Chin Microgenia: A Clinical Comparative Study

Osseous genioplasty versus chin implants: early complications and patient satisfaction

Osseous genioplasty and chin augmentation with implants are the two main treatment options for retrognathia. This retrospective cohort study was performed to compare the prevalence of complications and patient satisfaction following osseous genioplasty and chin augmentation by implant. Eighty patients were included: 38 underwent advancement osseous genioplasty and 42 received chin implants (alloplastic, either Medpor or Silastic) intraorally or extraorally. The patients were assessed for complications 12 months after surgery, including neurosensory disturbances, infection or extrusion, wound dehiscence, and the need for reoperation. Patient satisfaction was evaluated using a visual analogue scale. The infection rate was significantly higher in the chin implant group than in the genioplasty group (P = 0.028). Moreover, dehiscence and the need for reoperation appeared to be more common following chin augmentation with implants. However, there was no significant difference in the prevalence of neurosensory disturbances between the two groups (P = 0.137). In the chin implants group, the extraoral approach resulted in a lower dehiscence rate than the intraoral approach. Patients in the genioplasty group had significantly higher satisfaction scores than those in the chin implant group (P = 0.001). Overall, the rates of the complications assessed were lower and patient satisfaction was higher after osseous genioplasty when compared to chin augmentation with implants.

The Application and Efficacy of Hyaluronic Acid Fillers for Chin Enhancement and Retrusion Correction: A Systematic Review of Patient-Reported Outcomes

A frequent facial abnormality called chin retrusion, also known as retrognathia, can be detrimental to a person's self-esteem and overall face aesthetics. Hyaluronic acid (HA) injections are one non-surgical approach to this problem that may provide individuals seeking chin augmentation with a relatively less invasive and potentially more affordable alternative. The present literature does not provide enough in-depth systematic reviews of the use of HA in chin augmentation. By completing a complete examination of the information that is currently available, this study intends to fill this knowledge gap, supporting physicians and researchers in better comprehending the efficacy and implications of HA in chin augmentation. The safety and success of any esthetic procedure should be made based on the results reported by the patients, including satisfaction and quality of life. Patients need to receive comprehensive surgical instructions from a medical professional to optimize the results of the HA injections for chin enhancement surgery. Regardless of the reported safety of using HA injections, some unwanted side effects have also been recorded. Indeed, healthcare professionals can make more informed decisions and give a patient comprehensive information about the procedure's risks and benefits to the patients. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. EMBASE, OVID, and Google Scholar databases were searched up to June 2023. We concentrated on adult patients treated with HA for chin enhancement, and our research was limited to studies conducted in English. A total of 2,738 patients from 24 articles were studied, with 2,259 receiving HA injections for chin augmentation. When applicable, aesthetic outcomes were assessed using scales such as the Global Aesthetic Improvement Scale (GAIS)/FACE-Q and the Galderma Chin Retrusion Scale. Patient satisfaction increased noticeably. Among the studies, some reported complications following HA injection. While three studies found no significant negative effects, one highlighted a major necrotic complication. HA has proven to be an effective and safe alternative to chin augmentation surgery, with the majority of patients showing high satisfaction rates. However, large-scale randomized controlled trials are needed to obtain meaningful results, which will contribute to the further development of non-surgical cosmetic procedures. These studies may facilitate further innovation and refinement of these techniques and potentially expand the application of HA fillers in facial aesthetics.

Complications Following Alloplastic Chin Augmentation: A Systematic Review of Implant Materials and Surgical Techniques

BACKGROUND

Alloplastic implantation has become a popular method of chin augmentation. Historically, silicone was the most commonly used implant, but porous materials have grown in favor due to improved fibrovascularization and stability. Nevertheless, it is unclear which implant type has the most favorable complication profile. This systematic review aims to compare the complications of published chin implants and surgical approaches to provide data-driven recommendations for optimizing chin augmentation outcomes.

METHODS

The PubMed® database was queried on March 14, 2021. We selected studies reporting data on alloplastic chin augmentation excluding additional procedures such as osseous genioplasty, fat grafting, autologous grafting, and fillers. The following complications were extracted from each article: malposition, infection, extrusion, revision, removal, paresthesias, and asymmetry.

