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Objective@#To discuss the efficacy of computer aided design (CAD) and computer aided manufacturing (CAM) in the treatment of microgenia by osseous genioplasty.@*Methods@#From July 2015 to January 2018, 17 cases (Male, n=5, Female, n=12), aged from 17 to 32 years, with the meanage of 24 years, were enrolled. All patients had microgenia, and underwent osseous genioplasty. Computed tomography (CT) was performed preoperatively and 7-10 days postoperatively for all cases. Based on preoperative CT data, CAD was applied to make individualized surgical plan, surgery simulation, todetermine the movement of mentum. CAM was used to prefabricate the individualized surgical templates and transfer the CAD into intraoperative guidance. The registration of CAD and postoperative CT were performed to evaluate the surgical accuracy.@*Results@#All patients were satisfied with the surgical outcomes. The deformity of microgenia was significantly corrected. The Pg error was (0.24±0.08) mm, and the Me error was (0.15±0.17) mm.@*Conclusions@#The application of CAD increases the accuracy of surgical planning, and CAM provides areliable guidance with individualized template. Anoptimal surgical outcome can be achieved.
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Objective To analyze the clinical efficacy and technical key points of genioplasty for the deformities of the chin.Methods 153 patients with chin deformities were treated with the genioplasty,and the chin was moved in any direction,including sagittally,vertically and transversely;the key points of this procedure were summarized.Results There was no severe complication such as infection or nonunion observed.15 patients had ecchymosis and faded in 2 weeks;33 patients had hypaesthesia and recovered in 12 weeks.With the 12-24 months follow-up,all the patients healed well with satisfactory aesthetic results.Conclusions The genioplasty is a reliable and efficient method for the deformities of the chin,and it can significantly improve the appearance of the chin.
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Objective To analyze and discuss the possible reasons of the bone resorption beneath the prostheses after chin augmentation.Methods Twelve patients were admitted to our department for further correction after chin augmentation with materials.The bone resorption was observed through the clinical research and X-ray examination.Results All the patients were underwent the removal of the materials,genioplasty was performed in 8 patients,and two patients were treated by chin augmentation with polyethylene.All the patients were satisfied with their facial contouring.Mild bone resorption was found in seven patients (depth of bone resorption ≤2 mm),in which five patients were used with silicone materials,two patients were performed with expanded polytetrafluoroethylene implants.Moderate bone resorption was seen in three cases.All of them were used with silicone implants (2 mm ＜ depth of bone resorption ≤4 mm).Severe bone resorption happened in two patients (depth of bone resorption ＞4 mm).One was used with silicone implant,and the other one was carried out with expanded polytetrafluoroethylene implant.Conclusions The imbalance among mentalis muscle,materials and underlying bone might be one of the key reasons.Thus for mild and moderate microgenia cases,chin augmentation with material is suitable,while long-term fellow-up study is necessary.But for the cases of severe mirogenia or microgenia and micrognathia with dentofacial deformity or mentalis muscle hyperactivity,genioplasty might be performed as well to correct their deformities.
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Objective To evaluate the efficacy of self-disigned long-thick silicone prothesis in the treatment of severe microgenia.Methods A long-thick silicone prothesis was designed according to the measurement results gained by a coordinate caliper.The designed long-thick silicone prothesis was sterilized by uperization.The procedure commenced under local anesthesia for all patients.The prothesis was placed through an intraoral incision.The digital photographs were taken at the pretreatment visits and 3 months and 12 months after treatment follow-up to observe the change of the chin projection.Results 20 cases of severe microgenia were treated with this technique.All wounds healed primarily.There was no infection,extrusion and rejective reaction.The profiles of chins were improved obviously and reached aesthetic standard.Only one implant required adjustment 3 months after first operation because of displacement.After 12 months follow-up the reshaping contour of the chins were satisfied.Locations of silicone prothesis were stable.No differences of the chin projection were observed.All patients were satisfied with their cosmetic results.Conclusions Implanting long-thick silicone prothesis to correct severe microgenia is safe,effective,simply,cheap and less invasive.
