ORIGINAL ARTICLE Effects of incisions made with electrocautery and scalpel on upper lip length: a pilot study E. Parente 1 , R. Coser 2 , D. Passeado Branco Ribeiro 3 , P. José Medeiros 3 , M. de Moraes 4 & F. Ritto 5 1 Division of Oral and Maxillofacial Surgery, Master Degree Student, FO-UERJ, Rio de Janeiro, Brazil 2 Division of Oral and Maxillofacial Surgery, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil 3 Division of Oral and Maxillofacial Surgery, FO-UERJ, Rio de Janeiro, Brazil 4 Division of Oral and Maxillofacial Surgery, FOP–UNICAMP, Piracicaba, São Paulo, Brazil 5 Division of Oral and Maxillofacial Surgery, PhD Student, FOP-UNICAMP, Piracicaba, Brazil Abstract Aim: To compare the changes in the upper lip (UL) length after performing incisions with scalpel and electrocautery for maxillary impaction. Patients and methods: Patients submitted to maxillary superior reposition- ing greater than 3 mm were randomly assigned to two groups. Only cases with a smaller maxillary advancement were included. Incisions were made with scalpel in Group 1 and with electrocautery in Group 2. Pre- and post- operative lateral cephalometric radiographs were used to calculate the changes in the UL length (subnasal and stomium superior), and superior movement of the UL relative to maxillary impaction. Results: Sixteen patients that underwent maxillary impaction were evalu- ated. Four patients were previously excluded. The mean maxillary impac- tion was 4.85 mm and the mean advancement was 1.87 mm. The mean UL shortening was 0.53 mm, and the mean UL superior movement relative to maxillary impaction was 11.88%. In the five patients of Group 1, the mean lip shortening was 0.32 mm and superior movement of the UL relative to maxillary impaction was 10.91% on average. The seven patients of Group 2 presented a mean lip shortening of 0.68 mm, and superior movement of the UL relative to maxillary impaction was 15.41% on average. Conclusion: Although Group 2 showed greater UL shortening than Group 1, it was not statistically significant. Key words: maxilla, orthognathic, surgery Correspondence to: Dr E Parente CIRURGIA BUCOMAXILOFACIAL (HUPE) Boulevard Vinte e Oito de Setembro, 77 Vila Isabel CEP: 20551-900 Rio de Janeiro Brazil Tel.: (55) (21) 8844-7470 Fax: (55) (21) 2549-6932 email: eduardoparente@hotmail.com Accepted: 8 June 2011 doi:10.1111/j.1752-248X.2011.01132.x Clinical relevance Understanding the changes in the upper lip (UL) morphology after maxillary surgery is essential for prediction of the patient’s final appearance. Superior maxillary repositioning has been indicated to correct vertical maxillary excess, but it is frequently associated with UL shortening. Wound healing is an important issue, and soft tissue scarring and contraction will affect the lip length. This study compared the varia- tions on the UL length after maxillary impaction, per- formed with electrocautery and scalpel incisions and suggests that electrocautery has greater potential to cause lip shortening, even though it was not statisti- cally significant. Introduction The amount of teeth and gingiva showing after max- illary surgery are affected by the movements of osseous tissue and changes in the morphology of the upper lip (UL) 1 . Superior maxillary repositioning has been indicated to reduce the upper incisor exposure, correct the gummy smile and improve the lip seal in patients with vertical maxillary excess 2–4 . However, it Source of funding for research: CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) Oral Surgery ISSN 1752-2471 166 Oral Surgery 4 (2011) 166–170. © 2011 John Wiley & Sons A/S