{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:03:25Z","timestamp":1780074205835,"version":"3.54.0"},"reference-count":54,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To analyze the impact of surgical change in anterior face height and skeletal relapse on the long-term soft tissue profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Cephalometric radiographs of 81 patients taken before surgery and at five time points during a 3-year follow-up period were analyzed. All patients had Le Fort I and bilateral sagittal split osteotomies. The patients were divided into three subgroups according to the change in anterior face height during surgery. Calculations of soft to hard tissue ratios were based on the long-term soft tissue response relative to the surgical repositioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The horizontal surgical repositioning varied considerably, depending on whether anterior face height was increased or decreased. For upper lip prominence, the pattern of long-term change was the same irrespective of change in face height. In all groups, upper lip thickness decreased in both the short term and the long term, particularly in patients with surgical increase in face height. Lower lip thickness increased in the short term but decreased during the follow-up period. There were significant associations between horizontal soft tissue and corresponding hard tissue changes, except for soft tissue A-point and upper lip, when face height was increased. The ratios were higher for mandibular variables than for maxillary variables, particularly for B-point and pogonion when anterior face height had decreased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A change in facial height influences the soft tissue response. The mandibular soft tissues closely follow skeletal relapse beyond 2\u00a0months postsurgery. The findings have clinical implications for the relative maxillary and mandibular repositioning when planning surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/043012-356.1","type":"journal-article","created":{"date-parts":[[2012,10,30]],"date-time":"2012-10-30T09:02:23Z","timestamp":1351587743000},"page":"533-539","source":"Crossref","is-referenced-by-count":19,"title":["Soft tissue response after Class III bimaxillary surgery"],"prefix":"10.2319","volume":"83","author":[{"given":"Gundega","family":"Jakobsone","sequence":"first","affiliation":[{"name":"Associate Professor, Department of Orthodontics, Riga Stradins University, Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arild","family":"Stenvik","sequence":"additional","affiliation":[{"name":"Professor, Department of Orthodontics, University of Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisen","family":"Espeland","sequence":"additional","affiliation":[{"name":"Professor, Department of Orthodontics, University of Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-83-3-533-b01","series-title":"Angle Orthod","first-page":"217","article-title":"Factors influencing the predictability of soft tissue profile changes following mandibular setback surgery","volume":"71","author":"Mobarak\n              KA .,","year":"2001","unstructured":"Mobarak\n              KA ., \n            \n              Krogstad\n              O . \n            \n              Espeland\n              L . \n            \n              Lyberg\n              T . \n          \n          Factors influencing the predictability of soft tissue profile changes following mandibular setback surgery . Angle Orthod . 2001 ;71 :217 \u2013227 ."},{"key":"i0003-3219-83-3-533-b02","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","first-page":"1","article-title":"An alternative soft tissue analysis following mandibular setback by sagittal split ramus osteotomy","volume":"100","author":"Iizuka\n              T .,","year":"2005","unstructured":"Iizuka\n              T ., \n            \n              Eggensperger\n              N . \n            \n              Wilke\n              S . \n            \n              Seto\n              I . \n            \n              Th\u00fcer\n              U . \n          \n          An alternative soft tissue analysis following mandibular setback by sagittal split ramus osteotomy . Oral Surg Oral Med Oral Pathol Oral Radiol Endod . 2005 ;100 :1 \u20138 ."},{"key":"i0003-3219-83-3-533-b03","series-title":"J Oral Maxillofac Surg","first-page":"697","article-title":"Predictability of upper lip soft tissue changes with maxillary advancement","volume":"47","author":"Stella\n              JP .,","year":"1989","unstructured":"Stella\n              JP ., \n            \n              Streater\n              MR . \n            \n              Epker\n              BN . \n            \n              Sinn\n              DP . \n          \n          Predictability of upper lip soft tissue changes with maxillary advancement . J Oral Maxillofac Surg . 1989 ;47 :697 \u2013703 ."