Nasolabial esthetics after Le Fort I osteotomy and V-Y closure: a statistical evaluation.
The Le Fort I osteotomy results in predictable long-term effects. The soft tissues, however, can be difficult to control because of considerable variation in their adaptation. Several adverse reactions can take place, including thinning and lateral retraction of the lip, accentuation of the nasolabial groove, reduced vermilion exposure, and increase of the nasolabial angle. In this study on 51 selected patients, the V-shaped wound in the vestibule of the maxilla after the Le Fort I osteotomy was closed with a "Y," with the bast of the "Y" in the midline of the upper lip (V-Y closure). Forward multiple regression analysis was calculated for each bony landmark. Regression equations were formulated if P < .05. The equation with the bony point with the highest r2 value was considered the most important independent variable. The selected independent variables were used to form 4 subgroups with identical vectors of movements: impaction, advancement, impaction and advancement, and dorsal impaction. In these 4 subgroups, forward multiple regression analysis was used to select equations with the highest r2 value (P < .05). The selected equations demonstrated that a V-Y plasty as single soft tissue procedure suffices only in advancement cases, and only if the nose does not need additional upward rotation. In the other 3 subgroups, additional procedures are necessary, such as alar cinch suture, reduction of the anterior nasal spine, or grinding of the paranasal area in order to prevent the above-mentioned adverse soft tissue changes.
Rosenberg
Antoine
A
University Medical Center Utrecht, Department of Oral-Cranio-Maxillofacial Surgery, The Netherlands. aj.rosenberg@wanadoo.nl
Muradin
Marvick S M
MS
van der Bilt
Andries
A
D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D001864:Bone Wires; D002508:Cephalometry; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D008046:Lip / Q000473:pathology*; D008047:Lip Diseases / Q000209:etiology; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D008443:Maxillary Sinus / Q000601:surgery; D009068:Movement; D009295:Nasal Bone / Q000601:surgery; D009666:Nose / Q000473:pathology* / Q000601:surgery; D009668:Nose Diseases / Q000209:etiology; D019340:Osteotomy, Le Fort / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012399:Rotation; D013100:Sphenoid Bone / Q000601:surgery; D013524:Surgical Flaps / Q000009:adverse effects / Q000706:statistics & numerical data*; D013536:Suture Techniques