Morphological changes of cheek soft tissue due to orthognathic surgery of maxillary advancement, rotation, and mandibular setback

Objective

This study evaluated the changes in cheek soft tissue after orthognathic surgery using facial photographs and cephalograms. Cheek soft tissue was defined as the cheek line, which is the contour of the cheek starting from the infraorbital region and continuing to the corners of the mouth on a lateral photograph.

Methods

Seventy-eight Japanese patients (48 females and 30 males) with skeletal class III underwent maxillary advancement, clockwise rotation, and mandibular setback. The changes in cheek size and the position of the cheek points on the cheek line after orthognathic surgery were examined experimentally using a previously proposed image analysis software program.

Results

The maxillary advancement was 4.4 mm, the clockwise rotation was 2.8 mm, and the mandibular setback was 4.4 mm, and there was no significant sex difference in skeletal movement. The ratio of change in cheek size increased (mean 2.7) and showed an anterior change at the points on the cheek line. The change in cheek point showed a significant sex difference; the upper cheeks were more advanced in males. Cheek changes were positively correlated only with maxillary advancement, and the upper cheek points in men was also showed a correlation.

Conclusion

Orthognathic surgery for skeletal class III affected cheek bulge, and maxillary advancement had a greater effect on the cheek line. There were sex differences in the postoperative changes in the cheek line, with the changes in the cheek contour in females increasing radially, whereas the changes in males tended to be similar to skeletal movement.