RESULTS

Among the 39 articles analyzed, the year of publication ranged from 1982 to 2020; additionally, 31 were retrospective case series, 5 were retrospective cohort or comparative studies, 2 were case reports, and 1 was a prospective case series. More than 3104 patients were included. Among the 11 implants reported, the 3 implants with the highest number of publications were silicone, high-density porous polyethylene (HDPE), and expanded polytetrafluoroethylene (ePTFE). Silicone demonstrated the lowest rates of paresthesias (0.4%) compared to HDPE (20.1%, P < 0.01) and ePTFE (3.2%, P < 0.05). In contrast, there were no statistically significant differences in rates of implant malposition, infection, extrusion, revision, removal, or asymmetry when stratified by implant type. Various surgical approaches were also documented. Compared with subperiosteal implant placement, the dual-plane technique demonstrated higher rates of implant malposition (2.8% vs 0.5%, P < 0.04), revision (4.7% vs 1.0%, P < 0.001), and removal (4.7% vs 1.1%, P < 0.01), but a lower incidence of paresthesias (1.9% vs. 10.8%, P < 0.01). Compared with extraoral incisions, intraoral incisions resulted in higher rates of implant removal (1.5% vs 0.5%, P < 0.05) but lower rates of asymmetry (0.7% vs 7.5%, P < 0.01).

CONCLUSION

Silicone, HDPE, and ePTFE had low overall complication rates, demonstrating an acceptable safety profile regardless of implant selection. Surgical approach was found to significantly influence complications. Additional comparative studies on surgical approach while controlling for implant type would be beneficial for optimizing alloplastic chin augmentation practices.

An unusual extraction pattern for retreatment in a patient with dental protrusion and a deficient soft-tissue chin

A patient with dental protrusion and deficient soft-tissue chin, previously treated with maxillary first premolar extraction, sought retreatment to improve his facial profile. Orthognathic surgery was proposed as the ideal treatment option, but the patient declined. Therefore, other orthodontic options were considered. The combined intrusion and retraction force systems supported with skeletal anchorage on both arches and a midpalatal miniscrew successfully reduced the protrusion and rotated the mandible counterclockwise to improve the facial profile and chin projection. Sagittal correction enhanced by active vertical control with skeletal anchorage and de-wedging with posterior extraction was illustrated. In addition, advancement genioplasty was performed after orthodontic treatment to improve the chin projection further. The mechanics and results of this retreatment case were discussed.

Effect of concentrated growth factor on lower lip hypoesthesia after osseous genioplasty: a prospective, split-mouth, double-blind randomized controlled trial

Lower lip hypoesthesia is the most common complication following osseous genioplasty. Concentrated growth factor (CGF) has recently been shown to improve neural regeneration. The aim of this study was to evaluate the effect of concentrated growth factor on neurosensory recovery after osseous genioplasty. Patients who underwent osseous genioplasty between June 2017 and February 2020 were enrolled. CGF was applied to the mental nerve on one side. The treatment side was randomized, and the other side was considered as the control. Lower lip hypoesthesia was assessed preoperatively and postoperatively (1 week, 1, 3, 6, and 9 months) using the two-point discrimination test and a 10-point visual analogue scale (self-reported paresthesia). The assessor was blinded. Twenty-six female patients completed the study. At 1 and 3 months, both the mean two-point discrimination value and mean visual analogue scale score were significantly lower in the CGF group than in the control group (P < 0.001). At 3 months, the percentage of patients with lower lip hypoesthesia in the CGF group was significantly lower than that in the control group (P < 0.001). Both groups showed resolution of lower lip hypoesthesia at 6 months. Concentrated growth factor may accelerate the recovery of long-standing sensory nerve impairment following mental osteotomy.

Postoperative Complications in Genioplasty and Their Association with Age, Gender, and Type of Genioplasty

Objective

The objective of our study was to determine the incidence of postoperative complications associated with different kinds of genioplasties done with or without concomitant orthognathic surgeries.

Materials and Methods

Patients in whom facial asymmetry was corrected by genioplasty with age ranging from 16 to 55 at the Department of Oral and Maxillofacial Surgery were included in the study. Patients with facial asymmetry due to congenital problems were excluded.

Results

59 patients were included, of which 38 were males and 21 were females with the age range of 16-55 (mean: 27.3729, Std. deviation: 4.70472). Advancement genioplasty was performed in 15.3%, reduction genioplasty was done in 16.9%, and advancement genioplasty with rotation was performed in 67.8% cases. In 28.8% cases, genioplasty was performed as an adjunct procedure with orthognathic surgery, and in 71.2% cases, genioplasty was performed alone. 3.4% patients developed infection, 8.5% had hematoma, and 6.8% had temporary numbness. Postoperative complications were seen more in men than in women. Correction of chin asymmetry by rotation/advancement showed the highest number of complications (84%).

