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A new minimally invasive genioplasty procedure
169 This heuristic finding explores the indications and potential of the technique due to piezosurgery and in depth review of the threedimensional (3D) dynamics of segment positioning (courtesy 3D planning techniques) which allows for contact point elimination and stabilisation of ramus segment as well as the simultaneous harvesting of bone. http://dx.doi.org/10.1016/j.ijom.2017.02.578 Long-term clinical performance of a biodegradable versus a titanium fixation system in maxillofacial surgery: a multicentre randomised clinical trial N. van Bakelen ∗ , B. Gareb, J. de Visscher, T. Hoppenreijs, E. Bergsma, R. Bos University Medical Center Groningen, Groningen, The Netherlands Background: Biodegradable fixation systems could reduce/eliminate problems associated with titanium removal in a second operation. Objectives: The aim of this study was to compare the long-term (i.e. five years postoperatively) clinical performance of a titanium and a biodegradable fixation system in maxillofacial surgery. Methods: The present multicentre randomised controlled trial was performed in four hospitals in the Netherlands. Patients treated with a bilateral sagittal split osteotomy and/or a Le Fort I osteotomy, and those treated for fractures of the mandible, maxilla, or zygoma from December 2006 to July 2009 were recruited. Inclusion of the 230 patients was based on power analysis using the outcome measure: bone healing after 8 weeks.1 The patients were randomly assigned to a titanium group (KLS Martin) or a biodegradable group (Inion CPS). Findings: After five years postoperatively, plate removal was performed in 22 of the 134 (16.4%) patients treated with titanium and in 23 of the 87 (26.4%) patients treated with the biodegradable system, respectively (P = 0.036, hazard ratio (HR) biodegradable (95% CI) = 2.0 (1.05–3.8), HR titanium = 1). occlusion, visual analogue scale pain scores, and MFIQ showed good and (almost) pain free mandibular function in both groups. Conclusion: The KLS Martin titanium system is preferable to the Inion CPS biodegradable system in the abovementioned surgical procedures.
Reference 1. Buijs, G. J., van Bakelen, N. B., Jansma, J., de Visscher, J. G., Hoppenreijs, T. J., Bergsma, J. E., et al. (2012). A randomized clinical trial of biodegradable and titanium fixation systems in maxillofacial surgery. J Dent Res, 91, 299–304.
http://dx.doi.org/10.1016/j.ijom.2017.02.579 A new minimally invasive genioplasty procedure S. Van Roy ∗ , N. Nadjmi, G. Van Hemelen, E. Van de Casteele ZMACK, AZ MONICA Antwerpen, Antwerp, Belgium Background: The chin has an important role in completing facial harmony. In order to enhance the appearance of a small chin several techniques have been described in literature. Nevertheless, according to Sykes et al., the gold standard is still genioplasty.
Objectives: The aim of this study was to define a new minimally invasive technique to perform a chin osteotomy and to assess the postoperative dysfunction, discomfort and recovery time compared to the standard technique described by Trainer and Obwegeser (1957). Methods: From January 2016 till September 2016 we performed 13 genioplasties, according to our new technique. When performing a minimally invasive genioplasty (MIG) procedure, the standard horizontal mucosal incision through the Mm Mentales is replaced by a vertical incision through the labial frenulum onto the bony midline. The Mm Mentales are kept intact by elevating, instead of transecting the bellies. In patient follow-up we noticed a remarkable improvement in postoperative dysfunction and recovery of the Mentalis muscles and nerves. Seeing these results we started a prospective study with two groups of patients in whom the lower lip sensibility and functionality will be assessed. In group one the patients are treated according to the new MIG technique and in group two they are treated according to the standard technique. All included patients need a chin advancement of 4–8 mm. Results: Preliminary results showed better postoperative recuperation and overall better functional outcome using the MIG technique. Not all patients were evaluated so definitive results will be presented at the International Conference on Oral and Maxillofacial Surgery. http://dx.doi.org/10.1016/j.ijom.2017.02.580 Risk factors for osseous mandibular inferior border defects after bilateral sagittal split osteotomy J. Verweij ∗ , J. van Rijssel, G. Mensink, P. Gooris, R. van Merkesteyn Leiden University Medical Centre, Leiden, The Netherlands Background: Bone defects of the inferior border of the mandible (osseous inferior border defects) after bilateral sagittal split osteotomy (BSSO) can cause an unaesthetic postoperative outcome and sometimes necessitates secondary surgical intervention. Objectives: The purpose of this study was to estimate the frequency of osseous inferior border defects after BSSO and to identify factors associated with an increased risk for osseous defects of the inferior border. Methods: This retrospective cohort study included consecutive patients who underwent BSSO advancement, according to the Hunsuck modification using splitter and separators. Risk factors included extent of mandibular movement, rotation of the occlusal plane, postoperative position of the proximal segment, the pattern of the lingual fracture, the occurrence of bad split, and presence of third molars. The primary outcome variable was the presence/absence of osseous inferior border defects. Findings: The study sample consisted of 200 patients with a mean follow-up of 13 months (range 6–38 months). The mean mandibular advancement and rotation was respectively 5.8 mm and 5.4 degrees clockwise. Osseous inferior border defects were present in 7.0% of sagittal splits and 12.5% of patients. Significant risk factors for inferior border defects included increased advancement, increased clockwise rotation, cranial rotation of the proximal mandibular segment, and a type II split originating in the lingual cortex. Conclusion: Osseous inferior border defects occur significantly more often in cases with large mandibular advancement, increased
Reference 1. Buijs, G. J., van Bakelen, N. B., Jansma, J., de Visscher, J. G., Hoppenreijs, T. J., Bergsma, J. E., et al. (2012). A randomized clinical trial of biodegradable and titanium fixation systems in maxillofacial surgery. J Dent Res, 91, 299–304.
