Physical Therapy for Smile Improvement After Orthognathic Surgery.

The purpose of this study was to investigate the effect of physical therapy for smile improvement on the smile esthetics-related properties after orthognathic surgery. The samples consisted of 44 adult patients (13 males and 31 females; mean age of 22.6 years old), who had undergone LeFort I osteotomy and BSSRO by a single surgeon. After a video clip of smile education was shown to patients (see Supplemental Digital Content, Video, http://links.lww.com/SCS/A238), smile training of 5 minutes per day was started 1-month after surgery for 3 months. Frontal facial photographs of the posed smile were taken before (T1, 1 month after surgery) and after smile training (T2, 4 months after surgery). Five variables including the smile height, upper lip curvature, smile arc, most visible maxillary posterior tooth, and buccal corridor ratio during posed smile were investigated. When compared with the T1 stage, the T2 stage showed improvement of the smile height (average or high: 32% versus 50%, P <0.05), upper lip curvature (upward: 52% versus 73%, P <0.05), most visible maxillary posterior tooth (first premolar: 48% versus 59%, P <0.05), and buccal corridor ratio (14% versus 11%, P <0.05). Although the smile arc did not show significant difference (P >0.05), there was a tendency of increase in the parallel smile arc from 77% at T1 to 82% at T2.In this small cohort of patients, for the period of observation, it appears that this smile training improves the smile esthetics-related properties in orthognathic surgery patients. However, it is necessary to perform further long-term follow-up studies with control groups.