Conclusion

Temporary neurosensory disturbance of the inferior alveolar nerve is the most common complication that occurs after genioplasty. Patients shall be counselled preoperatively, and informed consent shall be obtained prior to surgery.

Validation of a Chin Retrusion Scale for Chinese Subjects

ABSTRACT

Chin augmentation procedures are gaining in popularity. The purpose of this study was to validate the China (Allergan) Chin Retrusion Scale (CACRS) and to evaluate the reliability of the scale. A team of 10 physicians based in Beijing, China, consisting of 1 principal investigator and 9 independent raters, assessed a pool of subject images. Using standardized equipment to capture 2-dimensional images, 100 subjects were photographed from a left, lateral, 90° view. Two measures were used to assess the validity of the scale: rater evaluations of clinically significant differences in 52 pairs of images and rater assessment of chin retrusion using the CACRS to grade the 100 images. The CACRS demonstrated almost perfect inter-rater agreement during 2 validation sessions, with intraclass correlation coefficients of 0.89 and 0.90 at sessions 1 and 2, respectively. Overall inter-rater agreement for all 9 raters was almost perfect, with a weighted kappa of 0.82. Based on inter- and intra-rater agreement, the CACRS was validated for physician ratings of chin retrusion in Chinese subjects. Results from clinical significance evaluations indicated that a 1-grade difference between image pairs was considered clinically meaningful for the CACRS. The CACRS is a validated and reliable photonumeric scale for the assessment of chin retrusion in Chinese men and women. The scale is a clinically significant reference tool for evaluating the effect of chin augmentation.

Invisalign appliance: aesthetic and efficiency

BACKGROUND

The patients' request for treatment with clear aligners is constantly increasing. The aligners permit to the clinicians a valid way to solve a lot of orthodontic cases but the patients' compliance and the clinicians' capabilities and knowledge of the technique is fundamental for the outcome.

METHODS

Seventy-two digital models of 18 consecutive patients treated with Invisalign and Smart Track aligners for 14 weeks were analyzed. The operator positioned 24 points on each model and were obtained the values of arch depth and perimeter of arch before and after the treatment. The variations of measurement were calculated with t student test.

RESULTS

A decrease of arch depth and perimeter was found from t0 to t1 and the most relevant difference was observed in the upper arch depth with a decrease of 1.3 mm and in the upper arch perimeter with a difference of 1.1 mm.

CONCLUSIONS

There was always a decrease of the values of arch depth and arch perimeter at the end of the treatment, especially in the upper arch. These changes must be considered by the clinicians to perform a better treatment to obtain the most predictable results and a patient's higher satisfaction.

Enhance Mandibular Symphyseal Surface Bone Growth with Autologous Mesenchymal Stem Cell Sheets: An Animal Study

INTRODUCTION

The size and shape of the chin strongly influence facial profile and harmony. The current correction of chin deficiency mostly relies on genioplasty surgery involving osteotomy. To avoid osteotomy, one possible alternative is to enhance bone growth at the mental protuberance area with cell sheet transplantation. This study was undertaken to evaluate the efficacy of this approach in a pig model.

MATERIALS AND METHODS

Five 4-month-old pigs were included for mandibular bone marrow aspiration and MSC isolation. Triple-layer MSC sheets were then fabricated and utilized using culture-expanded MSCs. Four weeks after bone marrow aspiration, subperiosteal pockets were created on the labial symphyseal surface, followed by transplantation of autogenous MSC sheets to one randomly chosen side with the other side (control) receiving no transplantation. Six weeks after the surgery, the pigs were euthanized and the specimens from both sides were collected for computed tomography (CT) and histological and immunohistochemical analysis. Measurements between the experimental and control sides were compared using paired t tests.

RESULTS

MSC sheet fabrication and transplantation were reliably conducted. The labial cortical bone thickness increased significantly with MSC sheet transplantation by an average of 2 mm (p = 0.0001). The average measurements of mineral apposition rate and cell proliferation at the cell sheet side tended to be higher than the control side although the differences did not reach statistical significance (p = 0.1-0.2). Tissue mineral density measurements from CT images and bone volume fraction (BV/TV) measurements from histologic images were identical between the two sides (p > 0.5).

CONCLUSION

These data provide a proof of concept that autologous MSC sheets may be transplanted to the subperiosteal region of the mandibular symphysis to stimulate local surface bone growth.

