Studies of orthognathic surgery often focus on pre-surgical versus post-surgical changes in facial shape. In contrast, this study provides an innovative comparison between post-surgical and control shape. Forty orthognathic surgery patients were included, who underwent three different types of surgical correction: Le Fort I maxillary advancement, bilateral sagittal split mandibular advancement, and bimaxillary advancement surgery. Control facial images were captured from volunteers from local communities in Glasgow, with patterns of age, sex, and ethnic background that matched those of the surgical patients. Facial models were fitted and Procrustes registration and principal components analysis used to allow quantitative analysis, including the comparison of group mean shape and mean asymmetry. The primary characteristic of the difference in shape was found to be residual mandibular prognathism in the group of female patients who underwent Le Fort I maxillary advancement. Individual cases were assessed against this type of shape difference, using a quantitative scale to aid clinical audit. Analysis of the combined surgical groups provided strong evidence that surgery reduces asymmetry in some parts of the face such as the upper lip region. No evidence was found that mean asymmetry in post-surgical patients is greater than that in controls.

Glasgow Dental Hospital and School The University of Glasgow Glasgow UK

Institute of Mathematics and Statistics Masaryk University Brno Czech Republic

School of Dentistry University of Birmingham Birmingham UK

School of Mathematics and Statistics The University of Glasgow Glasgow UK

Zobrazit více v PubMed

Worms F.W., Speidel T.M., Bevis R.R., Waite D.E. Posttreatment stability and esthetics of orthognathic surgery. Angle Orthod. 1980;50:251–273. PubMed

Kim D.S., Huh K.H., Lee S.S., Heo M.S., Choi S.C., Hwang S.J., Yi W.J. The relationship between the changes in three-dimensional facial morphology and mandibular movement after orthognathic surgery. J Craniomaxillofac Surg. 2013;41:686–693. PubMed

Templeton K.M., Powell R., Moore M.B., Williams A.C., Sandy J.R. Are the peer assessment rating index and the index of treatment complexity, outcome, and need suitable measures for orthognathic outcomes. Eur J Orthod. 2006;28:462–466. PubMed

Arad I., Jandu J., Bassett P., Fleming P.S. Influence of single-jaw surgery vs bimaxillary surgery on the outcome and duration of combined orthodontic-surgical treatment. Angle Ortho. 2011;81:983–987. PubMed PMC

Ponduri S., Pringle A., Illing H., Brennan P.A. Peer assessment rating (PAR) index outcomes for orthodontic and orthognathic surgery patients. Br J Oral Maxillofac Surg. 2011;49:217–220. PubMed

Jeremiah H.G., Cousley R.R., Newton T., Abela S. Treatment time and occlusal outcome of orthognathic therapy in the East of England region. J Orthod. 2012;39:206–211. PubMed

Ubaya T., Sherriff A., Ayoub A., Khambay B. Soft tissue morphology of the naso-maxillary complex following surgical correction of maxillary hypoplasia. Int J Oral Maxillofac Surg. 2012;41:727–732. PubMed

Kau C.H., Zhurov A., Richmond S., Cronin A., Savio C., Mallorie C. Facial templates: a new perspective in three dimensions. Orthod Craniofac Res. 2006;9:10–17. PubMed

Hammond P., Hutton T.J., Allanson J.E., Campbell L.E., Hennekam R.C., Holden S., Patton M.A., Shaw A., Temple I.K., Trotter M., Murphy K.C., Winter R.M. 3D analysis of facial morphology. Am J Med Genet A. 2004;126:339–348. PubMed

Zhao X., Dellandréa E., Chen L., Kakadiaris I.A. Accurate landmarking of three-dimensional facial data in the presence of facial expressions and occlusions using a three-dimensional statistical facial feature model. IEEE Trans Syst Man Cybern B Cybern. 2011;41:1417–1428. PubMed

Srivastava A., Samir C., Joshi S.H., Daoudi M. Elastic shape models for face analysis using curvilinear coordinates. J Math Imaging Vis. 2009;33:253–265.

Vittert L, Bowman AW, Katina S. Statistical models for manifold data with applications to the human face. arXiv.org, Cornell University, 2017. arxiv.org/abs/1701.07328.

Landmark IDAV software. Davis, CA: Institute for Data Analysis and Visualization, 2017.

Dryden I.L., Mardia K.V. Wiley; New York: 1998. Statistical shape analysis.

Mardia K.V., Bookstein F.L., Moreton I.J. Statistical assessment of bilateral symmetry of shapes. Biometrika. 2000;87:285–300.

Kent J.T., Mardia K.V. Shape Procrustes tangent projections and bilateral symmetry. Biometrika. 2001;88:469–485.

Klingenberg C.P., Barluenga M., Meyer A. Shape analysis of symmetric structures: quantifying variation among individuals and asymmetry. Evolution. 2002;56:1909–1920. PubMed

Bock M.T., Bowman A.W. On the measurement and analysis of asymmetry with applications to facial modelling. J R Stat Soc Ser C Appl Stat. 2006;55:77–91.

R Core Team . R Foundation for Statistical Computing; Vienna, Austria: 2017. R: A language and environment for statistical computing.

Hoffman G.R., Brennan P.A. The skeletal stability of one-piece Le Fort 1 osteotomy to advance the maxilla: Part 1: Stability resulting from non-bone grafted rigid fixation. Br J Oral Maxillofac Surg. 2004;42:221–225. PubMed

Hoffman G.R., Brennan P.A. The skeletal stability of one-piece Le Fort 1 osteotomy to advance the maxilla: Part 2: The influence of uncontrollable clinical variables. Br J Oral Maxillofac Surg. 2004;42:226–230. PubMed

Hajeer M.Y., Ayoub A.F., Millett D.T. Three-dimensional assessment of facial soft-tissue asymmetry before and after orthognathic surgery. Br J Oral Maxillofac Surg. 2004;42:396–404. PubMed

Functional data analysis and visualisation of three-dimensional surface shape