Evaluation of soft tissue profile changes around the nose and upper lip following maxillary anterior alveolar osteotomy with Wassmund and Wunderer technique in Japanese - 04/10/24

Doi : 10.1016/j.jormas.2024.102101

Hisashi Ozaki ^a,^b,^⁎ , Hiroki Mori ^a,^b, Morihiko Takashima ^a,^c, Satoshi Kurokawa ^a, Erika Miyamoto ^a, Daisuke Kobayashi ^a, Yuichiro Imai ^a,^c, Yoshihiko Yokoe ^a,^b
^a Department of Oral and Maxillofacial Surgery, Kyoto Oral Health Care Center, Rakuwakai Otowa Hospital, 2 Otowachinji-cho, Yamashina-ku, Kyoto-shi, Kyoto, Japan
^b Kyoto Jaw Deformity Center, Rakuwakai Otowa Hospital, 2 Otowachinji-cho, Yamashina-ku, Kyoto-shi, Kyoto, Japan
^c Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijyou-cho, Kashihara-shi, Nara, Japan

^⁎Corresponding author at: Department of Oral and Maxillofacial Surgery, Kyoto Oral Health Care Center, Rakuwakai Otowa Hospital, 2 Chinji-machi, Yamashina-ku, Kyoto 607-8062, Japan.Department of Oral and Maxillofacial SurgeryKyoto Oral Health Care CenterRakuwakai Otowa Hospital2 Chinji-machi, Yamashina-kuKyoto607-8062Japan

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Highlights

•	WW technique allows for retraction of the upper lip area with minimal nasal changes.
•	Positioning of the maxillary anterior teeth is an important key factor.
•	This study was investigated with a larger number of cases (N=37) than past reports.

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Abstract

Purpose

The extent to which maxillary anterior alveolar osteotomy alters the facial profile remains unclear. The present study retrospectively analyzed and evaluated changes in maxillary anterior fragments and soft tissue from the nose to upper lip from pre- to postoperatively in patients who underwent the Wassmund and Wunderer (WW) technique.

Methods

Thirty-seven Japanese patients with maxillary prognathism underwent orthognathic surgery with the WW technique were retrospectively included in the present study. Changes in both hard- and soft-tissue landmarks and correlations between both tissues were evaluated using lateral cephalograms taken immediately before and ≥6 months after orthognathic surgery.

Results

The maxillary anterior segment showed predominantly posterior movement, with only slight upward movement. Posterior shift and lingual inclination of the maxillary anterior teeth were prominent. As for soft tissues, the change in the nasal tip was small and posterior change was large in the subnasal and upper lip areas. Nasolabial angle, nasal height, and inclination of nasal tip increased, while upper lip protrusion, nasal tip angle, and philtrum length decreased. Correlations were found between posterior changes in hard tissues and posterior changes in soft tissues. Among these, posterior changes and lingual inclination of the maxillary anterior teeth strongly correlate with posterior changes of the upper lip.

Conclusion

Posterior shift of the maxillary anterior segment using the WW technique is useful because it can greatly improve the protrusion of the upper lip while minimizing nasal morphological changes, and the positioning of the maxillary anterior teeth may be an important key factor.

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Keywords : Maxillary anterior alveolar osteotomy, Wassmund and Wunderer technique, Maxillary prognathism, Orthognathic surgery