[Feasibility of Delaire cephalometric analysis to predict the ideal sagittal position of the maxilla and chin for surgery-first patients in orthognathic surgery].

OBJECTIVE: There is no universally accepted method for determining the ideal sagittal position of the maxilla in orthognathic surgery. The purpose of this study was to compare how well the Delaire's cephalometric analysis correlated with postoperatively findings in patients who underwent orthognathic surgery planned using other cephalometric analyses, as well as to evaluate the feasibility of the Delaire's cephalometric analysis in predicting the ideal sagittal position of the maxilla and chin. METHODS: In the study, 35 patients with skeletal Class III malocclusion were involved and met the criteria. Treatment plans were developed using photographs, 3-D photographs, radiographs, and standard cephalometric measurements. The Delaire's cephalometric analysis data, like the phase measurements ( angleC1-L1 and angleC1-L2) of the sagittal positions of the maxillary and the chin separating the reference line (L1) of NP point and the reference line (L2) of Me point, were analyzed using Dolphin Imaging software. At the same time, the analyses on standard measurements were also performed. Four orthognathic doctors, 4 orthodontic doctors and 4 college students from non-medical majors were selected as aesthetic evaluators to assess the patients' profile aesthetic by visual analogue scale (VAS). The results through the Delaire's cephalometric analysis were statistically compared with that through standard methods. RESULTS: The mean of angleC1-L1 was 83.93 degrees +/-2.99 degrees and angleC1-L2 was 89.08 degrees +/-2.48 degrees for males postoperatively, and 85.67 degrees +/-3.60 degrees and 88.30 degrees +/-4.20 degrees for females postoperatively. Compared with the reference values of Chinese gooddouble ended arrowlooking people, there was no significant difference of NP point, whereas there was a significant difference of Me point. The postoperative aesthetic scores were: the mean was 6.71+/-0.25 of upper jaws, 6.81+/-0.30 of chins and 6.90+/-0.29 of the overall for males; and 7.19+/-0.22, 7.26+/-0.34 and 7.39+/-0.29 for females. Compared with preoperative scores, there was a significant improvement. Furthermore, the scores of chins and the overall scores were related to the sagittal position of the chins. CONCLUSION: Compared with standard cephalometric analysis, the Deliare's cephalometric analysis well unravel the preoperative deformity and the final esthetic sagittal positions of maxillary and chin in the present sample, and could be a useful tool for the planning of surgery-first approach in orthognathic surgery.