Assessment of the Effect of Simulated Rhinoplasty and Genioplasty on the Facial Profile Attractiveness of Patients with a Convex Face.

AIM: This study was performed to evaluate the effect of rhinoplasty and genioplasty on facial profile attractiveness assessed by orthodontists and laypersons. MATERIALS AND METHODS: In this study, posttreatment cephalo-grams of 30 class II patients with convex profile and nasal hump who had undergone camouflage treatment were traced. These profile outlines were modified by computer software to simulate rhinoplasty and genioplasty. Then, all these outlines were converted into silhouettes. There were four groups: no modification, rhinoplasty (R), genioplasty (G), and rhinoplasty plus genioplasty (RG). Esthetic assessment of all patients was done by two panels: six orthodontists and six laypersons. Data were analyzed using Friedman's and Wilcoxon's test with a significance level of 0.05. RESULTS: The highest mean esthetics scores belonged to RG (3.9 ± 0.6), followed by R (3.5 ± 0.5), G (2.4 ± 0.5), and the initial image of the patients (2.13 ± 0.5). There was a significant improvement following all surgeries as determined by all evaluators (p < 0.001), except for orthodontists who did not find genioplasty more esthetic than no modification (p = 0.139). The mean score of esthetics by orthodontists was more than laypersons in all groups (p > 0.05). CONCLUSION: Both rhinoplasty and genioplasty improved the attractiveness of the patients' facial profiles. The greatest improvement in the facial profile attractiveness in convex faces was observed after simultaneous nasal hump elimination and chin argumentation procedures. CLINICAL SIGNIFICANCE: Although both rhinoplasty and genioplasty could improve patients' profile, the best result is achieved when combination of them is used for treatment of convex facial profile patients.

Prediction of lip response to orthodontic treatment using a multivariable regression model.

BACKGROUND: This was a retrospective cephalometric study to develop a more precise estimation of soft tissue changes related to underlying tooth movment than simple relatioship betweenhard and soft tissues. MATERIALS AND METHODS: The lateral cephalograms of 61 adult patients undergoing orthodontic treatment (31 = premolar extraction, 31 = nonextraction) were obtained, scanned and digitized before and immediately after the end of treatment. Hard and soft tissues, angular and linear measures were calculated by Viewbox 4.0 software. The changes of the values were analyzed using paired t-test. The accuracy of predictions of soft tissue changes were compared with two methods: (1) Use of ratios of the means of soft tissue to hard tissue changes (Viewbox 4.0 Software), (2) use of stepwise multivariable regression analysis to create prediction equations for soft tissue changes at superior labial sulcus, labrale superius, stomion superius, inferior labial sulcus, labrale inferius, stomion inferius (all on a horizontal plane). RESULTS: Stepwise multiple regressions to predict lip movements showed strong relations for the upper lip (adjusted R (2) = 0.92) and the lower lip (adjusted R (2) = 0.91) in the extraction group. Regression analysis showed slightly weaker relations in the nonextraction group. CONCLUSION: Within the limitation of this study, multiple regression technique was slightly more accurate than the ratio of mean prediction (Viewbox4.0 software) and appears to be useful in the prediction of soft tissue changes. As the variability of the predicted individual outcome seems to be relatively high, caution should be taken in predicting hard and soft tissue positional changes.