Assessment of changes in selected parameters of Arnett’s soft tissue cephalometric analysis (STCA) in patients with maxillary constriction treated with the method of surgically assisted maxillary expansion using a bone-borne appliance

Assessment of changes in selected parameters of Arnett’s soft tissue cephalometric analysis (STCA) in patients with maxillary constriction treated with the method of surgically assisted maxillary expansion using a bone-borne appliance | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of changes in selected parameters of Arnett’s soft tissue cephalometric analysis (STCA) in patients with maxillary constriction treated with the method of surgically assisted maxillary expansion using a bone-borne appliance Rafał Nowak, Anna Olejnik, Ewa Zawiślak, Ada Kaczmarek-Niedzielska, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7323705/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 15 Apr, 2026 Read the published version in Head & Face Medicine → Version 1 posted 11 You are reading this latest preprint version Abstract Background: Maxillary constriction is a common issue encountered in adult patients seeking orthodontic or surgical treatment and often requires surgical intervention. While the skeletal and dental outcomes of surgically assisted maxillary expansion have been widely studied, its effects on facial soft tissue remain less understood. This study aimed to assess changes in selected parameters of Arnett’s soft tissue cephalometric analysis in patients treated with bone-borne surgically assisted maxillary expansion. Methods: This retrospective study included 42 adult patients (24 males, 18 females; mean age: 27.67 years) diagnosed with transverse maxillary deficiency. All patients underwent surgically assisted maxillary expansion using a bone-borne distractor. Lateral cephalograms were obtained before treatment and 6–8 months after active distraction. Sixteen soft tissue cephalometric parameters and angular measurements (SNA, SNB, ANB) were evaluated. Cephalometric analysis was independently performed by two trained observers, each conducting duplicate measurements. Statistical analysis included the Wilcoxon signed-rank test for paired comparisons and Spearman’s rank correlation coefficient for assessing associations. Results: Significant clockwise rotation of both the maxillary and mandibular occlusal planes was observed. Vertical changes included an increase in maxillary anterior height and upper lip length. Sagittal soft tissue changes included reduced nasal tip projection and posterior displacement of the chin. Among airway parameters, only the dimension at the chin level showed a significant increase. The SNB angle decreased, while the ANB angle increased significantly, indicating a backward mandibular rotation. No significant differences were observed in parameter changes between skeletal class II and III subgroups. Significant correlations were found between occlusal plane rotation and changes in maxillary height and soft tissue projection. Conclusions: Bone-borne surgically assisted maxillary expansion results in both skeletal and measurable soft tissue changes. Clockwise occlusal plane rotation is associated with increased facial height and posterior repositioning of the chin. These findings highlight the relevance of soft tissue cephalometric analysis in treatment planning and patient communication. Maxillary Expansion Cephalometry Orthognathic Surgical Procedures Facial Soft Tissues Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 15 Apr, 2026 Read the published version in Head & Face Medicine → Version 1 posted Editorial decision: Revision requested 27 Oct, 2025 Reviews received at journal 27 Oct, 2025 Reviewers agreed at journal 27 Oct, 2025 Reviews received at journal 24 Oct, 2025 Reviews received at journal 30 Sep, 2025 Reviewers agreed at journal 28 Sep, 2025 Reviewers agreed at journal 28 Sep, 2025 Reviewers invited by journal 28 Sep, 2025 Editor assigned by journal 12 Aug, 2025 Submission checks completed at journal 12 Aug, 2025 First submitted to journal 08 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7323705","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":526524511,"identity":"ce963f6a-b049-4c7c-9096-a39a3c225bbb","order_by":0,"name":"Rafał 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expansion using a bone-borne appliance","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"head-and-face-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hafm","sideBox":"Learn more about [Head \u0026 Face Medicine](http://head-face-med.biomedcentral.com)","snPcode":"13005","submissionUrl":"https://submission.nature.com/new-submission/13005/3","title":"Head \u0026 Face Medicine","twitterHandle":"@HeadNeckMed","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Maxillary Expansion, Cephalometry, Orthognathic Surgical Procedures, Facial Soft Tissues","lastPublishedDoi":"10.21203/rs.3.rs-7323705/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7323705/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e\u003cp\u003eMaxillary constriction is a common issue encountered in adult patients seeking orthodontic or surgical treatment and often requires surgical intervention. While the skeletal and dental outcomes of surgically assisted maxillary expansion have been widely studied, its effects on facial soft tissue remain less understood. This study aimed to assess changes in selected parameters of Arnett\u0026rsquo;s soft tissue cephalometric analysis in patients treated with bone-borne surgically assisted maxillary expansion.