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Comparison of Modified Triangular and Horizontal Osteotomy in Sliding Genioplasty
Jianbin Zhuang1, Peng An1, Jingyi Xie1
1Resident, Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China.
Background:
Osteotomy design may influence labiomental and transverse chin contour changes after advancement genioplasty. Two common osteotomy designs are horizontal and triangular.
Purpose:
The purpose was to measure and compare operative changes in the mental region between modified triangular and conventional horizontal osteotomy designs after advancement genioplasty. The specific changes are listed as outcome variables.
Study Design, Setting, Sample:
This retrospective cohort study was conducted at our institution from January 2020 to March 2025. Eligible subjects were adults aged ≥ 18 years with chin retrognathia who underwent virtual surgical planning and three-dimensional printed template-guided genioplasty with planned 8-mm advancement. Patients with prior chin surgery, craniofacial syndromes, trauma-related deformities, preoperative conditions or medications affecting bone healing, incomplete imaging records, or simultaneous orthognathic procedures were excluded.
Predictor Variable:
Osteotomy design, coded as conventional horizontal osteotomy or modified triangular osteotomy.
Main Outcome Variables:
Labiomental sulcus depth, soft tissue mentolabial angle, bony mentolabial angle, and chin width at the osteotomy level, measured preoperatively and 3 months postoperatively. Secondary categorical outcomes included target attainment for labiomental sulcus depth and bony mentolabial angle.
Covariates:
Covariates included age and sex.
Analyses:
Paired t-tests or Wilcoxon signed-rank tests, Mann-Whitney U tests, Fisher exact tests, and Spearman correlations (r) were used. Statistical significance was set at P < .05.
Results:
The sample was composed of 32 subjects with a mean age of 26.8 (3.9) years, and 16 (50%) were female. The triangular group showed statistically significantly smaller increases in labiomental sulcus depth (+1.67 [1.42] mm vs +2.60 [1.08] mm; P = .024) and chin width (+3.12 [0.26] mm vs +5.17 [0.73] mm; P < .001) than the horizontal group. The change in soft tissue mentolabial angle did not differ statistically significantly between groups (-15.20 [18.00] ° vs -17.39 [11.61] °; P = .5). Sulcus-depth target attainment was 75% (12/16) in the triangular group and 0% (0/16) in the horizontal group (P < .001), with respective bony mentolabial angle target attainments of 100% (16/16) and 0% (0/16) (P < .001).
Conclusions And Relevance:
Modified triangular osteotomy was associated with less postoperative widening and more frequent attainment of the predefined bony mentolabial angle range.
