Feasibility of Chin Wing Osteotomy: Can it be considered a routine procedure in orthognathic surgery?

Abstract

The Chin Wing osteotomy represents a choice of alternative genioplasty, well described in literature but until today slightly used, mainly due to the greater risk of damage to the inferior alveolar nerve (IAN) related compared to the classic genioplasty. The study aims to better analyze the rate of nerve damage and its real impact on the patient's daily life. A retrospective study of 26 patients who underwent to BSSO in a first stage without IAN sensitivity disturbs reported and chin wing genioplasty in a second stage, between 2019 and 2024 was performed. A total of 23 patients were included and subdivided in two groups: 10 patients underwent BSSO+ mini Chin wing osteotomy (Group B), 13 patients underwent BSSO+ complete Chin Wing osteotomy (Group A). We analyzed rates of IAN damage by using some clinical neurosensory at least 12 months after surgery testing lower lip and chin area residual sensitivity for each group. We also analyzed patients' quality of life after chin wing osteotomy by using a subjective questionnaire and life quality questionnaire (OHIP-14) administered at the patient's 1 year follow up appointment. There was 72% recovery in Group A and 70 % recovery in Group B after 1 year follow up. Only for two-point discrimination and tactile sensitivity significant difference between anterior and complete chin wing osteotomy was found: slight better sensitivity after mini wing osteotomy. The sensibility of IAN discreetly preserved and which does not interfere with quality of life. Excellent patient satisfaction from a functional and aesthetic point of view was reached.