International Journal of Oral and Maxillofacial Surgery
Technical NoteOrthognathic SurgeryChin shield osteotomy – a new genioplasty technique avoiding a deep mento-labial fold in order to increase the labial competence
Section snippets
Surgical technique
The surgery can be carried out under local anaesthesia, depending on whether other corrections need to be executed at the same time. The genioplasty can be facilitated by immobilisation of the mandible via a peri-operative inter-maxillary fixation.
The incision runs from premolar to premolar. The mucosa is superficially incised in the vestibulum, 0.5–1.0 cm below the muco-gingival junction. After identification of the ramus labialis of the mental nerve, the incision is continued vertically down
Case report
A 26-year-old female patient was referred to the maxillofacial surgeon for an orthognathic and aesthetic correction. Her profile showed a dental occlusion angle class II, a protrusion of the front and a retrogeny (Fig. 3, Fig. 4). The clinical picture was dominated by marked labial incompetence. This was partly due to the length of the maxilla with 10 mm incisal exposure, but also to a mandibular retrusion with an overjet of 5 mm. Marked mentalis hyperactivity was present, caused by the labial
Discussion
The goal of genioplasty in profile improvement is to correct the position of the jaw line, and to provide an aesthetic sub-labial fold and a competent lip seal. Excessive chin advancement can lead to a marked sub-labial fold and increased soft tissue tension resulting in labial incompetence4, 5, 6, 15, 18, 19, 22.
One method of avoiding an excessive sub-labial fold is to augment this region with autologous bone from the iliac crest7 or other autologous material such as cartilage from the ear or
Competing interests
None declared
Funding
None
Ethical approval
Not required
Acknowledgements
We would like to thank Drs Beat Merz and Viola Schmidt-Schäffer for help in preparing this publication.
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Advantages of performing mentoplasties with customized guides and plates generated with 3D planning and printing. Results from a series of 23 cases
2018, Journal of Cranio-Maxillofacial SurgeryCitation Excerpt :All these surgical and technical difficulties argue in support of those who defend the use of chin prosthetics as allowing for simpler and more predictable procedures, although there is a disadvantage with respect to the long-term outcome of the prosthesis (Friedland et al., 1976; Wolfe, 1987; Cohen et al., 1991; Yaremchuk, 2003; Scolozzi, 2015; Sykes and Fitzgerald, 2016). Moreover, an optimal surgical plan and accurate intraoperative performing is the premise for achieving a satisfactory postoperative outcome for genioplasty (Triaca et al., 2009; Ahmad Akhoundi et al., 2012; Polley and Figueroa, 2013; Kang et al., 2014; Li et al., 2017). Currently simplified techniques are being developed for genioplasty using a customized guide manufactured with three-dimensional (3D) printing technology (Olszewski et al., 2010; Hierl et al., 2013; Hsu et al., 2013; Keyhan et al., 2013, 2016; Salvato et al., 2014; Berridge and Heliotis, 2016; Brunso et al., 2016; Ferretti and Reyneke, 2016).
Modification of horizontal sliding osteotomy for asymmetrical chin
2017, British Journal of Oral and Maxillofacial SurgeryProfile changes after conventional and chin shield genioplasty
2014, Journal of Oral Biology and Craniofacial ResearchCitation Excerpt :Other modifications made from time to time include sagittal split genioplasty,9 M shaped genioplasty,10 horizontal flip genioplasty,11 oblique mandibular chin-body osteotomy for correction of broad chin,12 and transverse reduction genioplasty to reduce width of chin.13,14 Triaca et al,2 introduced chin shield osteotomy as a new genioplasty technique to avoid a deep mentolabial fold and increase labial competence. It has also been reported that genioplasty performed during puberty promotes spontaneous lip closure15–17 as was also seen in both our groups where lip competency was achieved after genioplasty.
Genioplasty and Mandibular Implants
2021, Facial Plastic SurgeryCaptain America's Shield Genioplasty
2021, Journal of Craniofacial Surgery