Related Experiment Video
Updated: Jun 8, 2025
Treatment of Facial Deformities using 3D Planning and Printing of Patient-Specific Implants
Published on: May 23, 2020
A Novel Method of Correcting Lower Facial Asymmetry: Computer-Assisted Surgery with Contralateral Mandibular Outer
Zhiyang Xie1,2, Yarui Wu3, Shunchao Yan1
1Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, Gulou District, No. 146, Hanzhong Road, Nanjing, 210029, Jiangsu Province, People's Republic of China.
Background:
Lower facial asymmetry often results in an esthetically unpleasing appearance. The purpose of this study was to develop a novel method for correcting lower facial asymmetry using mandibular augmentation with sandwich bone grafts from the contralateral mandibular outer cortex (MOC), and to evaluate the efficacy of this method using computer-assisted techniques.
Methods:
The medical records of 16 patients with lower facial asymmetry who underwent mandibular augmentation with sandwich bone grafts from the contralateral MOC between January 2016 and December 2019 were retrospectively reviewed. Preoperative computer-aided design (CAD) was performed based on CBCT data, MOC grafts were harvested from the donor side using a 3D printed osteotomy guide template and grafted to the recipient side in sandwich manner to augment the contralateral mandible. Effectiveness was evaluated through pre- and postoperative CBCT data and FACE-Q questionnaire scores. Neurosensory recovery of the inferior alveolar nerve was assessed using the functional sensory recovery (FSR) scale.
Results:
All procedure were successfully completed, and the asymmetry was effectively corrected three-dimensionally with no serious complications. The patients' FACE-Q scores for satisfaction with the lower facial area significantly increased from 52.19±7.51 to 86.69±7.50. No significant differences were observed in the pre- and postoperative lengths of mandibular ramus or body on either side. The donor site volume increased by 559.38±335.12 mm3 at 6 months postoperatively. The recipient site volume increased by 4415.94±1017.21 mm3 on the 7th day postoperatively and decreased by 202.63±300.85 mm3 at 6 months, reflecting a bone resorption rate of 5.67 ± 8.12%. The median FSR time for the chin and lower lip was 90 days.
Conclusions:
Mandibular augmentation with contralateral MOC sandwich grafts effectively increases mandibular width and volume with a low resorption rate. This method allows for three-dimensional restoration of facial symmetry in cases of mild to moderate lower facial asymmetry, achieving a harmonious and symmetric appearance.
Level Of Evidence Iv:
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. www.springer.com/00266.
