Clinical Study on the Minimally Invasive-Guided Genioplasty Using Piezosurgery and 3D Printed Surgical Guide

A retrospective clinical study was performed regarding the minimally invasive-guided genioplasty technique (MIGG technique) described in a previous clinical note. The aims of this clinical study were to study the incidence of immediate complications with this technique compared with a control group using a nonminimally genioplasty technique, to validate the accuracy of the three-dimensional (3D) printed cutting guide, and to evaluate the duration of the surgery and the satisfaction of the surgeons with this technique.

One controlled group, including 56 patients, operated with a classical genioplasty and one group, including 24 patients operated with the MIGG technique. The inclusion criteria were patients from 18 years old benefiting from orthognathic surgery for dysmorphic maxillofacial disorders, sleep apneas, or posttraumatic malocclusion; operated by the three same surgeons. A database was retrospectively made, including the demographics parameters, the indication, the type and the duration of surgery, the incidence of complication, and the type of complication. The accuracy of the cutting guide was also studied by the comparison of two distances in the MIGG group on the preoperative surgical simulation and on the postoperative cephalometric radiography. A satisfaction survey for the surgeons of the department regarding the MIGG technique was also analyzed.

No statistical difference was found in the incidence of complications between the MIGG group and the control group. Using a guide does not cause more surgical infection. The protection of the inferior alveolar nerve is obvious. The absence of statistical difference is due to the fact that the majority of patients also benefited from the bilateral sagittal split osteotomy during surgery. The 3D-cutting guide used is very accurate: There is indeed no significative difference in the measurements A and B before and after the genioplasty. The MIGG technique is thus a predictable, safe, and easy-to-use technique that should be used routinely by maxillofacial surgeons. It combines the latest technologies in piezosurgery and in 3D-guided surgery by the creation of a validated-accurate 3D-printed cutting guide. This technique is affordable by the use of open-source program and a desktop fused deposit Modeling 3D-printer. Finally, the comfort of the surgeon is improved, and the operating time is decreased.