124% posteriorly at Li. The calculated mean slope angle, based on ${\Delta}H/{\Delta}V$ ratio, was 61.25 and the measured mean slope angle was 60.17. Thus, the calculated and measured slope angles have a similarity. Conclusion: In setback genioplasty, soft tissue moves posteriorly and inferiorly. In particular, at the Me' and Pg', the inferior movement of the soft tissue is greater than the posterior movement. Also, the predictable results (measured slope angle) after operation can be achieved by the calculated slope angle. Thus, the relationship of soft and hard tissue changes must be considered as the results are predictable.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.4
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• pp.284-290
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• 1998

The purpose of this study was to assess the soft tissue changes using twenty skeletal class III malocclusion patients who treated with bimaxillary surgery for the correction of dentofacial deformities. Patients were divided into two groups. One was impaction and advancement of maxilla with mandibular set-back (Group 1), the other was downward and advancement of maxilla with mandibular set-back (Group 2). Preoperative and postoperative one year cephalometric data were analyzed and compared. Results obtained were as follows: 1. The ratio of horizontal changes of soft tissue to hard tissue at Nt to ANS, Ls to UI, Li to LI, sPog to Pog were 1:0.60, 1:0.79, 1:0.47, 1:0.63 in group 1 respectively, and 1:0.59, 1:0.48, 1:0.83, 1:1.09 in group 2 respectively. Soft tissue changes were highly predictable at the upper lip, lower lip, and chin area. 2. The ratio of vertical changes of soft tissue to hard tissue at Nt to ANS, Li to LI were 1:0.72, 1:0.06 in group 1, and others showed no statistically significant difference. 3. The ratio of horizontal changes of Ls to hard tissue movements at LI(h) was 1:-0.82 in group 1 and at UI(h), LI(h) were 1:0.48, 1:0.01 in group 2. These ratios of group 1 were greater than those of group 2. 4. The direction of horizontal change of Li was the same as that of hard tissue change. The ratio of horizontal changes of Li to LI was 1:0.47 in group 1 and others showed no statistically significant difference. 5. The changes of upper lip thickness and length were -1.6mm, -1.4mm in group 1, and -1mm, -2.7mm in group 2. 6. The ratios of thickness of upper lip to ANS, UI, LI were 1:-0.83, 1:-0.37, 1:0.11 in group 1. There was similar trend in group 2, and there were no statistically significant difference. These results suggest that prediction of changes in soft tissue of upper lip, lower lip, and chin were 79%, 47%, and 63% in group 1, and 48%, 83%, and 109% in group 2. There was a tendency to decrease in thickness and increase in length of the upper lip.