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Long-term osseous and soft tissue changes after large chin advancements
1Division of Oral and Maxillofacial Surgery, University of Texas, Southwestern Medical Center, Dallas.
Summary
Large advancement genioplasties (greater than 10 mm) can cause bone resorption, but preserving a broad musculo-periosteal pedicle minimizes this. Chin soft tissues adapt well to bone movement, showing stable results long-term.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Plastic Surgery
Background:
- Large advancement genioplasties aim to improve chin projection.
- Preserving a musculo-periosteal pedicle is crucial to prevent complications.
- Excessive stretching of suprahyoid muscles can lead to instability and resorption.
Purpose of the Study:
- To evaluate long-term bone and soft tissue changes after large advancement genioplasties (>10 mm).
- To assess osseous remodeling and soft tissue adaptation following mandibular osteotomy with pedicle preservation.
Main Methods:
- Horizontal osteotomy of the inferior border of the mandible was performed.
- A broad musculo-periosteal pedicle was preserved to the advanced genial segment.
- Radiographic assessment was used for long-term follow-up (mean 26.8 months).
Main Results:
- Observed 17% bone resorption, but it was not progressive.
- Soft tissues followed bony movement in a 1:0.83 ratio, remaining unaltered.
- The preservation of the pedicle minimized osseous resorption and stabilized soft tissue changes.
Conclusions:
- A broad musculo-periosteal pedicle is essential for minimizing bone resorption and achieving predictable soft tissue results in large advancement genioplasties.
- Longer follow-up (25-30 years) is needed to fully assess the impact of stabilization devices and osseous remodeling, especially in younger patients.