Alterações no perfil facial em pacientes submetidos à cirurgia ortognática

Abstract

Changes in maxillary mandibular segments are performed only after prediction of surgical movements through cephalometric analysis and expected determination of optimal positioning of hard and soft facial tissues. The objective of this study was to evaluate the correlation between the movement of soft tissue in the anteroposterior direction using TVL as reference in patients submitted to orthognathic surgery. The sample consisted of analyzing 54 radiographs of 27 patients (09 males and 18 females) with a mean age of 29 years. Imaging studies were performed before and 6 months after orthognathic surgery. Nine points (PALS, PALI, Pg ', EST, PA, PB, Pg, PAICS and PAICI) were labeled and measured against TVL using a Meazure 2.0 software. Males, although representing 33.3% of our sample, had more significant movements comparing pre and post (PALI - LVV, PAICI - LVV, PALI - EST, p <.005) in relation to the female sex. Changes in the PAICI do not significantly change the PALS projections (ƥ =, 232; p =, 244), but significantly change the position of the PAICS (ƥ =, 546; p =, 003) and PALI (ƥ =, 502 ; P = 0.008). Changes in PAICS caused significant changes in the lower third in points such as PB (ƥ =, 462, p =, 015), PALI (ƥ =, 383; p =, 049), Pg '(ƥ =, 498; ), Pg (ƥ =, 426, p =, 027) and PAICI (ƥ =, 667, p <.001). Already higher mean soft tissue movement was the thickness of the lower lip (PALI - EST) with 1.14 mm of movement (p <0.05). The greatest change in movement recorded for the lower lip thickness was in a mandibular advancement of 5.9 mm along with a maxillary recoil of 4.5 mm. The ratio of mandibular and maxillary movement to this point is 1: 0.65 and 1: 0.3, respectively. For the hard tissue PAICI obtained the highest mean of movement in relation to LVV, being: 1.37mm (p =, 163). Therefore, it is concluded that the lower lip thickness does not accompany significant changes in the projection of the lower and upper lips. Movements in the PAICI do not significantly alter the PALS projections, but change the position of the PAICS. Movements in PAICS cause more significant alterations in the lower third and to make evaluations of predictions of soft tissue points it is necessary to evaluate at least three correlated points in the same segment.