title: Soft tissue response in orthognathic surgery patients treated by bimaxillary osteotomy: cephalometry compared with 2-D photogrammetry.
abstract: OBJECTIVE
  Since improvement of facial aesthetics after orthognathic surgery moves increasingly into the focus of patients, prediction of soft tissue response to hard tissue movement becomes essential for planning. The aim of this study was to assess the facial soft tissue response in skeletal class II and III patients undergoing orthognathic surgery and to compare the potentials of cephalometry and two-dimensional (2-D) photogrammetry for predicting soft tissue changes.
  
  
  METHODS
  Twenty-eight patients with class II relationship and 33 with class III underwent bimaxillary surgery. All subjects had available both a traced lateral cephalogram and a traced lateral photogram taken pre- and postsurgery in natural head position (median follow-up, 9.4 ± 0.6 months).
  
  
  RESULTS
  Facial convexity and lower lip length were highly correlated with hard tissue movements cephalometrically in class III patients and 2-D photogrammetrically in both classes. In comparison, cephalometric correlations for class II patients were weak. Correlations of hard and soft tissue movements between pre- and postoperative corresponding landmarks in horizontal and vertical planes were significant for cephalometry and 2-D photogrammetry. No significant difference was found between cephalometry and 2-D photogrammetry with respect to soft to hard tissue movement ratios.
  
  
  CONCLUSIONS
  This study revealed that cephalometry is still a feasible standard for evaluating and predicting outcomes in routine orthognathic surgery cases. Accuracy could be enhanced with 2-D photogrammetry, especially in class II patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medical Centre Bremen-Mitte, School of Medicine, University of Göttingen, Bremen, Germany. janrustem@gmx.de
authors.forename: Jan
authors.initials: J
authors.lastname: Rustemeyer
authors.forename: Alice
authors.initials: A
authors.lastname: Martin
mesh_terms: D000328:Adult; D002508:Cephalometry; D004954:Esthetics; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery*; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D063166:Maxillary Osteotomy / Q000379:methods*; D057909:Orthognathic Surgery / Q000379:methods*; D010780:Photogrammetry; D011183:Postoperative Complications / Q000175:diagnosis; D015203:Reproducibility of Results; D016896:Treatment Outcome; D055815:Young Adult