Lip morphology changes following orthognathic surgery for class III malocclusion

Objectives: To test the hypothesis that there is no difference in the morphology of the lips and to determine the degree of improvement in the smile after orthognathic surgery for Class III malocclusion. Materials and Methods: The sample subjects included 30 adult female patients with dentoskeletal Class III malocclusion and 28 adult female volunteers with normal occlusion. Frontal facial photographs were taken before and after treatment, and 35 landmarks were placed on each tracing made from the frontal facial photograph. Thereafter, the landmarks were digitized into an x and y coordinate system with the subnasal point as the origin. The pretreatment rest and smile conditions were compared with the posttreatment conditions, respectively, using paired t-tests. In addition, two sample t-tests were used to test for differences between groups. Results: Both the upper and lower lips in the smiles of the Class III pretreatment group were positioned downward, and the upward movement of the upper lip and commissure points were smaller compared with the control group. When smiling, the horizontal direction of the mouth corners was statistically significantly different between the pretreatment and posttreatment conditions, whereas these were wider in the posttreatment than in the pretreatment conditions. These characteristics of the Class III smile improved after orthognathic treatment, but the differences with the control group remained unchanged immediately after treatment. Conclusion: The hypothesis is rejected. The soft tissue morphology of patients with dento-skeletal Class III malocclusion shows a significant improvement after orthognathic surgery. (Angle Orthod 2010;80:344-353.).