Functional genioplasty in growing patients

Abstract

Objective: To evaluate the role of age as a moderator of bone regeneration patterns and symphysis remodeling after genioplasty. Method: Fifty-four patients who underwent genioplasty at the end of their orthodontic treatment were divided into three age groups: younger than 15 years at the time of surgery (group 1), 15 to 19 years (group 2), and 20 years or older (group 3). Twenty-three patients who did not accept genioplasty and had a follow-up radiograph 2 years after the end of their orthodontic treatment were used as a control group. Patients were evaluated at three time points: immediate preoperative (T1), immediate postoperative (T2,) and 2 years postsurgery (T3). Results: The mean genial advancement at surgery was similar for the three age groups, but the extent of remodeling around the repositioned chin was greater in group 1, less in group 2, and still less in group 3. Symphysis thickness increased significantly during the 2-year postsurgery interval for the three groups, and this increase was significantly greater in group 1 than in group 3. Remodeling above and behind the repositioned chin also was greater in the younger patients. This was related to greater vertical growth of the dentoalveolar process in the younger patients. There was no evidence of a deleterious effect on mandibular growth. Conclusion: The outcomes of forward-upward genioplasty include increased symphysis thickness, bone apposition above B point, and remodeling at the inferior border. When indications for this type of genioplasty are recognized, early surgical correction (before age 15) produces a better outcome in terms of bone remodeling. (Angle Orthod. 2015;85:360-373.)

Diagnosis and Innovative Multidisciplinary Management of Hallermann-Streiff Syndrome

“…The amount of new bone formation and the extent of remodeling around the repositioned chin is greater than in the case it is performed after the age of 15 (Chamberland et al, 2015). Therefore, when indicated for cosmetic concerns, it appears useless to wait for a later age.…”

“…Therefore, when indicated for cosmetic concerns, it appears useless to wait for a later age. It improves facial aesthetics, which can be a serious psychosocial handicap, even early in life (Chamberland et al, 2015). It allows redirection of mandibular growth reducing the open bite in wide angle class II patients (Precious and Delaire, 1985;Frapier et al, 2010).…”

Early Orthognathic Surgery: A Review

“…Several studies have reported that genioplasty is the most stable of the orthognathic surgery procedures and that significant relapse is almost never observed. 49,51,57,58 In contrast, few reports noted some greater relapse in younger patients when compared to adults but it was neither clinically nor statistically significant. 50 The use of expensive bone screws may not be required for all genioplasty procedures to achieve better postsurgical stability 59 since it can be expected with the use of wire fixation.…”

“…Some studies showed better healing after surgery in young patients following this type of surgery. 49,50 Other reports found that after genioplasty, bone remodeling of the mandibular alveolar bone above and behind the osteotomy site increased when this surgery is done in young growing patients. [51][52][53][54][55][56] On the contrary, there are some concerns about possible negative effects of the early surgery on growth postoperatively and decreased stability would be a major reason for waiting until little or no growth remained.…”

“…50 The use of expensive bone screws may not be required for all genioplasty procedures to achieve better postsurgical stability 59 since it can be expected with the use of wire fixation. 49…”