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Objective To evaluate the value of the clinical application of piezosurgery-assisted sliding genioplasty.Methods A total of 9 patients (7 women,2 man,aged 19-40 years) with microgenia were performed operation by intraoral V incision with subperiosteal exposure of the mandibular mentum area.Note relaxtion and preservation of the mental nerves.A horizontal osteotomy of cortical bone on anterior mandible was underwent by the conventional electric bone saw and internal plate bone was sectioned with the piezoelectric device.The segment was divided with preservation of the lingual soft tissue attachment and was advanced in the mandibular mentum area.These was fixed in the reposition by titanium plate and screw for preventing displacement.Results The piezoelectric device produced selective sectioning of the mineralized bone structures,bone was cut precisely without damage to vital anatomic structures and dental pulp,and was much easier to control and less aggressive,creating only minimal damage to soft tissues.The operative effects were satisfactory during 3- 6 months of follow-up.Stable chin contours were created and became nature.Iatrogenic problems with bleeding,in fection,mental nerve injury had been avoided.Conclusions Piezosurgery is a safe and precise technique to reduce the complication rate and to improve the treatment outcomes of genioplasties.
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El mentón juega un papel muy importante en la estética facial. Diferentes deformidades tanto de volumen como de posición pueden presentarse a este nivel, y es la microgenia una de las más frecuentes. Las opciones de tratamiento incluyen el uso de siliconas, materiales aloplásticos e injerto óseo autólogo. Los autores reportan el uso del hueso extraído del ángulo mandibular para el aumento del mentón. Se presenta el caso de una paciente femenina de 18 años de edad, de raza blanca, la cual fue atendida por el Grupo multidisciplinario de cirugía ortognática del Hospital V I Lenin, debido a la preocupación por el ancho de su cara. El examen físico y los exámenes complementarios correspondientes diagnosticaron una prominencia bilateral del ángulo mandibular asociada con una microgenia. Se decidió realizar cirugía remodeladora de ambos ángulos mandibulares y genioplastia de aumento de altura y discreto avance, con utilización del hueso extraído del gonion. Se lograron resultados estéticos satisfactorios sin evidencia de reabsorción ósea. Se concluyó que la utilización del injerto óseo autólogo del ángulo mandibular constituye una alternativa de tratamiento eficaz para la corrección de la microgenia(AU)
Chin play a very important role in facial aesthetics. Different deformities of volume and of position may occur at this level and it is the microgenia one of the more frequent. Treatment options include the use of silicone, alloplasty materials and autologous bone graft. Authors report the use of the bone removed from mandibular angle to increase the chin. This is the case of a white female patient aged 18 seen by the Orthognathics Multidisciplinary Staff of V I Lenin Hospital due to its uncommon face width. The corresponding physical examination as well as the complementary ones diagnosed a bilateral prominence of mandibular angle associated with a microgenia. Surgery carried out was of remodeling type of both mandibular angles and genioplasty.of height increase and a discrete advancement using the bone removed from the gonion. There were satisfactory aesthetic results without evidence of bone reabsorption. We conclude that use of autologous graft of mandibular angle is an effective treatment alternative for correction of microgenia(AU)
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Humans , Female , Adolescent , Dentofacial Deformities/surgery , Genioplasty/methods , Mandibular Injuries/diagnostic imagingABSTRACT
PURPOSE: Mid and lower facial convexity is more common in Oriental people than in Caucasian. Bimaxillary dentoalveolar protrusion is characterized by procumbent teeth, protruding lips, acute nasolabial angle, gummy smile, receding chin, facial convexity. Especially, pure maxillary dentoalveolar protrusion is less frequent than bimaxillary dentoalveolar protrusion. Therefore, it is important to make an accurate decision for the operation throughout the history taking, cephalogram, dental cast to arrive at accurate diagnosis and surgical plan. METHODS: From December 2002 to June 2004, ten patients with maxillary dentoalveolar protrusion and microgenia were corrected by maxillary anterior segmental osteotomy and advancement genioplasty. 10 patients were analyzed by preoperative and postoperative clinical photography, posteroanterior and lateral cephalograms. RESULTS: No major complications were occurred throughout the follow-up period except one of the over- recessed, otherwise most of the patients were satisfied with the result. CONCLUSION: We could correct the occulusal relationship with teeth and improve lower facial profile, asthetically and functionally, by maxillary anterior segmental osteotomy and advancement genioplasty.