Comparison of soft‑tissue changes in simultaneous maxillomandibular distraction with mandibular distraction with second‑stage maxillary osteotomy.
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Date
2016-11
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Abstract
Background: The purpose of this study was to compare the frontal lip cant changes in common
facial asymmetry (FA) cases after simultaneous maxillomandibular distraction osteogenesis (DO)
and mandibular DO with maxillary orthognathic surgery.
Materials and Methods: Retrospective analysis of FA cases at tertiary craniofacial referral
was performed. Patients of either gender with all medical imaging records and pre‑ and
post‑operative (1 year) facial photographs in natural head position were included in the study.
The lip cant change was assessed by the ratio of the linear dimension between affected and
unaffected side labial commissures and the bi‑pupillary reference line. Difference between the
pre‑ and post‑operative ratio was analyzed. Statistical analysis was performed for the outcome.
P ≤0.05 was taken as significant.
Results: The mean preoperative measured value of the affected side was 0.845 ± 0.036 while the
postoperative value was 0.95 ± 0.032. The effective change was 0.11 ± 0.044. The postoperative
ratio compared with simultaneous DO case was 0.98 ± 0.06 while that of mandibular distraction
with orthognathic surgery was 0.92 ± 0.08 (P = 0.048). The mean change of the simultaneous
DO case was measured as 0.114 ± 0.041 while the same for the mandibular distraction with
orthognathic surgery was 0.069 ± 0.035 (P = 0.013).
Discussion and Conclusion: The results indicate that the simultaneous DO yields more better
frontal lip cant change between both halves than the mono‑DO with orthognathic surgery. The
mean change is much higher in the simultaneous DO cases indicating a more effective correction
and desired result. The biological reason and lip musculature mechanism behind the response
in both conditions are discussed.
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Keywords
Distraction histiogenesis, internal ramus distraction, maxillary osteotomy, simultaneous distraction, soft - tissue changes
Citation
Balaji S M, Balaji Preetha. Comparison of soft‑tissue changes in simultaneous maxillomandibular distraction with mandibular distraction with second‑stage maxillary osteotomy. Indian Journal of Dental Research. 2016 Nov-Dec; 27(6): 643-647.