NO LEVEL ASSIGNED

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Oral mucosal complications in orthodontic treatment

BACKGROUND

Orthodontic therapy is used to solve numerous oral problems, but the use of fixed oral devices can also impact negatively the oral cavity, if the treatment is not steadily under control. The aim of this study is to evaluate tooth, bone and soft tissues lesions due to the presence of fixed orthodontic appliances.

METHODS

One hundred patients with fixed orthodontic appliances were included in the study. In particular, 20 patients with rapid palatal expander (RPE), 20 patients with Forsus appliance, 20 patients with a fixed multibracket appliance treatment, 20 patients with just the lower vestibular multibracket treatment and 20 patients with both upper and lower vestibular multibracket treatment. An accurate oral examination of the oral cavity, comprehending teeth, bone and soft tissues, was carried out thoroughly, in order to find possible lesions caused by the fixed orthodontic treatment.

RESULTS

Concerning RPE, 35% patients had reversible palatal lesions, while 45% patients had the impression of the appliance on the tongue. Periodontal damages were observed in 5% of the patients, as well as tooth lesions (i.e. dental caries). 20% of the patients with Forsus appliance experienced the lesion on the cheek mucosa, while 10% individuals reported periodontal problems, and 15% of the subject suffered for WSL (white spot lesion) and dental caries. Upper vestibular multibracket appliance caused superior labial lesions (15%), cheek mucosal lesions (20%), gingivitis (55%), white spot lesions (WSL) of superior teeth (15%), while dental recessions and periodontitis due to the appliance were rarely observed (5%). Lower vestibular multibracket appliance was frequently the cause of inferior labial lesions (15%), cheek mucosal lesions (15%), gingivitis (50%), WSL of inferior teeth (20%) and also in lower arch dental recessions and periodontitis due to the appliance were rarely observed (5%). Patients with both superior and inferior multibracket appliance experienced upper and/or lower lip lesions (25%), lesions of cheek mucosa (25%), gingivitis (65%) and WSL (30%), and just in few cases periodontitis (10%). Data shows a more critical oral situation in patients with both superior and inferior appliances than people with one-arch therapy.

CONCLUSIONS

Orthodontic therapy offers a considerable number of advantages, but it is important to underline what may be the adverse consequences also. This allows the orthodontist to inform the patient of all the possible effects of their therapeutic choice. In most cases, RPE can cause an impression of the device on the tongue and reversible lesions of the palate. On the other hand, the orthodontic fixed therapy can cause gingivitis, followed by mucosal lesions, labial lesions and WSL. For these reasons, an accurate assessment of the patients before the application of fixed orthodontic treatment is necessary. Oral hygiene instructions and motivation are very important, as well as periodic controls of the fixed oral device.

Alloplastic Facial Implants: A Systematic Review and Meta-Analysis on Outcomes and Uses in Aesthetic and Reconstructive Plastic Surgery

BACKGROUND

Alloplastic materials in facial surgery have been used successfully for various applications in the reconstructive restoration or aesthetic augmentation of the facial skeleton. The objective of this study was to conduct a comprehensive systematic review of alloplastic implant materials utilized to augment the facial skeleton stratified by anatomical distribution, indication, specific material used, and respective outcomes.

METHODS

A comprehensive systematic review on alloplastic facial implant data was conducted utilizing Medline/PubMed database. Articles were stratified by (1) anatomic localization in the face, as well as (2) alloplastic material.

RESULTS

A total of 17 studies (n = 2100 patients, follow-up range = 1 month-27 years) were included. Overall, mersilene mesh implants were associated with the highest risk of infection (3.38%). Methyl methacrylate implants were associated with the highest rate of hematoma (5.98%). Implants placed in the malar region (2.67%) and frontal bones (2.50%) were associated with the highest rates of infection. Implants placed in the periorbital region were associated with the highest rate of inflammation (8.0%), explantation (8.0%), and poor cosmetic outcome (17.0%). Porous implants were shown to be more likely to potentiate infection than non-porous implant types.

CONCLUSIONS

Alloplastic facial implants are a reliable means of restoring facial symmetry and achieving facial skeletal augmentation with a relatively low complication profile. It is important for plastic surgeons to understand the relative risks for each type of implant to develop postoperative complications or poor long-term cosmetic results. Interestingly, porous implants were shown to be more likely to potentiate infection than non-porous implant types.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Osteotomy in Genioplasty by Piezosurgery

BACKGROUND

The chin is the most prominent and median sector of the lower third of the face giving harmony to nose and lips. The authors present the application of piezoelectric scalpel for the correction of different chin deformities. The distinctive characteristics of this device allow the authors to avoid or reduce the immediate genioplasty complications.

