The Minimally Invasive-Guided Genioplasty Technique using Piezosurgery and 3D printed surgical guide: An innovative technique.

INTRODUCTION: Mental nerve injuries with neurosensory deficits, asymmetries, and intra-operative bleeding are the main immediate complications of genioplasty. Following a recent systematic review, three-dimensional (3D)-printed cutting guide could improve the predictability and accuracy of this surgical technique avoiding postoperative asymmetries. Furthermore, anatomical structures in the surgical area (mental nerve and teeth roots) are better protected, reducing the morbidity and providing safer results. Ultrasonic piezoelectric osteotomy allows by its intrinsic characteristics, a selective cut of mineralized structure with a lower risk of vascular and nervous damage (microvibrations), intra-operative precision (thin cutting scalpel and no macro-vibrations), and blood-free site (cavitation effect). The aim of this article is to present a new minimally invasive technique: the minimally invasive-guided genioplasty technique (aka MIGG technique). This technique combines the advantages of piezosurgery and of a space-saving 3D-printed cutting guide, requiring open-source programs and an affordable 3D printing technology. MATERIALS AND METHODS: All the steps of this technique are described: preoperative surgical planning (CT scanner, segmentation with 3D slicer®, and design of the cutting guide with Blender®) and 3D printing of the guide and sterilization of it. The surgical procedure is presented in detail as well as the postoperative care. CONCLUSION: The MIGG technique offers, according to the authors, a better postoperative recuperation, a reduction in operating time, less complications, and protection of the anatomical structures (mental nerve, teeth, lingual soft tissue and vessels). This minimally invasive technique for genioplasty is a promising approach to perform a chin osteotomy.

Genioplasty with surgical guide using 3D-printing technology: A systematic review.

BACKGROUND: The purpose of this systematic review is to evaluate the current state of the art of making genioplasties using 3D printing technology. MATERIAL AND METHODS: A multi-database single-reviewer systematic review identified sixteen papers that fulfilled the selection criteria. There were mainly case series and case reports available (Level IV of the Oxford Evidence-based medicine scale); only two prospective study (Level III) evaluated this subject. These articles are analyzed in details and summarized in this review. RESULTS: The realization of genioplasties with surgical guide using 3D-printing technology could improve predictability and accuracy. It protects anatomical structures in the environment of the surgery, reducing by this way the morbidity and providing safer results. The type of printer and material used as well as the sterilization techniques should be further developed by the authors. The use of open-access software should also be further explored to allow the use of these new technologies by the largest number of surgeons. CONCLUSIONS: Finally, prospective multi-center studies with larger samples should be performed to definitively conclude the benefits of this new technology and allow for its routine use. This article is the first systematic review on this topic. Key words:Genioplasty, printing, three-dimensional, surgery, computer-assisted.

Prevalence of caries and malocclusion in an indigenous population in Chiapas, Mexico.

OBJECTIVES: To assess the prevalence of caries and malocclusion in Mayan Mexican adolescents, 14-20 years of age, living in Chiapas, Mexico. METHODS: This was a cross-sectional, population-based, quantitative, epidemiological study. Sites were chosen to capture subjects representative of the state's Mayan population. A total of 354 subjects were recruited. Caries experience was quantified, via visual inspection, using the Decayed, Missing and Filled Surface (DMFS) index. Malocclusion was quantified using the Index of Complexity, Outcome and Need (ICON). RESULTS: Our data showed that 99% of the population had caries experience, with a median DMFS score of 8. Of the 99% with caries experience, over half had caries affecting more than five tooth surfaces. Thirty-seven per cent of the students had unmet orthodontic treatment need, and 46.46% presented a Class II, and 39.09% a Class III, anterior-posterior relationship. CONCLUSIONS: Less than 1% of the population had any exposure to orthodontics, demonstrating the lack of access to care. Likewise, only 1% of the population was found to have no caries experience, exhibiting a large unmet treatment need. The median DMFS score of 8 was also high in comparison with the median DMFS in the USA of 6. Our data suggest a correlation between the lack of access to care and high prevalence of caries and malocclusion in Mexican Mayans who inhabit Chiapas, Mexico.

Association between growth stunting with dental development and skeletal maturation stage.

The aim of this study was to determine the influence of growth stunting on the maturation stage of the medium phalanx of the third finger (MP3) and the dental development of the left mandibular canine in 280 high school children (140 stunted and 140 normal controls; equally distributed by sex) between 9.5 and 16.5 years of age, from a representative Peruvian school. Periapical radiographs of the MP3 from the left hand were used to determine the skeletal maturity stage, according to an adaptation of the Hägg and Taranger method. Panoramic radiographs were used to determine the dental maturity stage of the lower left canine, according to Demirjian method. Stunting was determined by relating height and age, according to the World Health Organization recommendations. There was no statistically significant difference in the skeletal maturation stage (P = .134) and the dental development stage (P = .497) according to nutritional status, even when considering different age groups (P > .183). A high correlation (r = 0.85) was found between both maturity indicators regardless of the nutritional status (growth stunted, r = 0.855 and normal controls, r = 0.863) or sex (boys, r = 0.809 and girls, r = 0.892). When skeletal level was considered, correlations values were similar between advanced (r = 0.903) and average (r = 0.895) maturers but lower (r = 0.751) for delayed maturers. Growth stunting was not associated with dental development and skeletal maturity stages in Peruvian school children.