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Influence of maxillary advancement surgery on skeletal and soft-tissue changes in the nose - a retrospective cone-beam computed tomography study.

Hellak AF, Kirsten B, Schauseil M, Davids R, Kater WM, Korbmacher-Steiner HM - Head Face Med (2015)

Bottom Line: Both of these changes were statistically highly significant (P = 0.000).The nasolabial angle declined by an average of -6.65° (±7.71°).This should be taken into account in the treatment approach and in the information provided to patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthodontics, University Hospital, Georg-Voigt-Strasse 3, Marburg, 35039, Germany. hellak@med.uni-marburg.de.

ABSTRACT

Objectives: Surgical correction of skeletal maxillary retroposition is often associated with changes in the morphology of the nose. Unwanted alar flaring of the nose is observed in many cases. The aim of the present study was therefore to investigate the influence of surgical advancement of the maxilla on changes in the soft-tissue morphology of the nose. Having a coefficient that allows prediction of change in the nasal width in Caucasian patients after surgery would be helpful for treatment planning.

Materials and methods: All 33 patients included in this retrospective study were of Caucasian descent and had skeletal Class III with maxillary retrognathia. They were all treated with maxillary advancement using a combination of orthodontic and maxillofacial surgery methods. Two cone-beam computed tomography (CBCT) datasets were available for all of the study's participants (16 female, 17 male; age 24.3 ± 10.4 years): the first CBCT imaging was obtained before the planned procedure (T0) and the second 14.1 ± 6.4 months postoperatively (T1). Morphological changes were recorded three-dimensionally using computer-aided methods (Mimics (Materialise NV, Leuven/Belgium), Geomagic (Geomagics, Morrisville/USA)). Statistical analysis was carried out using SPSS 21 for Mac.

Results: The mean sagittal advancement of the maxilla was 5.58 mm. The width of the nose at the alar base (Alb) changed by a mean of + 2.59 mm (±1.26 mm) and at the ala (Al) by a mean of + 3.17 mm (±1.32 mm). Both of these changes were statistically highly significant (P = 0.000). The increase in the width of the nose corresponded to approximately half of the maxillary advancement distance in over 80 % of the patients. The nasolabial angle declined by an average of -6.65° (±7.71°).

Conclusions: Maxillary advancement correlates with a distinct morphological change in nasal width. This should be taken into account in the treatment approach and in the information provided to patients.

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Related in: MedlinePlus

The user interface in Geomagic Control after completion of the superimposition of the cone-beam computed tomograms from T0 and T1. The colors diverge from green to show the skeletal changes
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Fig3: The user interface in Geomagic Control after completion of the superimposition of the cone-beam computed tomograms from T0 and T1. The colors diverge from green to show the skeletal changes

Mentions: For measurement of the skeletal repositioning of the maxilla, the CBCT for T0 and T1 were superimposed using Geomagic Control 2014.0 (Geomagics, Morrisville, USA). Superimposition was carried out at the foramen magnum with surrounding bone and at the anterior skull base at 100,000 polygons [34, 35] (Fig. 2). Figure 3 shows the user interface in Geomagic Control after completion of the superimposition. A level parallel with the Frankfurt plane was placed through the A point (Fig. 4). At this level, individual measurement values were collected in regions 13, 11, 21, and 23 in the needle view, and a mean was calculated (Fig. 5). The calculated repositioning of these points represents the skeletal advancement of the maxilla. All of the measurements were repeated by the same operator after an interval of 2 weeks.Fig. 2


Influence of maxillary advancement surgery on skeletal and soft-tissue changes in the nose - a retrospective cone-beam computed tomography study.

Hellak AF, Kirsten B, Schauseil M, Davids R, Kater WM, Korbmacher-Steiner HM - Head Face Med (2015)

The user interface in Geomagic Control after completion of the superimposition of the cone-beam computed tomograms from T0 and T1. The colors diverge from green to show the skeletal changes
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4495703&req=5

Fig3: The user interface in Geomagic Control after completion of the superimposition of the cone-beam computed tomograms from T0 and T1. The colors diverge from green to show the skeletal changes
Mentions: For measurement of the skeletal repositioning of the maxilla, the CBCT for T0 and T1 were superimposed using Geomagic Control 2014.0 (Geomagics, Morrisville, USA). Superimposition was carried out at the foramen magnum with surrounding bone and at the anterior skull base at 100,000 polygons [34, 35] (Fig. 2). Figure 3 shows the user interface in Geomagic Control after completion of the superimposition. A level parallel with the Frankfurt plane was placed through the A point (Fig. 4). At this level, individual measurement values were collected in regions 13, 11, 21, and 23 in the needle view, and a mean was calculated (Fig. 5). The calculated repositioning of these points represents the skeletal advancement of the maxilla. All of the measurements were repeated by the same operator after an interval of 2 weeks.Fig. 2

Bottom Line: Both of these changes were statistically highly significant (P = 0.000).The nasolabial angle declined by an average of -6.65° (±7.71°).This should be taken into account in the treatment approach and in the information provided to patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthodontics, University Hospital, Georg-Voigt-Strasse 3, Marburg, 35039, Germany. hellak@med.uni-marburg.de.

ABSTRACT

Objectives: Surgical correction of skeletal maxillary retroposition is often associated with changes in the morphology of the nose. Unwanted alar flaring of the nose is observed in many cases. The aim of the present study was therefore to investigate the influence of surgical advancement of the maxilla on changes in the soft-tissue morphology of the nose. Having a coefficient that allows prediction of change in the nasal width in Caucasian patients after surgery would be helpful for treatment planning.

Materials and methods: All 33 patients included in this retrospective study were of Caucasian descent and had skeletal Class III with maxillary retrognathia. They were all treated with maxillary advancement using a combination of orthodontic and maxillofacial surgery methods. Two cone-beam computed tomography (CBCT) datasets were available for all of the study's participants (16 female, 17 male; age 24.3 ± 10.4 years): the first CBCT imaging was obtained before the planned procedure (T0) and the second 14.1 ± 6.4 months postoperatively (T1). Morphological changes were recorded three-dimensionally using computer-aided methods (Mimics (Materialise NV, Leuven/Belgium), Geomagic (Geomagics, Morrisville/USA)). Statistical analysis was carried out using SPSS 21 for Mac.

Results: The mean sagittal advancement of the maxilla was 5.58 mm. The width of the nose at the alar base (Alb) changed by a mean of + 2.59 mm (±1.26 mm) and at the ala (Al) by a mean of + 3.17 mm (±1.32 mm). Both of these changes were statistically highly significant (P = 0.000). The increase in the width of the nose corresponded to approximately half of the maxillary advancement distance in over 80 % of the patients. The nasolabial angle declined by an average of -6.65° (±7.71°).

Conclusions: Maxillary advancement correlates with a distinct morphological change in nasal width. This should be taken into account in the treatment approach and in the information provided to patients.

Show MeSH
Related in: MedlinePlus