Three-dimensional analysis of midfacial soft tissue changes according to maxillary superior movement after horizontal osteotomy of the maxilla.

Three-dimensional diagnostic and treatment planning is a promising means of improving orthognathic surgical results from the standpoint of facial aesthetics. In such planning, cone-beam computed tomography is a useful tool. The purpose of the present study was to evaluate three-dimensional soft tissue changes in the midfacial region, with specific reference to post-Le Fort I osteotomy maxillary superior movement. Twenty-two patients underwent both Le Fort I osteotomy superior impaction and bilateral sagittal split ramus osteotomy of the mandible (ie, double-jaw surgery). Reference planes and 27 × 10 grids were used in evaluating the midfacial soft tissue areas. The extent of soft tissue change before and after surgery was calculated and analyzed. The results showed no statistical difference between the male and female subjects (P > 0.05). For both the male and the female patients after double-jaw surgery, the soft tissue in the triangular area, which includes both the nasolabial grooves and the upper lip, moved in the anterior direction and maxillary superiorly. It is essential that clinicians concerned about the management of soft tissue and the quality of treatment outcomes understand the pattern of soft tissue change after double-jaw surgery.