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Mandibular Augmentation With a New Sandwich Osteotomy: A Morphologic Study.

Wuyuan Tan1, Bing Yu2, Feng Niu2

  • 1Department of Plastic and Aesthetic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan.

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This study shows that sandwich osteotomy with coral or coralline hydroxyapatite (CHA) effectively increases mandibular thickness and volume. CHA demonstrated superior results for mandibular augmentation in goats.

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Area of Science:

  • Plastic and Craniofacial Surgery
  • Biomaterials in Regenerative Medicine
  • Skeletal Reconstruction

Background:

  • Facial asymmetry is a common concern in plastic and craniofacial surgery, often linked to hemimandibular dysplasia.
  • Reduced mandibular thickness, alongside length and height deficits, significantly contributes to facial asymmetry.
  • Current surgical options for mandibular augmentation require further refinement.

Purpose of the Study:

  • To evaluate the therapeutic efficacy of mandibular augmentation using a novel sandwich osteotomy technique.
  • To assess the use of natural coral and coralline hydroxyapatite (CHA) as interpositional grafts for mandibular augmentation.
  • To compare the outcomes of natural coral versus CHA grafts in enhancing mandibular dimensions.

Main Methods:

  • A sandwich osteotomy procedure was performed on nine goats, splitting the bilateral mandibular outer cortex.
  • Interpositional grafting was done using either natural coral or CHA in separate groups.
  • Goats were observed at 6, 12, and 18 months post-surgery, with data analyzed using t-tests.

Main Results:

  • Computed tomography confirmed successful healing and increased mandibular thickness across all groups and time points.
  • Significant increases in mandibular thickness and volume were observed compared to pre-operative measurements (P < 0.05).
  • The coralline hydroxyapatite (CHA) group showed significantly better volume improvement than the natural coral group (P < 0.05).

Conclusions:

  • Sandwich osteotomy with interpositional grafting of natural coral or CHA offers a promising approach for mandibular augmentation.
  • The technique effectively increased mandibular thickness and volume, addressing a key component of facial asymmetry.
  • Coralline hydroxyapatite (CHA) presents a potentially superior graft material for enhancing mandibular dimensions compared to natural coral.