http://dx.doi.org/10.1016/j.ijom.2017.02.579 A new minimally invasive genioplasty procedure S. Van Roy ∗ , N. Nadjmi, G. Van Hemelen, E. Van de Casteele ZMACK, AZ MONICA Antwerpen, Antwerp, Belgium Background: The chin has an important role in completing facial harmony. In order to enhance the appearance of a small chin several techniques have been described in literature. Nevertheless, according to Sykes et al., the gold standard is still genioplasty.
Objectives: The aim of this study was to define a new minimally invasive technique to perform a chin osteotomy and to assess the postoperative dysfunction, discomfort and recovery time compared to the standard technique described by Trainer and Obwegeser (1957). Methods: From January 2016 till September 2016 we performed 13 genioplasties, according to our new technique. When performing a minimally invasive genioplasty (MIG) procedure, the standard horizontal mucosal incision through the Mm Mentales is replaced by a vertical incision through the labial frenulum onto the bony midline. The Mm Mentales are kept intact by elevating, instead of transecting the bellies. In patient follow-up we noticed a remarkable improvement in postoperative dysfunction and recovery of the Mentalis muscles and nerves. Seeing these results we started a prospective study with two groups of patients in whom the lower lip sensibility and functionality will be assessed. In group one the patients are treated according to the new MIG technique and in group two they are treated according to the standard technique. All included patients need a chin advancement of 4–8 mm. Results: Preliminary results showed better postoperative recuperation and overall better functional outcome using the MIG technique. Not all patients were evaluated so definitive results will be presented at the International Conference on Oral and Maxillofacial Surgery. http://dx.doi.org/10.1016/j.ijom.2017.02.580 Risk factors for osseous mandibular inferior border defects after bilateral sagittal split osteotomy J. Verweij ∗ , J. van Rijssel, G. Mensink, P. Gooris, R. van Merkesteyn Leiden University Medical Centre, Leiden, The Netherlands Background: Bone defects of the inferior border of the mandible (osseous inferior border defects) after bilateral sagittal split osteotomy (BSSO) can cause an unaesthetic postoperative outcome and sometimes necessitates secondary surgical intervention. Objectives: The purpose of this study was to estimate the frequency of osseous inferior border defects after BSSO and to identify factors associated with an increased risk for osseous defects of the inferior border. Methods: This retrospective cohort study included consecutive patients who underwent BSSO advancement, according to the Hunsuck modification using splitter and separators. Risk factors included extent of mandibular movement, rotation of the occlusal plane, postoperative position of the proximal segment, the pattern of the lingual fracture, the occurrence of bad split, and presence of third molars. The primary outcome variable was the presence/absence of osseous inferior border defects. Findings: The study sample consisted of 200 patients with a mean follow-up of 13 months (range 6–38 months). The mean mandibular advancement and rotation was respectively 5.8 mm and 5.4 degrees clockwise. Osseous inferior border defects were present in 7.0% of sagittal splits and 12.5% of patients. Significant risk factors for inferior border defects included increased advancement, increased clockwise rotation, cranial rotation of the proximal mandibular segment, and a type II split originating in the lingual cortex. Conclusion: Osseous inferior border defects occur significantly more often in cases with large mandibular advancement, increased