Is Augmentation Required to Correct Malar Deficiency With Maxillary Advancement?
PURPOSE: Patients with maxillary hypoplasia also have malar deficiency; therefore, planning can include consideration for simultaneous malar augmentation. The purpose of this study was to compare pre- and postoperative profiles of patients who underwent Le Fort I advancement, with and without malar augmentation, to assess the subjective perception of changes in malar eminence projection.
MATERIALS AND METHODS: Patients who had maxillary advancement and mandibular setback with and without malar augmentation were evaluated through a survey consisting of pre- and postoperative photographs that were assessed by professionals and laypersons, and a visual analog scale was used to assess the malar region. Next, pre- and postoperative images were shown side by side and participants were asked to indicate which patients had undergone malar augmentation. Statistical analysis used Wilcoxon signed rank test, independent-samples t test, Spearman rank order correlation, and Mann-Whitney U tests.
RESULTS: Of 43 patients, 23 met the inclusion criteria and only 7 of the 23 patients received simultaneous malarplasty. Patients in the 2 groups were perceived as having an increase in malar eminence projection postoperatively. In the malarplasty and non-malar cohorts, laypersons and professionals noted an increase in projection (P < .05). Laypersons tended to overestimate the number of malar procedures performed (sensitivity, 59.5%; specificity, 56.8%), whereas professionals were better able to accurately exclude malar augmentation (sensitivity, 44.2%; specificity, 69.9%).
CONCLUSIONS: Most patients with maxillary hypoplasia undergoing Le Fort I advancement can expect a subjective improvement in malar projection. The decision for malar augmentation at the time of maxillary advancement should be considered based on patient desires, but, in general, maxillary advancement alone might be sufficient for an optimal malar esthetic outcome.
MATERIALS AND METHODS: Patients who had maxillary advancement and mandibular setback with and without malar augmentation were evaluated through a survey consisting of pre- and postoperative photographs that were assessed by professionals and laypersons, and a visual analog scale was used to assess the malar region. Next, pre- and postoperative images were shown side by side and participants were asked to indicate which patients had undergone malar augmentation. Statistical analysis used Wilcoxon signed rank test, independent-samples t test, Spearman rank order correlation, and Mann-Whitney U tests.
RESULTS: Of 43 patients, 23 met the inclusion criteria and only 7 of the 23 patients received simultaneous malarplasty. Patients in the 2 groups were perceived as having an increase in malar eminence projection postoperatively. In the malarplasty and non-malar cohorts, laypersons and professionals noted an increase in projection (P < .05). Laypersons tended to overestimate the number of malar procedures performed (sensitivity, 59.5%; specificity, 56.8%), whereas professionals were better able to accurately exclude malar augmentation (sensitivity, 44.2%; specificity, 69.9%).
CONCLUSIONS: Most patients with maxillary hypoplasia undergoing Le Fort I advancement can expect a subjective improvement in malar projection. The decision for malar augmentation at the time of maxillary advancement should be considered based on patient desires, but, in general, maxillary advancement alone might be sufficient for an optimal malar esthetic outcome.
Full text links
Trending Papers
Management of type 2 diabetes in the new era.Hormones : International Journal of Endocrinology and Metabolism 2023 September 14
Beta-blocker therapy in patients with acute myocardial infarction: not all patients need it.Acute and critical care. 2023 August
The pathophysiology, diagnosis, and management of sepsis-associated disseminated intravascular coagulation.Journal of Intensive Care 2023 May 24
Pharmacological Treatments in Heart Failure With Mildly Reduced and Preserved Ejection Fraction: Systematic Review and Network Meta-Analysis.JACC. Heart Failure 2023 August 26
Hypertensive Heart Failure.Journal of Clinical Medicine 2023 August 3
SGLT2 Inhibitors vs. GLP-1 Agonists to Treat the Heart, the Kidneys and the Brain.Journal of Cardiovascular Development and Disease 2023 July 31
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app