},{"key":"i0003-3219-83-3-533-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"266","article-title":"Soft tissue changes associated with double jaw surgery","volume":"101","author":"Jensen\n              AC .,","year":"1992","unstructured":"Jensen\n              AC ., \n            \n              Sinclair\n              PM . \n            \n              Wolford\n              LM . \n          \n          Soft tissue changes associated with double jaw surgery . Am J Orthod Dentofacial Orthop . 1992 ;101 :266 \u2013275 ."},{"key":"i0003-3219-83-3-533-b05","series-title":"J Oral Maxillofac Surg","first-page":"1182","article-title":"Differences in soft tissue profile changes following mandibular setback in Chinese men and women","volume":"57","author":"Hu\n              J .,","year":"1999","unstructured":"Hu\n              J ., \n            \n              Wang\n              D . \n            \n              Luo\n              S . \n            \n              Chen\n              Y . \n          \n          Differences in soft tissue profile changes following mandibular setback in Chinese men and women . J Oral Maxillofac Surg . 1999 ;57 :1182 \u20131186 ."},{"key":"i0003-3219-83-3-533-b06","series-title":"J Oral Maxillofac Surg","first-page":"1331","article-title":"Evaluation of soft tissue changes with optical surface scan after surgical correction of Class III deformities","volume":"62","author":"Soncul\n              M .","year":"2004","unstructured":"Soncul\n              M . \n            \n              Bamber\n              MA . \n          \n          Evaluation of soft tissue changes with optical surface scan after surgical correction of Class III deformities . J Oral Maxillofac Surg . 2004 ;62 :1331 \u20131340 ."},{"key":"i0003-3219-83-3-533-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"544","article-title":"Long-term stability and prediction of soft tissue changes after LeFort I surgery","volume":"104","author":"Hack\n              GA .,","year":"1993","unstructured":"Hack\n              GA ., \n            \n              de Mol van Otterloo\n              JJ . \n            \n              Nanda\n              R . \n          \n          Long-term stability and prediction of soft tissue changes after LeFort I surgery . Am J Orthod Dentofacial Orthop . 1993 ;104 :544 \u2013555 ."},{"key":"i0003-3219-83-3-533-b08","series-title":"Angle Orthod","first-page":"389","article-title":"Long-term soft tissue changes after orthodontic and surgical corrections of skeletal Class III malocclusions","volume":"77","author":"Bailey\n              LJ .,","year":"2007","unstructured":"Bailey\n              LJ ., \n            \n              Dover\n              AJ . \n            \n              Proffit\n              WR . \n          \n          Long-term soft tissue changes after orthodontic and surgical corrections of skeletal Class III malocclusions . Angle Orthod . 2007 ;77 :389 \u2013396 ."},{"key":"i0003-3219-83-3-533-b09","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"35","article-title":"Surgical Class III treatment: long-term stability and patient perceptions of treatment outcome","volume":"13","author":"Bailey\n              LJ .,","year":"1998","unstructured":"Bailey\n              LJ ., \n            \n              Duong\n              HL . \n            \n              Proffit\n              WR . \n          \n          Surgical Class III treatment: long-term stability and patient perceptions of treatment outcome . 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Angle Orthod . 2005 ;75 :959 \u2013963 ."},{"key":"i0003-3219-83-3-533-b13","series-title":"Angle Orthod","first-page":"50","article-title":"Facial soft tissue profile following bimaxillary orthognathic surgery","volume":"78","author":"Altug-Atac\n              AT .,","year":"2008","unstructured":"Altug-Atac\n              AT ., \n            \n              Bolatoglu\n              H . \n            \n              Memikoglu\n              UT . \n          \n          Facial soft tissue profile following bimaxillary orthognathic surgery . Angle Orthod . 2008 ;78 :50 \u201357 ."},{"key":"i0003-3219-83-3-533-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"665","article-title":"Evaluation of the linearity of soft- to hard-tissue movement after orthognathic surgery","volume":"134","author":"Chew\n              MT .,","year":"2008","unstructured":"Chew\n              MT ., \n            \n              Sandham\n              A . \n            \n              Wong\n              HB . \n          \n          Evaluation of the linearity of soft- to hard-tissue movement after orthognathic surgery . Am J Orthod Dentofacial Orthop . 2008 ;134 :665 \u2013670 ."},{"key":"i0003-3219-83-3-533-b15","series-title":"Semin Orthod","first-page":"172","article-title":"Sagittal soft-tissue changes related to the surgical corrections of maxillary-deficient Class III malocclusions","volume":"15","author":"McCollum\n              AGH .,","year":"2009","unstructured":"McCollum\n              AGH ., \n            \n              Dancaster\n              JT . \n            \n              Evans\n              WG . \n            \n              Becker\n              PJ . \n          \n          Sagittal soft-tissue changes related to the surgical corrections of maxillary-deficient Class III malocclusions . Semin Orthod . 