1. Split-Overlapping Genioplasty: Surgical Technique, Morphological and Radiological Long-Term Outcomes.
- Author
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Roul-Yvonnet F, Quilichini J, and Leyder P
- Subjects
- Adolescent, Adult, Cephalometry methods, Female, France, Glycosides, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Pregnanes, Radiography methods, Retrognathia diagnosis, Surgical Flaps, Bone Resorption diagnosis, Bone Resorption etiology, Chin diagnostic imaging, Chin surgery, Genioplasty adverse effects, Genioplasty methods, Mandibular Osteotomy adverse effects, Mandibular Osteotomy methods, Maxillary Osteotomy adverse effects, Maxillary Osteotomy methods, Postoperative Complications diagnosis, Postoperative Complications prevention & control, Retrognathia surgery
- Abstract
Background: The overlapping bone flap genioplasty, described by Tessier, was developed to treat major retrognathia or long and retruded chins. For 15 years, we have used a modified version of this technique to avoid its drawbacks. The aim of this article is to describe our modification and evaluate the long-term morphologic and radiologic outcomes., Patients and Method: The authors included every split-overlapping genioplasty performed in our department between 2004 and 2014. Demographics, surgical data, and complications were recorded. Radiologic bone resorption was evaluated comparing preoperative, day-1 postoperative, and year-1 postoperative cephalometric x-rays. Morphologic outcomes were evaluated on standardized pre- and postoperative views using an analogic Likert scale., Surgical Technique: The main modification of the procedure consists in separating the posterior cortex of the transplant using a reciprocating saw. After overlapping the reduced transplant onto the mandible, the posterior cortex is used as an apposition graft to soften the labiomental crease., Results: Forty-seven patients were analyzed during this period. In 44 patients, the procedure was combined with mandibular and/or maxillary osteotomy. The average reduction of symphysis height was 5 mm, and the average pogonion advancement was 4.3 mm. After 1 year, we recorded 7% average bone resorption. No major complications (nerve injury, hematoma, among others) were reported. Morphologic outcomes were deemed satisfactory or very satisfactory in the vast majority of cases., Conclusion: Split-overlapping genioplasty is a safe and reliable procedure with stable, long-lasting outcomes. This versatile technique is particularly useful for the correction of a massive symphysis or high and retruded chins.
- Published
- 2017
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