CHANGES IN FACIAL MOVEMENT AFTER MAXILLARY OSTEOTOMIES

Purpose: Determine changes in facial movement while smiling after maxi llary Le Fort I osteotomies. Materials and Methods: Twenty patients (a ges 15 to 38) treatment-planned for maxillary Le Fort I osteotomies we re divided into two groups. Group A consisted of 10 patients who under went superior and/or posterior positioning of the maxilla. Group B con sisted of 10 patients who underwent anterior and/ or inferior repositi oning of the maxilla. All patients underwent preoperative and postoper ative (3 to 8 months) videographic analysis of a maximal closed mouth smile by the Johnson Maximal Static Response Assay, evaluating four la ndmarks around the mouth and nose (alar base-A, cheilion-C, labrale su perioris-Ls, and intermediate between cheilion and labrale superioris- lm). Results: Group A was noted to have a statistically significant de crease in movement of the face at points C and Im. No significant chan ge was seen for points Ls and A. Group B was noted to have a statistic ally significant increase in movement of the face at point A, C, and i m. Point Ls was also found to increase, however not significantly. Con clusion: Surgical repositioning of the maxilla anteriorly and/or infer iorly lengthens the facial musculature resulting in an increase in fac ial movement while smiling. Likewise surgically repositioning the maxi lla superiorly and/or posteriorly reduces the length of the facial mus culature, resulting in a decrease in facial movement while smiling.