Volume Change of Masticatory Muscles by Skeletal Class III Orthognathic Surgery with and Without Facial Asymmetry: A Cross-Sectional and Longitudinal Study

Objectives: This study aimed to analyze longitudinal changes in masticatory muscle volume at pretreatment and after orthognathic surgery in skeletal Class III patients with and without facial asymmetry. Methods: Patients were divided into symmetry and asymmetry groups (n = 30, each; male: female ratio 1: 1, for both groups; age at T1: asymmetry group 25.4 ± 8.1, symmetry group 22.9 ± 7.7). Computed tomography images were obtained at pretreatment (T1), one month after surgery (T2), and at 22 months postoperatively (T3). Three-dimensional reconstruction software was used to measure the volumes of the masseter, temporalis, medial pterygoid, and lateral pterygoid muscles. Results: At T1, the asymmetry group exhibited significantly smaller masseter and temporalis muscle volumes on the deviated side. These differences tended to decrease at T3. No significant bilateral differences were observed in the medial or lateral pterygoid muscles at each point. Longitudinal analyses showed that temporalis and lateral pterygoid muscle volumes decreased from T1 to T2 and increased from T2 to T3, whereas masseter muscle volume did not have a significantly longitudinal difference and the medial pterygoid muscle volume decreased significantly at T3. Conclusions: In Class III patients with facial asymmetry, pretreatment asymmetry of the masseter and temporalis muscle volumes tended to improve postoperatively as bilateral muscle volume increased.