Journal of Research and Advancement in Dentistry
Official publication of Magadh University and Kolhan University, Government of Bihar and Jharkhand, India
Official publication of Magadh University and Kolhan University, Government of Bihar and Jharkhand, India
Year : 2016
Volume : Volume 6
Issue : Issue 1
Address for correspondence :
Dr. Varalakshmi Chandaveni
varalakshmichandaveni@gmail.com
Background: In earlier days, the primary visual aid in discussing treatment with patients was a set of dental casts, the focus almost had to be on how the teeth fit. But as the facial esthetics became an integral part, cephalometric prediction of treatment outcomes has became a necessary part of planning orthognathic surgery for adults Aim: The aim of this study was to determine the accuracy of pre surgical cephalometric prediction methods to estimate post surgical changes in hard and soft tissues. Materials and methods: Study included 15 adult patients with age range of 15-24 yrs, mean age of 19.8 yrs. Presurgical decompensation followed by bilateral sagittal split osteotomy was performed on all subjects under the supervision of a single surgeon. Post surgical cephalograms were taken two months following surgery. For estimating the amount of hard and soft tissue changes LEGAN BURSTONE,STEINER’S, Mcnamara and RICKETTS cephalometric analysis were performed. Prediction tracing as given by PROFFIT and WHITE, LEWARD C. FISH and BRUCE N.EPKER were employed. The accuracy of prediction tracings were evaluated by a superimposition method with Basion- Nasion registered at CC point as described by RICKETTS. The horizontal and vertical discrepancy between the prediction tracings and post surgical tracings was measured and compared using paired t- test to evaluate the hard and soft tissue changes. Results: Hard tissue cephalometric measurements showed a mean relapse of 2mm and an increase of anterior face height by 1.2 mm. Angular and linear parameters of the soft tissues were in good concordance with the prediction except for the soft tissue chin thickness which did not move with the hard tissue pogonion in 1:1 ratio. The mandibular plane angle and gonial angle showed significant increase post surgically. Conclusion: Simple overlay tracing method will assist the orthodontist, surgeon and patient in estimating post treatment effects. However, caution must be exercised in estimating soft tissue changes and relapse tendency in these individuals.
Keywords: Pre surgical decompensation, Orthognathic surgery, Bilateral sagittal split osteotomy, cephalometric tracing.
