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Anti-skid Genioplasty Osteotomy by Pre-scoring with a Fissure Bur (Technical Note)
Ali Moradi1, Ali Mirzaei2, Ricardo Grillo3
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Background:
Starting a genioplasty osteotomy on the curved anterior mandible can cause the saw to skid. This poses a risk of deviating from the planned trajectory and potentially injuring the mental nerve. We propose a simple modification: pre-scoring the osteotomy line with a fissure bur to create shallow cortical tracks. These tracks act as a mechanical guide for the micro-saw.
Methods:
After bilateral exposure of the parasymphysis with visualization of the mental nerve, the planned osteotomy was marked beneath the foramina. A fissure bur was then used with copious irrigation to gently score the marked line, creating linear cortical tracks. A reciprocating or oscillating micro-saw was then introduced and advanced within these tracks to complete the osteotomy.
Results:
In a representative adult case, the saw engaged the bur-scored grooves without skidding, allowing the osteotomy to follow the planned path. The segment was mobilized and plated as intended. The pre-scoring step added approximately 2 minutes to the procedure and required no additional instruments. Transient lower-lip/chin hypoesthesia resolved by 8 weeks, and no re-operations were necessary.
Conclusion:
Pre-scoring provides a low-cost, easily adopted anti-skid step that improves initial directional control of the saw during genioplasty. This modification uses routine instruments and may enhance accuracy and safety near the mental nerve. However, meticulous retraction and irrigation remain essential.
