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Bone resorption, stability, and soft-tissue changes following large chin advancements
W D Polido1, L de Clairefont Regis, W H Bell
1Division of Oral and Maxillofacial Surgery, University of Texas, Southwestern Medical Center, Dallas 75235-9031.
Summary
Large chin advancements using horizontal osteotomy of the mandible are stable, preserving 76% of the initial bone movement. Maintaining the musculoperiosteal pedicle is crucial for minimizing bone resorption and achieving predictable soft-tissue changes.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Orthognathic Surgery
Background:
- Genioplasty is a surgical procedure to augment the chin.
- Large advancements in genioplasty present challenges in stability and soft-tissue adaptation.
- Preservation of vascularized tissue is often key in bone grafting and augmentation procedures.
Purpose of the Study:
- To evaluate the stability and outcomes of large advancement genioplasties performed with a specific surgical technique.
- To assess both hard tissue (bone) and soft tissue changes following the procedure.
- To determine the long-term preservation of the advanced genial segment.
Main Methods:
- Retrospective analysis of 10 patients undergoing large advancement genioplasty (mean 11.7 mm).
- Surgical technique involved horizontal osteotomy of the inferior mandibular border with a preserved musculoperiosteal pedicle.
- Lateral cephalometric radiographs were used for pre-operative, immediate post-operative, and long-term follow-up assessments.
Main Results:
- A mean follow-up of 15 months showed 76% of the initial bone advancement was preserved.
- An average of 24% osseous resorption was observed in the advanced genial segment.
- Soft tissue changes followed bony movement at a ratio of 1:0.88.
Conclusions:
- Horizontal osteotomy of the inferior mandibular border is a relatively stable method for significant chin advancement.
- Maintaining the musculoperiosteal pedicle attached to the advanced segment is vital for reducing bone resorption.
- This technique facilitates more predictable soft-tissue contouring in large genioplasty cases.