Predictability of upper lip soft tissue changes with maxillary advancement. 1989

J P Stella, and M R Streater, and B N Epker, and D P Sinn
Oral and Maxillofacial Surgery Department, John Peter Smith Hospital, Fort Worth, Texas 76104.

To improve predictability of the esthetic (soft tissue) results after maxillary advancement surgery, a better understanding of the relationships between the dental osseous movement and overlying soft tissue response is essential. Twenty-one adult patients who underwent isolated maxillary advancement via LeFort I osteotomies without adjunctive nasal soft tissue procedures and/or V-Y closure of the vestibular incision were studied. Homogeneity of the patient population was ensured by selecting cases with less than 2 mm vertical change. The mean maxillary advancement and mean change in Sn was calculated for these 21 patients. Additionally, the 21 patients were subdivided into two groups based on lip thickness: group 1 (lips between 10 and 17 mm thick) and group 2 (greater than 17 mm thick). In each patient group a linear regression (LR) was determined on the magnitude of maxillary advancement (MMA) to the change in soft tissue subnasale (Sn) and on the ratio of Sn change to bone move. The results using mean data showed that the relationships produce significantly high standard deviations; thus, a general correlation between change in soft tissue position to bony advancement cannot be made. Individuals with thin lips (12 to 17 mm) had a good correlation between the magnitude of bony move and amount of soft tissue change. However, increased lip thickness (greater than 17 mm) produced a less predictable correlation between soft and hard tissue changes. All lips thinned around 2 mm when compared with preoperative values. Lip thickness stabilized at approximately 6 months postoperatively.

UI MeSH Term Description Entries
D008046 Lip Either of the two fleshy, full-blooded margins of the mouth. Philtrum,Lips,Philtrums
D008437 Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the ORBIT, and contains the MAXILLARY SINUS. Maxillae,Maxillary Bone,Bone, Maxillary,Bones, Maxillary,Maxillary Bones,Maxillas
D010027 Osteotomy The surgical cutting of a bone. (Dorland, 28th ed) Osteotomies
D002508 Cephalometry The measurement of the dimensions of the HEAD. Craniometry
D004954 Esthetics The branch of philosophy dealing with the nature of the beautiful. It includes beauty, esthetic experience, esthetic judgment, esthetic aspects of medicine, etc. Aesthetics
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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