Introduction: Aesthetic correction of facial asymmetry is an essential goal of treatment and it is often difficult to achieve. Reliable three-dimensional (3D) measurements are required to support outcome studies. Patients and Methods: In the present study, 15 Caucasian adult subject, 9 females and 6 males, with maxillomandibular asymmetry and malocclusion were studied. The patients were treated with orthodontic and different surgical procedures in single or multiple steps. Posterioranterior (PA) and lateral (L) cephalometry and 3D facial surface data were obtained before (T0) and one year (T1) after surgery. Facial scan data at T0 and T1 were pooled together by electronic surface averaging to obtain the mean pre and post-treatment facial model. A symmetric facial model was constructed by averaging the actual T0 scans and their mirroring to obtain the virtual optimal symmetric face (S). Different linear and angular measurements were then calculated for comparison of the mean T0 and mean T1 models. Results: In L cephalograms an increase of posterior facial height and a normalization of overjet and overbite were observed. Comparing the PA measurements between T0 and T1, normalization of maxillo-mandibular dental midline alignment and of occlusal plane tilt, and a great improvement of lateral deviation of the chin were observed. The comparison of measurements of the cutaneous landmark distances on T0 and T1 revealed that the major postsurgical changes were in the lower face. In the frontal view an improvement of symmetry of the nasal base and an important correction of the lips, both vertically and horizontally, were observed. Increased support of the lips and increase of the inter-commissural distance were also shown. Residual defects were documented in the postoperative symmetry of the chin. Conclusion: Orthognathic surgery performed for the treatment of facial asymmetry, combined with dental occlusion problems, is still a challenge for maxillo-facial surgeons. Orthognathic surgery can give an important improvement of the facial asymmetry, but further changes of techniques are still possible. 3D evaluation results an effective method to support outcome studies on the surgical correction of complex facial deformities.
Soft tissue changes after orthodontic-surgical correction of jaws asymmetry evaluated by 3D surface laser scanner
Bianchi F. , A.;GERBINO, GIOVANNI;VERZE', Laura
2012-01-01
Abstract
Introduction: Aesthetic correction of facial asymmetry is an essential goal of treatment and it is often difficult to achieve. Reliable three-dimensional (3D) measurements are required to support outcome studies. Patients and Methods: In the present study, 15 Caucasian adult subject, 9 females and 6 males, with maxillomandibular asymmetry and malocclusion were studied. The patients were treated with orthodontic and different surgical procedures in single or multiple steps. Posterioranterior (PA) and lateral (L) cephalometry and 3D facial surface data were obtained before (T0) and one year (T1) after surgery. Facial scan data at T0 and T1 were pooled together by electronic surface averaging to obtain the mean pre and post-treatment facial model. A symmetric facial model was constructed by averaging the actual T0 scans and their mirroring to obtain the virtual optimal symmetric face (S). Different linear and angular measurements were then calculated for comparison of the mean T0 and mean T1 models. Results: In L cephalograms an increase of posterior facial height and a normalization of overjet and overbite were observed. Comparing the PA measurements between T0 and T1, normalization of maxillo-mandibular dental midline alignment and of occlusal plane tilt, and a great improvement of lateral deviation of the chin were observed. The comparison of measurements of the cutaneous landmark distances on T0 and T1 revealed that the major postsurgical changes were in the lower face. In the frontal view an improvement of symmetry of the nasal base and an important correction of the lips, both vertically and horizontally, were observed. Increased support of the lips and increase of the inter-commissural distance were also shown. Residual defects were documented in the postoperative symmetry of the chin. Conclusion: Orthognathic surgery performed for the treatment of facial asymmetry, combined with dental occlusion problems, is still a challenge for maxillo-facial surgeons. Orthognathic surgery can give an important improvement of the facial asymmetry, but further changes of techniques are still possible. 3D evaluation results an effective method to support outcome studies on the surgical correction of complex facial deformities.
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