METHODS

Fifty-five patients of defective chin have been treated from January 2006 to April 2008. Intraoral genioplasty was performed during the correction of dentofacial dysmorphisms or associated with nasal surgery. The authors used a piezoelectric cutting device to perform different osteotomies and if necessary, interpositional graft was used to stabilize bony segments.

RESULTS

Piezosurgery has been associated with a fewer number of postoperative complications, especially as regard intraoperative bleeding, nerve injuries (immediate and late), hematomas and seromas, asymmetry (immediate and early). The mean time for completing the complete procedure of genioplasty with piezosurgery was almost the same compared with the saw and drill.

CONCLUSION

Genioplasty represents one of the most common ancillary procedures and may be associated with corrective surgery of dentofacial dysmorphisms. Mental nerve injuries, asymmetries, intraoperative bleeding are the main immediate complications of genioplasty. Distinctive characteristics of ultrasonic piezoelectric osteotomy are selective cut of mineralized structure with less risk of vascular and nervous damage (microvibrations), intraoperative precision (thin cutting scalpel and no macrovibrations), blood free site (cavitation effect). In the authors' experience, piezoelectric scalpel, compared with saw and drill, enables them to reduce or avoid immediate complications of chin surgery, helping the surgeon to reach patients' satisfaction.

Injectable profiloplasty: Forehead, nose, lips, and chin filler treatment

INTRODUCTION

We propose a medical filler treatment algorithm of the profile which includes forehead, nose, and chin and to evaluate profilometric results and complications.

MATERIALS AND METHODS

83 case reviews of associated liquid forehead, nose, and chin plasty performed consecutively from 2014 to 2016. We monitored the horizontal and vertical sagittal stability into two age group: <40 y.o. and >40 y.o. using profilometric Arnett analysis measurements on the F, Gb, Na, Nd, Nt, Sn, ULA, LLA, B, Pg, and Gn soft-tissue points.

RESULTS

The results at both 3 and 6 months were consistent with the normal ranges indicated by Arnett, with a 0.8 mm maximum of defect/excess. Forehead treatment was performed in 51 (61.4%) patient. Patients >40 y.o. always needed a global correction of the forehead profile. We performed nasal treatment in 83 (100%) patient, acute nasolabial angles was the more frequent nasal defect. The lips were injected in 59 patients (71.1) more frequently >40 y.o. In 83 (100%) patients we perform a chin augmentation. The average advancement of the chin was 3 mm.

CONCLUSIONS

The correction of the projection of the forehead, of the profile and shape of the nose, of the lips and chin as well as an overall improvement in face aesthetics and harmony gives a good solution in patients avoiding the need for a surgical intervention, scars and cost of general anesthesia, thus providing the optimum in patient satisfaction.

Treatment Approach to Severe Microgenia Cases: Combined Use of Osseous and Implant Genioplasty

INTRODUCTION

As well as the chin is an important esthetic unit of the facial structure, it is also the region having a key role in the appearance of the face. Correction of cosmetic and functional deformities that may occur in this region because of serious hypoplasia (microgenia) is performed by chin augmentation. Chin augmentation is most frequently performed via implant or osseous genioplasty in the literature. Both 2 techniques have their own advantages and disadvantages. In the literature, various studies comparing these 2 techniques and their long-term results are present, but in some severe microgenia cases, these techniques can be insufficient only for augmentation. In such cases, combined use of implant and osseous genioplasty techniques can come up and data and experiences regarding such combined uses are limited in the literature. In our study, we aim to report our experiences and long-term results regarding 3 cases to whom chin augmentation combined with implant and osseous method is applied because of serious chin hypoplasia (microgenia).

METHOD

Three patients to whom chin augmentation combined with osseous and implant genioplasty was applied because of severe microgenia between 2011 and 2016 are included in our study. Before the chin restoration, orthognathic surgery or maxillomandibular distraction applications owing to existing obstructive sleep apnea, malocclusion, or facial asymmetry, are performed in the patients. In preoperative period, chin augmentation amount required is planned for all the patients via cephalometric analysis and the operations of all the patients are performed under general anesthesia via intraoral access.