2009 ;15 :172 \u2013184 ."},{"key":"i0003-3219-83-3-533-b16","series-title":"Angle Orthod","first-page":"441","article-title":"Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery","volume":"82","author":"Jakobsone\n              G .,","year":"2012","unstructured":"Jakobsone\n              G ., \n            \n              Stenvik\n              A . \n            \n              Espeland\n              L . \n          \n          Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery . Angle Orthod . 2012 ;82 :441 \u2013447 ."},{"key":"i0003-3219-83-3-533-b17","series-title":"J Craniomaxillofac Surg","first-page":"8","article-title":"Soft and hard tissue changes after bimaxillary surgery in Turkish female Class III patients","volume":"37","author":"Mar\u015fan\n              G .,","year":"2009","unstructured":"Mar\u015fan\n              G ., \n            \n              Cura\n              N . \n            \n              Emekli\n              U . \n          \n          Soft and hard tissue changes after bimaxillary surgery in Turkish female Class III patients . 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Am J Orthod Dentofacial Orthop . 2011 ;139 :80 \u201389 ."},{"key":"i0003-3219-83-3-533-b19","series-title":"Am J Orthod Dentofacial Orthop","first-page":"294","article-title":"Adaptations in lip posture and pressure following orthognathic surgery","volume":"93","author":"Proffit\n              WR .","year":"1988","unstructured":"Proffit\n              WR . \n            \n              Phillips\n              C . \n          \n          Adaptations in lip posture and pressure following orthognathic surgery . 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Eur J Orthod . 2000 ;22 :383 \u2013394 ."},{"key":"i0003-3219-83-3-533-b21","series-title":"Int J Oral Maxillofac Surg","first-page":"419","article-title":"Effect of bilateral sagittal split ramus osteotomy setback on the soft palate and pharyngeal airway space","volume":"37","author":"Muto\n              T .,","year":"2008","unstructured":"Muto\n              T ., \n            \n              Yamazaki\n              A . \n            \n              Takeda\n              S . \n            \n              Sato\n              Y . \n          \n          Effect of bilateral sagittal split ramus osteotomy setback on the soft palate and pharyngeal airway space . Int J Oral Maxillofac Surg . 2008 ;37 :419 \u2013423 ."},{"key":"i0003-3219-83-3-533-b22","series-title":"Am J Orthod Dentofacial Orthop","first-page":"286","article-title":"Changes in lip pressure following extension and flexion of the head and at changed mode of breathing","volume":"91","author":"Hellsing\n              E .","year":"1987","unstructured":"Hellsing\n              E . \n            \n              L'Estrange\n              P . \n          \n          Changes in lip pressure following extension and flexion of the head and at changed mode of breathing . Am J Orthod Dentofacial Orthop . 1987 ;91 :286 \u2013294 ."},{"key":"i0003-3219-83-3-533-b23","series-title":"Am J Orthod Dentofacial Orthop","first-page":"512","article-title":"Natural craniofacial changes in the third decade of life: a longitudinal study","volume":"122","author":"Akg\u00fcl\n              AA .","year":"2002","unstructured":"Akg\u00fcl\n              AA . \n            \n              Toygar\n              TU . \n          \n          Natural craniofacial changes in the third decade of life: a longitudinal study . Am J Orthod Dentofacial Orthop . 2002 ;122 :512 \u2013522 ."},{"key":"i0003-3219-83-3-533-b24","series-title":"Am J Orthod Dentofacial Orthop","first-page":"496","article-title":"The aging craniofacial complex: a longitudinal cephalometric study from late adolescence to late adulthood","volume":"134","author":"Pecora\n              NG .,","year":"2008","unstructured":"Pecora\n              NG ., \n            \n              Baccetti\n              T . \n            \n              McNamara\n              JA ., Jr . \n          \n          The aging craniofacial complex: a longitudinal cephalometric study from late adolescence to late adulthood . Am J Orthod Dentofacial Orthop . 2008 ;134 :496 \u2013505 ."},{"key":"i0003-3219-83-3-533-b25","series-title":"Angle Orthod","first-page":"50","article-title":"Age-related changes of the soft tissue profile from the second to the fourth decades of life","volume":"81","author":"Torlakovic\n              L .","year":"2011","unstructured":"Torlakovic\n              L . \n            \n              Faer\u00f8vig\n              E . \n          \n          Age-related changes of the soft tissue profile from the second to the fourth decades of life . Angle Orthod . 2011 ;81 :50 \u201357 ."