Comparison of soft tissue effects of different orthognathic surgical approaches in class III patients using photographic analysis

Orthognathic surgery is a widely used treatment method for the correction of skeletal anomalies between the maxilla and mandible. The aim of this study was to compare the effects of different surgical approaches (conventional orthognathic surgery [COS] and surgery first approach [SFA]) on soft tissue and facial aesthetics in adult class III malocclusion patients. A total of 50 patients were examined in two groups: 28 individuals in the COS group and 22 individuals in the SFA group. Frontal and profile photographs were taken and analyzed before (T0) and after (T1) surgery for both groups. 12 linear measurements were made in the frontal photographs, and 2 linear and 2 angular measurements were made in the profile photographs. The results showed that the treatment period in the SFA group was significantly shorter than in the COS group (p < .01). In addition, soft tissue facial angle was found to be significantly higher in the SFA group (p < .01). In the COS group, a significant decrease in the nasolabial angle and a significant increase in the E-line were recorded (p < .01). Soft tissue analysis performed on photographs can be considered as an effective tool in surgical planning. The results indicate that similar outcomes were observed in the COS and SFA groups post-surgery. These findings provide an important perspective in evaluating the effects of different orthognathic surgery methods on soft tissue and facial aesthetics.