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e\u003cp\u003eThis retrospective study included 42 adult patients (24 males, 18 females; mean age: 27.67 years) diagnosed with transverse maxillary deficiency. All patients underwent surgically assisted maxillary expansion using a bone-borne distractor. Lateral cephalograms were obtained before treatment and 6\u0026ndash;8 months after active distraction. Sixteen soft tissue cephalometric parameters and angular measurements (SNA, SNB, ANB) were evaluated. Cephalometric analysis was independently performed by two trained observers, each conducting duplicate measurements. Statistical analysis included the Wilcoxon signed-rank test for paired comparisons and Spearman\u0026rsquo;s rank correlation coefficient for assessing associations.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e\u003cp\u003eSignificant clockwise rotation of both the maxillary and mandibular occlusal planes was observed. Vertical changes included an increase in maxillary anterior height and upper lip length. Sagittal soft tissue changes included reduced nasal tip projection and posterior displacement of the chin. Among airway parameters, only the dimension at the chin level showed a significant increase. The SNB angle decreased, while the ANB angle increased significantly, indicating a backward mandibular rotation. No significant differences were observed in parameter changes between skeletal class II and III subgroups. Significant correlations were found between occlusal plane rotation and changes in maxillary height and soft tissue projection.\u003c/p\u003e\u003ch2\u003eConclusions:\u003c/h2\u003e\u003cp\u003eBone-borne surgically assisted maxillary expansion results in both skeletal and measurable soft tissue changes. Clockwise occlusal plane rotation is associated with increased facial height and posterior repositioning of the chin. These findings highlight the relevance of soft tissue cephalometric analysis in treatment planning and patient communication.\u003c/p\u003e","manuscriptTitle":"Assessment of changes in selected parameters of Arnett’s soft tissue cephalometric analysis (STCA) in patients with maxillary constriction treated with the method of surgically assisted maxillary expansion using a bone-borne appliance","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-09 18:14:24","doi":"10.21203/rs.3.rs-7323705/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-27T10:56:20+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-27T10:51:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"92460245752515466964315151974265290161","date":"2025-10-27T09:41:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-24T10:11:35+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-01T03:06:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"193361143619174870616234743033926757653","date":"2025-09-29T03:04:57+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"256000305253646899133384877501260700241","date":"2025-09-28T13:46:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-28T12:36:05+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-12T08:19:40+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-12T08:19:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"Head \u0026 Face Medicine","date":"2025-08-08T05:29:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"head-and-face-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hafm","sideBox":"Learn more about [Head \u0026 Face Medicine](http://head-face-med.biomedcentral.com)","snPcode":"13005","submissionUrl":"https://submission.nature.com/new-submission/13005/3","title":"Head \u0026 Face Medicine","twitterHandle":"@HeadNeckMed","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ac5d578f-76c4-4175-9b55-ff8d3a7344d1","owner":[],"postedDate":"October 9th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-04-20T16:02:17+00:00","versionOfRecord":{"articleIdentity":"rs-7323705","link":"https://doi.org/10.1186/s13005-026-00616-y","journal":{"identity":"head-and-face-medicine","isVorOnly":false,"title":"Head \u0026 Face Medicine"},"publishedOn":"2026-04-15 15:58:36","publishedOnDateReadable":"April 15th, 2026"},"versionCreatedAt":"2025-10-09 18:14:24","video":"","vorDoi":"10.1186/s13005-026-00616-y","vorDoiUrl":"https://doi.org/10.1186/s13005-026-00616-y","workflowStages":[]},"version":"v1","identity":"rs-7323705","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7323705","identity":"rs-7323705","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}