title: Soft tissue response to mandibular advancement and genioplasty.
abstract: Changes in facial esthetics after orthognathic surgery should be predictable if the results are to be satisfactory. The skeletal elements are moved in a planned and controlled manner, but the soft tissue drape is not as precisely managed. This study was on 31 patients who had undergone a mandibular advancement by means of a sagittal split osteotomy, 17 of whom had also received an advancement genioplasty and 6 received a maxillary impaction. The results showed a consistent 1:1 ratio of soft to hard tissue advancement at pogonion and B point, and that predictions could be accurate in both anteroposterior and vertical directions. When a genioplasty was added to the advancement, however, the results were much less consistent. The mean ratio was 0.9:1 of soft tissue to skeletal movement at pogonion, but the average difference between hard and soft tissue movement was +/- 2.6 mm. Thus the prediction of anteroposterior soft tissue changes was quite inaccurate. Changes in the vertical dimension were also more marked in the genioplasty group. The lower lip also showed a variable response, particularly in the genioplasty group, where the mean ratio was 0.5 mm lip advancement per 1.0 mm skeletal change, but again a range of 4.0 mm in either direction. There were no meaningful changes 1 year after surgery.
authors.affiliation: Faculty of Dentistry, University of Toronto, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Ewing
authors.forename: R B
authors.initials: RB
authors.lastname: Ross
mesh_terms: D000293:Adolescent; D000328:Adult; D002508:Cephalometry; D002648:Child; D002680:Chin / Q000473:pathology / Q000601:surgery*; D005145:Face; D006801:Humans; D008046:Lip / Q000473:pathology; D008137:Longitudinal Studies; D008310:Malocclusion / Q000601:surgery; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D014716:Vertical Dimension