Correction of chin deformities using customized surgical guide and repositioning plates

Abstract

Aim To assess the accuracy of using computer designed genioplasty osteotomy guide and customized repositioning plates in patients with chin deformities. Methods This was prospective randomized noncontrolled clinical study that was carried out on eight adult patients suffering from chin deformities as a result of unilateral temporomandibular joint ankylosis. Patients were selected from the outpatient clinic, Department of Oral and Maxillofacial surgery, Faculty of Dentistry, Tanta University. All cases were operated for genioplasty under general anesthesia. The incision was performed on the alveolar mucosa apical to the attached gingiva by 0.5 cm in two planes (mucosal and muscular), The cutting guide was seated to the mandibular dentition, the eight screw holes were then drilled, the cutting guide was temporarily fixed on the mandible by mini screws, once the osteotomy plane was marked by a surgical saw, the cutting guide was removed, osteotomy completed routinely and the customized reposition plates were installed to reposition the chin segment as planned. Finally, after the screws were placed and tightened, the chin segment was automatically moved to its final planned position and secured. Closure was done in two layers (the muscle layer followed by the mucosa). Results Genioplasty procedure using customized surgical guide and repositioning plates was performed in every case. Postoperative recovery was satisfactory for all patients. There were no intraoperative or postoperative complications, except self-limiting edema and some small hematomas with no clinical significance. Postoperative pain intensity measured by the Visual Analog Scale was acceptable for all patients. All cases reported full recovery from neurosensory disturbance after three months follow-up periods. Regarding patients' satisfaction, all the cases were very satisfied (grade I) with a percentage of 100% on the third month postoperatively. Conclusion The results obtained from this study show that using customized surgical guide and repositioning plates in performing genioplasty had advantages over conventional technique as they provided greater accuracy, safety, less complication during the surgery with decrease in surgery time, and made the results of genioplasty procedure more predictable. So, using customized surgical guide and repositioning plates simplified the genioplasty procedure.