Preoperative Anatomical Variables Affecting the Outcome of Surgical Correction in Class III Face Asymmetry

Abstract

Objective: The study investigated the preoperative anatomical variables that affect the outcome of surgical correction in patients with Class III facial asymmetry. Methods: The study recruited 37 consecutive patients with facial asymmetry who had 2-jaw orthognathic surgery. They were divided into two groups based on the surgical outcome: symmetrical (S group) or asymmetrical (A group), according to the asymmetry index. The CBCT images were obtained before surgery (T0) and after debond (T1). The 3D dentofacial measurements were compared between groups S and A by the Mann–Whitney test. Spearman correlation analysis was performed to examine the relationship of all dentoskeletal variables in T0 with the facial symmetry outcome. Results: Significant between-group differences were observed in preoperative time, including maxillary anterior occlusal canting, maxillary posterior occlusal canting, the gonion–Frankfort horizontal plane (FHP) distance, the mandibular ramus axis–FHP distances, and sagittal and transverse of condyle position. Conclusions: For patients with severe skeletal Class III asymmetry, preoperative anatomical variables, particularly preoperative “roll” and “yaw” discrepancies and anatomical limitations of the mandible, should be considered for favorable asymmetry correction. Based on the anatomic variables that affect the outcomes of facial asymmetry correction, prognosis and treatment limitation could be predicted before treatment.

Keywords

• virtual surgical planning
• 3D imaging
• oral maxillofacial surgery