Evaluation of soft and hard tissue changes before and after bimaxillary Lefort 1 advencement and bilateral Sagittal Split ramus osteotomy setback in orthognathic surgery patients

Maxillomandibular deformities can be corrected by applying orthognathic surgery operations in cooperation with orthodontics. Bimaxillary LeFort 1 and Bilateral Sagittal Split Ramus osteotomies are frequently used in Angle class III malocclusions. When the literature review is made, many studies evaluating relapse, stabilization and hard and soft tissue changes in orthognathic surgical procedures attract attention. This study was conducted in Gazi University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery between the years 2013-2017. The changes in the hard tissues of 45 class III patients operated by the same surgeon and the effects of these changes on the soft tissue through measurements made before the operation, after the operation and 6th month films. All patients included in the study underwent bimaxillary LeFort 1 maxillary advancement and mandibular setback with Bilateral Sagittal Split Ramus Osteotomy. In the study, 30 parameters of the preoperative, postoperative and 6th months were analyzed with the Dolphin system, and in addition, relapse amounts and rates were obtained by overlapping on cephalometric films. As a result of the completed examinations, it was observed that an aesthetic appearance and functional status were obtained in all patients. The average movement amount in the maxilla was measured as 3.4 mm and the average relapse was 0,6 mm. In the mandible, it was found that an average of 4,2 mm movement and 0,5 mm relapse were observed. These values indicate that 17% in maxilla and 12% relapse occurred in the mandible. When the measurements made both over the Dolphin system and using the overlap were compared with the literature, a similarity was observed with the data obtained from the studies. In orthognathic surgical procedures, hard and soft tissues should be considered as a whole and it should not be forgotten that relapse is inevitable. When evaluating these patients, the first goal should be to provide the patient with a long-term aesthetic and functional condition. Both the orthodontist and the surgeon should know the end of the operation and any possible changes in the long term before the operation. Thus, we can both enlighten our patients in the light of this information and take the necessary steps to prevent possible complications and relapses.