title: Three-dimensional morphometric analysis of mandibule in coronal plane after bimaxillary rotational surgery.
abstract: BACKGROUND
  The aim of this report is to present a new reference for aesthetic mandible surgery using three-dimensional cone-beam computed tomography-based treatment planning for orthognathic surgery which can be implemented in surgical planning and perioperative procedure.
  
  
  METHODS
  To make an objective standard for evaluating aesthetic mandibular outline, we make an aesthetic scoring criteria with consideration of asymmetry, broad mandibular border line, and prominent mandibular angle. Two maxillofacial surgeons and two orthodontists rated their aesthetical evaluation from 1 to 5. Experimental group consisting of 47 female and 38 male patients who had rotational orthognathic two-jaw surgery from 2010 to 2011 were chosen according to aesthetic scoring done by two maxillofacial surgeons and two orthodontists. A high aesthetic score (≥16) means the facial contour is symmetric, with no broad and narrow aesthetic mandible frontal profiles. Control A group consisted of ten female and ten male patients who had no orthognathic surgery experience and low aesthetic score (≤10). Control B group consisted of ten female and ten male patients who had no orthognathic surgery experience and had anaesthetic mandibular frontal profile and a high aesthetic score (≥16). The three-dimensional image of the patient was taken from dental cone-beam CT (DCT) scanning (experimental group and control A group: 6 months DCT after surgery, control B group: 1st visit DCT). Each DCT was reformatted to reorient the 3D image using 3D analyzing program (OnDemand3D, cybermed Inc, CA, USA). After selection of 12 landmarks and the construction of reoriented horizontal, vertical, and coronal reference lines, 15 measurements were taken in 3D analysis of frontal mandibular morphology. Afterwards, horizontal and vertical linear measurements and angular measurements, linear ratio were obtained.
  
  
  RESULTS
  Mean Go'Rt-Me'-Go'Ltangular measurement was 100.74 ± 2.14 in female patients and 105.37 ± 3.62 in male patients. These showed significant difference with control A group in both genders. Ratio of Go'Rt,Go'Lt-Me' length to some linear measurements (ratio of Me'-Cd'RtCd'Ltto Me'-Go'RtGo'Lt, ratio of Me'-Go' to Me'-Go'RtGo'Lt, ratio of Go'Rt-Go'Ltto Me'-Go'RtGo'Lt) showed significant difference with control A group in both genders.
  
  
  CONCLUSIONS
  This study was intended to find some standard measurement of mandible frontal view in 3D analysis of aesthetic patient. So, these potential measurement value may be helpful for orthognathic treatment planning to have more aesthetic and perspective outcomes.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, 626-870 Korea.
authors.forename: Sung-Tak
authors.initials: ST
authors.lastname: Lee
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, 626-870 Korea.
authors.forename: Na-Rae
authors.initials: NR
authors.lastname: Choi
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, 626-870 Korea.
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Song
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, 626-870 Korea.
authors.forename: Sang-Hun
authors.initials: SH
authors.lastname: Shin
keywords: Aesthetic mandibular outline; Frontal reference; Orthognathic surgery; Rotational surgery; V-line