Author(s): Johns FR, Johnson PC, Buckley MJ, Braun TW, Close JM
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Abstract PURPOSE: Determine changes in facial movement while smiling after maxillary Le Fort I osteotomies. MATERIALS AND METHODS: Twenty patients (ages 15 to 38) treatment-planned for maxillary Le Fort I osteotomies were divided into two groups. Group A consisted of 10 patients who underwent superior and/or posterior positioning of the maxilla. Group B consisted of 10 patients who underwent anterior and/ or inferior repositioning of the maxilla. All patients underwent preoperative and postoperative (3 to 8 months) videographic analysis of a maximal closed mouth smile by the Johnson Maximal Static Response Assay, evaluating four landmarks around the mouth and nose (alar base--A, cheilion--C, labrale superioris--Ls, and intermediate between cheilion and labrale superioris--Im). RESULTS: Group A was noted to have a statistically significant decrease in movement of the face at points C and Im. No significant change was seen for points Ls and A. Group B was noted to have a statistically significant increase in movement of the face at point A, C, and Im. Point Ls was also found to increase, however not significantly. CONCLUSION: Surgical repositioning of the maxilla anteriorly and/or inferiorly lengthens the facial musculature resulting in an increase in facial movement while smiling. Likewise surgically repositioning the maxilla superiorly and/or posteriorly reduces the length of the facial musculature, resulting in a decrease in facial movement while smiling.
This article was published in J Oral Maxillofac Surg
and referenced in Cosmetology & Oro Facial Surgery