RESULTS

Among 3 patients, 2 were male and 1 was female and their mean age was 27.3 years (22-33). In all the patients, primarily horizontal subapical sliding osteotomy was performed and advancement was performed. After osteotomy, mean 8-mm osseous advancement was obtained and Medpor implant was placed in the chin at the same session for additional augmentation. Mean advancement amount obtained by the Medpor implants was 9 mm. A total average of 17-mm augmentation was obtained in the patients via osseous and implant genioplasty. The reflection of this advancement amount on the soft tissue was measured as 13 mm. Mean follow-up period is 24 months and the patients did not encounter with a major complication in the postoperative period. In the postoperative period, early-period band application was performed at the chin of the patients to reduce edema and to support immobilization.

CONCLUSIONS

Chin contour is an important part of facial aesthetics and osseous genioplasty is the ideal treatment option for the correction of most chin deformities. However, in some serious microgenia cases, osseous genioplasty may be insufficient to correct the existing deformity. In such cases, it is seen that the combined correction procedures to be applied together with the implant use can be applicable in terms of the safety and its long-term results.

Development and Validation of a Photonumeric Scale for Assessment of Chin Retrusion

BACKGROUND

A validated scale is needed for objective and reproducible comparisons of chin appearance before and after chin augmentation in practice and clinical studies.

OBJECTIVE

To describe the development and validation of the 5-point photonumeric Allergan Chin Retrusion Scale.

METHODS

The Allergan Chin Retrusion Scale was developed to include an assessment guide, verbal descriptors, morphed images, and real subject images for each scale grade. The clinical significance of a 1-point score difference was evaluated in a review of multiple image pairs representing varying differences in severity. Interrater and intrarater reliability was evaluated in a live-subject validation study (N = 298) completed during 2 sessions occurring 3 weeks apart.

RESULTS

A difference of ≥1 point on the scale was shown to reflect a clinically meaningful difference (mean [95% confidence interval] absolute score difference, 1.07 [0.94–1.20] for clinically different image pairs and 0.51 [0.39–0.63] for not clinically different pairs). Intrarater agreement between the 2 live-subject validation sessions was substantial (mean weighted kappa = 0.79). Interrater agreement was substantial during the second rating session (0.68, primary end point).

CONCLUSION

The Allergan Chin Retrusion Scale is a validated and reliable scale for physician rating of severity of chin retrusion.

[Prosthetic genioplasty versus osseous genioplasty in aesthetic chin augmentation: Literature review and knowledge update]

Chin augmentation is commonly practiced, whether in microgenia treatment, in cases of orthognathic or cosmetic surgery. Located at the crossroads of many specialties, the technique choice still differs according to the surgeon specialiy. A large number of publications on the subject are available. A comparaison between different surgical methods is therefore possible concerning their indications and their complication. The purpose of this study was to carry out a literature review, with updating knowledge, as well as a synthesis indication regarding aesthetic osseous and alloplastic genioplasty. Despite the generalization of "modern" implants in France, prosthetic genioplasty remains more frequently the source of serious complications (infections, extrusions, bone erosions). Similarly, this technique has much more limited indications than osseous genioplasty, which has the advantage of a better longevity. In order to increase the aesthetic appearance of the chin, osseous genioplasty should be performed more easily and more frequently by surgeons on all sides.

Achieved chin position after genioplasty follows the planned horizontal change better than the planned vertical change

PURPOSE

The soft-tissue pogonion closely follows changes of the bony pogonion, but it is unknown how often an augmented bony pogonion reaches the intended position. Here we assessed the agreement between planned surgical changes and achieved results in chin surgery.

MATERIALS AND METHODS

Surgical treatment was planned based on clinical examination, cast model analysis, and cephalometric image analysis. The mobile chin segment was stabilized using one chin plate. Preoperative and postoperative cephalometric X-ray images were digitized, and cephalometric tracing was performed. We calculated and analyzed the changes between the preoperative and postoperative images as well as between planned genioplasty movements and actual surgical changes in the horizontal and vertical directions.

RESULTS

This study included 36 patients. In 34 patients, the absolute mean horizontal difference was less than 2 mm. We found a higher range of absolute error in vertical (0.00-5.60) compared to horizontal (0.01-3.64) movement. There was no significant difference between the mean planned chin movement and the mean achieved position with regard to the horizontal and vertical movement (p = 0.97 and 0.79, respectively).

CONCLUSIONS

The mean values for linear difference in both the horizontal and vertical directions were in line with the acceptable mean of ≤2 mm proposed in the literature.