Bimaxillary surgery in Class III malocclusion: soft and hard tissue changes.

The aim of this study was to quantify anteroposterior facial soft tissue changes with respect to underlying skeletal movements after Le Fort I maxillary advancement and mandibular setback surgery with sagittal split osteotomy in Class III skeletal deformity by using lateral cephalograms taken before and after the operation. The material consisted of 31 patient (15 female, 16 male cases, mean age was 26.7 ± 2.5 years) with Class III skeletal deformity. All patients were treated by Le Fort I maxillary advancement and mandibular setback surgery with sagittal split osteotomy. Lateral cephalograms were taken before and 1.4 ± 0.3 years after surgery. Wilcoxon test was used to compare the pre- and post-surgical measurements. Pearson correlation test was used to compare the relationships between the skeletal, dental and facial soft tissue changes. In the maxilla, the APOINTAP (the anteroposterior position of A point) and ITIPAP (the anteroposterior position of upper incisor) showed significant protractions (-3.19 ± 3.63, and -3.19 ± 4.52, p < 0.01). In the mandible, the L1TIPAP (the anteroposterior position of lower incisor, -3.20 ± 5.83, p < 0.01), L1TIPSI (the superoinferior position of lower incisor, -2.43 ± 10.31, p < 0.05), BPOINTSP (the superoinferior position of B point, -2.28 ± 12.51, p < 0.05) and BPOINTAP (the anteroposterior position of B point, -3.19 ± 9.31, p < 0.01) showed significant retractions and upper positions after bimaxillary surgery. The insignificant decrease in soft tissue Pog-Vert distance was correlated the significant upper position of B point and lower incisor (r: 0.851, p < 0.001 and r: 0.842, p < 0.001).