Review of Nasal Soft Tissue alterations in Class III Malocclusion patients following Lefort I Osteotomy

Abstract Background and Aim:  The primary aim of orthognathic surgery is to improve the aesthetic parameters of the face and dentition and to transform it into an acceptable clinical standard, which is often associated with the secondary aim of improving occlusal function. The most common treatment option for maxillofacial abnormalities in Class III malocclusion patients is bimaxillary surgery, treatment planning of which requires complete knowledge of soft tissue adaptation with the underlying hard tissue movements,so a complete treatment plan should be included both functional and esthetic results according to orthogenatic surgical prognosthic factors. Material and Methods: This review study was conducted by searching the keywords "orthognathic surgery", "maxilla", "soft tissue" and "nose" in Medline library and Google scholar databases among the studies published between the years 2012 and 2021. Finally, 14 studies were selected and reviewed. Results: Review of the previous studies have shown that changes in the soft tissue of maxilla and nose occurred after almost all maxillary osteotomies. Widening of alar width (AW) and alteration of nasolabial angle (NLA) have been reported frequently. Common preventative methods such as Alar Cinch suture have had little effect on preventing these changes. Conversely, the occurrence of these alterations may improve the beauty of the face, which depends on the race and ethnicity of patients and the perception of the aesthetic standards among them. Conclusion: Functional and aesthetic evaluation of the nasal soft tissue should be considered as a part of the diagnosis and treatment planning for orthognathic surgeries and also the strategies considering the management of these changes should be shared with patients. The effect of Alar cinch suture on the control of alar base changes is challenging and requires further study.