},{"key":"i0003-3219-83-3-533-b26","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"211","article-title":"Stability after surgical-orthodontic corrective of skeletal Class III malocclusion. III. Combined maxillary and mandibular procedures","volume":"6","author":"Proffit\n              WR .,","year":"1991","unstructured":"Proffit\n              WR ., \n            \n              Phillips\n              C . \n            \n              Turvey\n              TA . \n          \n          Stability after surgical-orthodontic corrective of skeletal Class III malocclusion. III. Combined maxillary and mandibular procedures . Int J Adult Orthod Orthognath Surg . 1991 ;6 :211 \u2013225 ."},{"key":"i0003-3219-83-3-533-b27","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"179","article-title":"Stability of skeletal Class III malocclusion after combined maxillary and mandibular procedures","volume":"16","author":"Costa\n              F .,","year":"2001","unstructured":"Costa\n              F ., \n            \n              Robiony\n              M . \n            \n              Sembronio\n              S . \n            \n              Polini\n              F . \n            \n              Politi\n              M . \n          \n          Stability of skeletal Class III malocclusion after combined maxillary and mandibular procedures . Int J Adult Orthod Orthognath Surg . 2001 ;16 :179 \u2013192 ."},{"key":"i0003-3219-83-3-533-b01","series-title":"Angle Orthod","first-page":"217","article-title":"Factors influencing the predictability of soft tissue profile changes following mandibular setback surgery","volume":"71","author":"Mobarak\n              KA .,","year":"2001","unstructured":"Mobarak\n              KA ., \n            \n              Krogstad\n              O . \n            \n              Espeland\n              L . \n            \n              Lyberg\n              T . \n          \n          Factors influencing the predictability of soft tissue profile changes following mandibular setback surgery . Angle Orthod . 2001 ;71 :217 \u2013227 ."},{"key":"i0003-3219-83-3-533-b02","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","first-page":"1","article-title":"An alternative soft tissue analysis following mandibular setback by sagittal split ramus osteotomy","volume":"100","author":"Iizuka\n              T .,","year":"2005","unstructured":"Iizuka\n              T ., \n            \n              Eggensperger\n              N . \n            \n              Wilke\n              S . \n            \n              Seto\n              I . \n            \n              Th\u00fcer\n              U . \n          \n          An alternative soft tissue analysis following mandibular setback by sagittal split ramus osteotomy . Oral Surg Oral Med Oral Pathol Oral Radiol Endod . 2005 ;100 :1 \u20138 ."},{"key":"i0003-3219-83-3-533-b03","series-title":"J Oral Maxillofac Surg","first-page":"697","article-title":"Predictability of upper lip soft tissue changes with maxillary advancement","volume":"47","author":"Stella\n              JP .,","year":"1989","unstructured":"Stella\n              JP ., \n            \n              Streater\n              MR . \n            \n              Epker\n              BN . \n            \n              Sinn\n              DP . \n          \n          Predictability of upper lip soft tissue changes with maxillary advancement . J Oral Maxillofac Surg . 1989 ;47 :697 \u2013703 ."},{"key":"i0003-3219-83-3-533-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"266","article-title":"Soft tissue changes associated with double jaw surgery","volume":"101","author":"Jensen\n              AC .,","year":"1992","unstructured":"Jensen\n              AC ., \n            \n              Sinclair\n              PM . \n            \n              Wolford\n              LM . \n          \n          Soft tissue changes associated with double jaw surgery . Am J Orthod Dentofacial Orthop . 1992 ;101 :266 \u2013275 ."},{"key":"i0003-3219-83-3-533-b05","series-title":"J Oral Maxillofac Surg","first-page":"1182","article-title":"Differences in soft tissue profile changes following mandibular setback in Chinese men and women","volume":"57","author":"Hu\n              J .,","year":"1999","unstructured":"Hu\n              J ., \n            \n              Wang\n              D . \n            \n              Luo\n              S . \n            \n              Chen\n              Y . \n          \n          Differences in soft tissue profile changes following mandibular setback in Chinese men and women . J Oral Maxillofac Surg . 1999 ;57 :1182 \u20131186 ."},{"key":"i0003-3219-83-3-533-b06","series-title":"J Oral Maxillofac Surg","first-page":"1331","article-title":"Evaluation of soft tissue changes with optical surface scan after surgical correction of Class III deformities","volume":"62","author":"Soncul\n              M .","year":"2004","unstructured":"Soncul\n              M . \n            \n              Bamber\n              MA . \n          \n          Evaluation of soft tissue changes with optical surface scan after surgical correction of Class III deformities . J Oral Maxillofac Surg . 2004 ;62 :1331 \u20131340 ."