Preliminary Research on Tongue Morphology Changes in Skeletal Class Ⅲ Patients after Bimaxillary Orthognathic Surgery

doi:10.13701/j.cnki.kqyxyj.2024.12.004

Abstract

Abstract: Objective: To evaluate the changes of tongue morphology in skeletal Class Ⅲ patients after bimaxillary orthognathic surgery, and to explore the relationships between the changes of tongue morphology and the sagittal movement distance of maxilla and mandible. Methods: Thirty-five patients with skeletal Class Ⅲ malocclusion who underwent LeFort I osteotomy and bilateral sagittal split mandibular osteotomy were included in this retrospective study. Spiral CT was collected 1 week before operation (T0), 1 month after operation (T1), and 6-12 months after operation (T2). The tongue position, length, height, area, and volume in oral cavity proper were measured. The data in T0, T1, and T2 were compared. The relationships between the changes of tongue morphology and the sagittal movement distance of maxilla and mandible were analyzed. Results: After orthognathic surgery, the tongue position in oral cavity proper was more backward and upward. The L2, L3, and L4 distance increased significantly at T1 and T2, and the amount of increase were (2.08±2.76) mm, (1.88±2.48) mm, and (1.64±2.31) mm at T2 compared with T0, respectively. At T1, the tongue height increased significantly, and the tongue sagittal position measurement, tongue length, and tongue volume in oral cavity proper decreased significantly compared with T0. At T2, the tongue height returned to T0 level, but the tongue sagittal position measurement, tongue length, and tongue volume in oral cavity proper still decreased significantly, and the amount of decrease were (4.41±5.53) mm, (4.81±6.96) mm, and (6.04±13.62) cm³ compared with T0, respectively. The change degree of the tongue sagittal position measurement and the tongue volume in oral cavity proper between T2 and T0 was positively correlated with the sagittal movement distance of supramentale (r=0.394, r=0.452). Conclusion: After bimaxillary orthognathic surgery, the relative position of the tongue in oral cavity proper was more backward and upward, while the tongue volume in oral cavity proper decreased. It suggests that the tongue underwent adaptive changes.

Key words: skeletal class Ⅲ malocclusion, bimaxillary orthognathic surgery, tongue morphology, tongue volume, spiral computed tomography

HU Xiaobei, ZHANG Kun, ZHANG Jianyun, WANG Yuxin. Preliminary Research on Tongue Morphology Changes in Skeletal Class Ⅲ Patients after Bimaxillary Orthognathic Surgery[J]. Journal of Oral Science Research, 2024, 40(12): 1054-1058.

References

[1] Toh AQJ, Leung YY. The effect of orthognathic surgery on temporomandibular disorder[J]. J Craniomaxillofac Surg, 2022, 50(3): 218-224.
[2] 张昆,邹维娜,蒲玉梅,等.三维重建技术评价双颌手术影响骨性Ⅱ类错牙合畸形患者上气道的初步研究[J].口腔医学研究, 2021,37(11): 1048-1053.
[3] Xu W, Tan H, Meng X, et al. Improved lip esthetics in patients with skeletal Class Ⅲ malocclusion and facial asymmetry after isolated mandibular orthognathic surgery[J]. Am J Orthod Dentofacial Orthop, 2022, 161(5): e407-e415.
[4] Jeong BJ, Ohe JY, Ryu JI, et al. The effect of tongue reduction for preventing adverse effects in patients undergoing class Ⅲ orthognathic surgery: a three-dimensional comparative analysis[J]. Clin Oral Investig, 2024, 28(3): 162.
[5] Tseng YC, Wu JH, Chen CM, et al. Correlation between change of tongue area and skeletal stability after correction of mandibular prognathism[J]. Kaohsiung J Med Sci, 2017, 33(6): 302-307.
[6] Uslu-Akcam O, Gokalp H. Tongue size and posterior airway space changes in class Ⅲ malocclusion after maxillomandibular surgery: A retrospective study[J]. Int J Orthod Milwaukee, 2015, 26(4): 37-43.
[7] Kravanja SL, Hocevar-Boltezar I, Music MM, et al. Three-dimensional ultrasound evaluation of tongue posture and its impact on articulation disorders in preschool children with anterior open bite[J]. Radiol Oncol, 2018, 52(3): 250-256.
[8] Sekar MR, Parameswaran R, Rajkumar B, et al. Intraoral volume changes in relation to the hard tissue shape changes in asymmetric patients before and after orthognathic surgery - A retrospective CT study[J]. J Stomatol Oral Maxillofac Surg, 2024, 125(1): 101629.
[9] 王子祎,钟馨桐,苏萌萌,等.青少年骨性Ⅱ类不同垂直骨面型舌与下颌骨形态的相关性研究[J].中华口腔正畸学杂志, 2022, 29(6): 70-74.
[10] 张吉霞,王建国,邓琪,等.骨性Ⅲ类BSSRO术后舌骨舌体的三维位置改变[J].口腔医学研究, 2013, 29(6): 565-568.
[11] Teramoto A, Suzuki S, Higashihori N, et al. 3D evaluation of the morphological and volumetric changes of the tongue and oral cavity before and after orthognathic surgery for mandibular prognathism: a preliminary study[J]. Prog Orthod, 2020, 21(1): 21-30.
[12] Jakobsone G, Neimane L, Krumina G. Two- and three-dimensional evaluation of the upper airway after bimaxillary correction of Class Ⅲ malocclusion[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 110(2): 234-242.