title: Soft tissue changes and its stability as a sequlae to mandibular advancement.
abstract: OBJECTIVE
  To predict the changes and evaluate the stability that occurs in the soft tissues following the skeletal movement subsequent to surgical advancement of the mandible through bilateral sagittal split osteotomy and to provide the patient reliable information with regard to esthetic changes that can be expected following the treatment.
  
  
  METHODS
  Twenty adult patients diagnosed with skeletal class II malocclusion and underwent bilateral sagittal split osteotomy for mandibular advancement by a mean of 8 mm using rigid fixation were included in the study. Soft tissue changes brought about by the surgical procedure and their stability over a period of time were evaluated prospectively using 12 linear (4 vertical and 8 horizontal) and 4 angular measurements on profile cephalograms which were taken preoperatively after the pre-surgical orthodontics (T1) and postoperatively with duration of 1 month (T2) and 6 months (T3) respectively.
  
  
  RESULTS
  It was observed that compared to the linear measurements, the angular measurements showed significant changes. The improvement in the esthetic outcome is a direct reflection of the angular changes whereas the linear changes played a contributing role. Following mandibular advancement surgery the profiles of the patients was perceived to have improved with reduction in the facial convexity, an increase in the lower facial height, decrease in the depth of the mentolabial sulcus and improvement in the lip competency with lengthening, straightening and thinning of the lower lip.
  
  
  CONCLUSIONS
  The soft tissue response and its stability depends on the stability of the surgical procedure itself, postsurgical growth and remodeling of the hard tissues and soft tissue changes as a result of maturation and aging.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Andhra Pradesh, India.
authors.forename: Uday Kiran
authors.initials: UK
authors.lastname: Uppada
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Andhra Pradesh, India.
authors.forename: Ramen
authors.initials: R
authors.lastname: Sinha
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Andhra Pradesh, India.
authors.forename: D Sreenatha
authors.initials: DS
authors.lastname: Reddy
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Andhra Pradesh, India.
authors.forename: Dushyanth
authors.initials: D
authors.lastname: Paul
keywords: Bilateral sagittal split ramus osteotomy; orthognathic maxilla; profile cephalogram; retrognathic mandible