},{"key":"i0003-3219-83-3-533-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"544","article-title":"Long-term stability and prediction of soft tissue changes after LeFort I surgery","volume":"104","author":"Hack\n              GA .,","year":"1993","unstructured":"Hack\n              GA ., \n            \n              de Mol van Otterloo\n              JJ . \n            \n              Nanda\n              R . \n          \n          Long-term stability and prediction of soft tissue changes after LeFort I surgery . Am J Orthod Dentofacial Orthop . 1993 ;104 :544 \u2013555 ."},{"key":"i0003-3219-83-3-533-b08","series-title":"Angle Orthod","first-page":"389","article-title":"Long-term soft tissue changes after orthodontic and surgical corrections of skeletal Class III malocclusions","volume":"77","author":"Bailey\n              LJ .,","year":"2007","unstructured":"Bailey\n              LJ ., \n            \n              Dover\n              AJ . \n            \n              Proffit\n              WR . \n          \n          Long-term soft tissue changes after orthodontic and surgical corrections of skeletal Class III malocclusions . Angle Orthod . 2007 ;77 :389 \u2013396 ."},{"key":"i0003-3219-83-3-533-b09","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"35","article-title":"Surgical Class III treatment: long-term stability and patient perceptions of treatment outcome","volume":"13","author":"Bailey\n              LJ .,","year":"1998","unstructured":"Bailey\n              LJ ., \n            \n              Duong\n              HL . \n            \n              Proffit\n              WR . \n          \n          Surgical Class III treatment: long-term stability and patient perceptions of treatment outcome . 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Eur J Orthod . 1998 ;20 :25 \u201333 ."},{"key":"i0003-3219-83-3-533-b11","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"27","article-title":"Analysis of soft tissue profile changes associated with mandibular setback and double-jaw surgeries","volume":"14","author":"Enacar\n              A .,","year":"1999","unstructured":"Enacar\n              A ., \n            \n              Taner\n              T . \n            \n              Toroglu\n              S . \n          \n          Analysis of soft tissue profile changes associated with mandibular setback and double-jaw surgeries . Int J Adult Orthod Orthognath Surg . 1999 ;14 :27 \u201335 ."},{"key":"i0003-3219-83-3-533-b12","series-title":"Angle Orthod","first-page":"959","article-title":"Soft and hard tissue changes after bimaxillary surgery in Chinese Class III patients","volume":"75","author":"Chew\n              MT .","year":"2005","unstructured":"Chew\n              MT . \n          \n          Soft and hard tissue changes after bimaxillary surgery in Chinese Class III patients . Angle Orthod . 2005 ;75 :959 \u2013963 ."},{"key":"i0003-3219-83-3-533-b13","series-title":"Angle Orthod","first-page":"50","article-title":"Facial soft tissue profile following bimaxillary orthognathic surgery","volume":"78","author":"Altug-Atac\n              AT .,","year":"2008","unstructured":"Altug-Atac\n              AT ., \n            \n              Bolatoglu\n              H . \n            \n              Memikoglu\n              UT . \n          \n          Facial soft tissue profile following bimaxillary orthognathic surgery . Angle Orthod . 2008 ;78 :50 \u201357 ."},{"key":"i0003-3219-83-3-533-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"665","article-title":"Evaluation of the linearity of soft- to hard-tissue movement after orthognathic surgery","volume":"134","author":"Chew\n              MT .,","year":"2008","unstructured":"Chew\n              MT ., \n            \n              Sandham\n              A . \n            \n              Wong\n              HB . \n          \n          Evaluation of the linearity of soft- to hard-tissue movement after orthognathic surgery . Am J Orthod Dentofacial Orthop . 2008 ;134 :665 \u2013670 ."},{"key":"i0003-3219-83-3-533-b15","series-title":"Semin Orthod","first-page":"172","article-title":"Sagittal soft-tissue changes related to the surgical corrections of maxillary-deficient Class III malocclusions","volume":"15","author":"McCollum\n              AGH .,","year":"2009","unstructured":"McCollum\n              AGH ., \n            \n              Dancaster\n              JT . \n            \n              Evans\n              WG . \n            \n              Becker\n              PJ . \n          \n          Sagittal soft-tissue changes related to the surgical corrections of maxillary-deficient Class III malocclusions . Semin Orthod . 2009 ;15 :172 \u2013184 ."},{"key":"i0003-3219-83-3-533-b16","series-title":"Angle Orthod","first-page":"441","article-title":"Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery","volume":"82","author":"Jakobsone\n              G .,","year":"2012","unstructured":"Jakobsone\n              G ., \n            \n              Stenvik\n              A . \n            \n              Espeland\n              L . \n          \n          Importance of the vertical incisor relationship in the prediction of the soft tissue profile after Class III bimaxillary surgery . 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