Introduction: Quantifying soft tissue changes after orthognathic surgery is increasingly important in surgical planning, but little is actually known about the changes in facial appearance after maxillomandibular advancement (MMA) in patients with Obstructive Sleep Apnea Syndrome (OSAS). In the current study, we investigated soft tissues in OSAS patients before and after MMA. Patients and Methods: Ten patients with severe OSAS, who underwent MMA, were considered. Age, RDI, ODI and cephalometric data were examined. In addition, facial surface data were acquired using a three-dimensional (3D) laser scanner before (T0) and one year (T1) after surgery. Scan data at T0 and T1 were pooled by electronic surface averaging to obtain the mean pre and post-treatment facial model. A virtual optimal face (V) was constructed by averaging the scans of 40 healthy adult men. Different linear measurements and shell-to-shell deviation were then calculated for comparison of the mean T0 and T1 models. The mean post-surgical face was also compared with V. Results: Ten males (age range 33 to 60 years) were studied. The mean RDI improved from 74.08 ± 34.49 to 10.34 ± 7.2/h; the mean ODI improved from 59.5 ± 25.34 % to 9.11 ± 8.05 %. The mean maxillo-mandibular advancement was 10.3 mm. Measurements at T0 and T1 documented that the major post surgical changes were in the lower area of the face. The comparison of facial surface at T0 and T1 showed an overall increase of the sagittal projection of the cheeks, lips and of the chin. After treatment, the distance between alr (right alar crest point) and all (left alar crest point) increased. The comparison of the mean T1 model and V only demonstrated a transversal increase of the post-treatment facial model at the cross section through ch; sagittal measurements showed no significant differences. Conclusion: MMA is a highly effective treatment for OSAS. Despite significant maxillomandibular advancement, our evaluations of 3D laser scanning showed that surgery in OSAS patients can detect great post-treatment changes on soft tissues, without an impairment of the facial appearance.
Soft tissue changes after maxillomandibular advancement in osas patients: a three-dimensional study
Bianchi F. , A.;GERBINO, GIOVANNI;VERZE', Laura;
2012-01-01
Abstract
Introduction: Quantifying soft tissue changes after orthognathic surgery is increasingly important in surgical planning, but little is actually known about the changes in facial appearance after maxillomandibular advancement (MMA) in patients with Obstructive Sleep Apnea Syndrome (OSAS). In the current study, we investigated soft tissues in OSAS patients before and after MMA. Patients and Methods: Ten patients with severe OSAS, who underwent MMA, were considered. Age, RDI, ODI and cephalometric data were examined. In addition, facial surface data were acquired using a three-dimensional (3D) laser scanner before (T0) and one year (T1) after surgery. Scan data at T0 and T1 were pooled by electronic surface averaging to obtain the mean pre and post-treatment facial model. A virtual optimal face (V) was constructed by averaging the scans of 40 healthy adult men. Different linear measurements and shell-to-shell deviation were then calculated for comparison of the mean T0 and T1 models. The mean post-surgical face was also compared with V. Results: Ten males (age range 33 to 60 years) were studied. The mean RDI improved from 74.08 ± 34.49 to 10.34 ± 7.2/h; the mean ODI improved from 59.5 ± 25.34 % to 9.11 ± 8.05 %. The mean maxillo-mandibular advancement was 10.3 mm. Measurements at T0 and T1 documented that the major post surgical changes were in the lower area of the face. The comparison of facial surface at T0 and T1 showed an overall increase of the sagittal projection of the cheeks, lips and of the chin. After treatment, the distance between alr (right alar crest point) and all (left alar crest point) increased. The comparison of the mean T1 model and V only demonstrated a transversal increase of the post-treatment facial model at the cross section through ch; sagittal measurements showed no significant differences. Conclusion: MMA is a highly effective treatment for OSAS. Despite significant maxillomandibular advancement, our evaluations of 3D laser scanning showed that surgery in OSAS patients can detect great post-treatment changes on soft tissues, without an impairment of the facial appearance.
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