Fogorvosi szemle, 2021 (114. évfolyam, 1-4. szám)
2021-12-01 / 4. szám
FOGORVOSI SZEMLE 114. évf. 4 . sz. 20 2 1 . 1 6 8 – 1 79. n Érkezett: 2021. március 16. Elfogadva: 2021. április 20. DOI https://doi.org/10.33891/FSZ.114.4.168-179 Introduction It is widely known that deficiencies associated with malocclusion and craniofacial deformities are usually comorbid with cognitive difficulties and psychiatric disorders. Therefore, it is important to consider the adaptation of soft tissue and its contours during treatment planning whilst accommodating the limitations presented by the patients’ disabilities [1 , 34 ]. As bimaxillary surgery provides more favourable results for the aesthetic facial proportion, it has been increasingly used, especially in patients with mandibular prognathism [8 , 21 ]. Previous post-operative studies on the soft tissue changes after the bimaxillary surgery were mainly based on the use of two-dimensional (2D) methods as an inspection tool, e.g. cephalometric images, anteroposterior graphs, and photogrammetric analyses [17 , 31 ], in which super imposition and magnification were considered limitations affecting the final results. In the new era of three-dimensional (3D) imaging techniques, we can overcome these disadvantages and utilise more reliable diagnostic tools. Cone-beam computed tomography (CBCT) is highly utilized for soft tissue inspection, although, the high radiation dose should always be taken into consideration [6 , 32 ]. New 3D im aging methods for soft tissue visualization, such as laser surface scanning and stereophotogrammetry, have recently been introduced [10 ]. These friendly, non-inva sive procedures require a short scanning time; however they are large footprint and are not easy to operate. Using a structured-light scanning device, facial texture and colour details can be easily collected with high resolution without exposure to the external radiation hazards [3 ], and is benefited by fast scanning time, portabil ity, and flexible operability [30 ]. To our knowledge, there were only a few studies that used a 3D-facial scanner to evaluate the soft tissue changes after the orthognathic surgery of skeletal class III patients. Nevertheless, only some examined deviations at specific points or calculated linear and angular measurements [7 , 29 ]. Such finding may be improved by evaluating facial regions on a 3D-basis assessment. Therefore, the purpose of our prospective study is to perform an extensive evaluation of the short-term soft tissue changes in various morphological regions of the face after the bimaxillary surgery of skeletal class III patients using a 3D handheld structured-light scanner. University of Szeged, Faculty of Medicine, Department of Oral & Maxillofacial Surgery, Craniofacial Unit, Hungary* University of Szeged, Faculty of Medicine, Department of Oral & Maxillofacial Surgery, Hungary** Three-dimensional changes of the facial soft tissue after bimaxillary surgery of skeletal class III patients: a prospective study DR. ALKHAYER ALI* DR. PIFFKÓ JÓZSEF ** DR. SEGATTO EMIL * Soft tissue adaptation and contours are of paramount importance in the design of orthognathic surgeries. The aim of our study was to investigate the use of three-dimensional handheld structured-light scanners for an extensive evaluation of the post-operative soft tissue changes in various morphological regions of the face following the bimaxillary surgery of skeletal class III patients. Our study sample consisted of 12 patients (6 males and 6 females) with mean age of (22 ± 2.17 years), with skeletal class III malocclusion, all which required bimaxillary osteotomy as the second step of their comprehensive treatment. The three-dimensional facial images were acquired one week before surgery (T0 ), and there after, 6 months after surgery (T1 ), using a 3D-handheld structured light scanner. Linear and angular measurements were recorded and compared. Three-dimensional deviation analyses were done for the 7 morphological regions of the face. Based on obtained results, we found statistically significant increases in the nasal and the nasal base widths, the nasal tip angle, the upper lip height, and the lower lip angle; significant decreases in the lower lip height and the inter-labial angle were also found. The three-dimensional soft tissue changes after the bimaxillary surgery of skeletal class III patients were observed in majority of the facial regions, with the most significant ones found in the middle third of the face, the nose, and the upper lip areas. These findings must be taken into account during treatment planning. Keywords: Orthognathic Surgery, class III malocclusion, Facial Soft tissue, Three-Dimensional Imaging Original article
