The influence of Le Fort 1 maxillary advancement osteotomy on nasal morphology and aesthetics

Objectives: The aims of this investigation were to determine whether nasal morphology differs in Portuguese Caucasians with class I occlusion and class III malocclusion, to objectively quantify the nasal changes produced by the Le Fort 1 maxillary advancement osteotomy in patients with Class III skeletal discrepancies and to determine whether these alterations cause a significant change in the subjective evaluation of frontal and profile, nasal and facial aesthetics according to orthodontists. Materials and methods: Facial and nasal cephalometric measurements were performed in the frontal and profile photographs and lateral cephalograms of 80 individuals each with class I occlusion and class III malocclusion, equally divided between the genders. The nasal alterations caused by the Le Fort 1 maxillary advancement osteotomy in 32 men and 48 women with class III malocclusion were also measured. The changes in frontal and profile, facial and nasal aesthetics were subjectively evaluated in 19 men and 42 women. Results and conclusions: The group with Class III occlusion presented larger columella width, frontal nasal length and height, frontal nasal length/morphological width and frontal nasal height/morphological width ratios and smaller alar slope and superior alar angles. In profile, this group displayed greater values for total facial convexity and nasomental angles and nasal height, length and protrusion and smaller ones for facial convexity, nasofacial and supratip break angles. Le Fort 1 maxillary advancement osteotomy significantly increased transverse nasal dimensions and elevated and advanced pronasale and subnasale. Nasal height, length, depth of the supratip break, upper and lower dorsal convexities, nasal, subnasale and nostril projections, nasal protrusion and the nasal prominence, supratip break, nasolabial and nasal tip rotation angles were reduced. Columella depth and the nasal tip, nasal projection and dorsal contour angles increased. Both frontal and profile facial attractiveness and nasal profile aesthetics were significantly improved