Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

A Study on the Prediction of Hard and Soft Tissue Changes after Setback Genioplasty

후진 이부성형술의 경조직과 연조직 측모 변화 예측에 관한 연구

  • Yang, Jung-Eun (Department of Oral and Maxillofacial Surgery, Section of Dentistry, School of Medicine, Inha University) ;
  • Kim, Il-Kyu (Department of Oral and Maxillofacial Surgery, Section of Dentistry, School of Medicine, Inha University) ;
  • Cho, Hyun-Young (Department of Oral and Maxillofacial Surgery, Section of Dentistry, School of Medicine, Inha University) ;
  • Ju, Sang-Hyun (Department of Oral and Maxillofacial Surgery, Section of Dentistry, School of Medicine, Inha University) ;
  • Pyeon, Young-Hoon (Department of Oral and Maxillofacial Surgery, Section of Dentistry, School of Medicine, Inha University) ;
  • Jung, Bum-Sang (Department of Oral and Maxillofacial Surgery, Section of Dentistry, School of Medicine, Inha University) ;
  • Pae, Sang-Pill (Department of Oral and Maxillofacial Surgery, Section of Dentistry, School of Medicine, Inha University) ;
  • Cho, Hyun-Woo (Department of Oral and Maxillofacial Surgery, Section of Dentistry, School of Medicine, Inha University)
  • 양정은 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 김일규 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 조현영 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 주상현 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 편영훈 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 정범상 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 배상필 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 조현우 (인하대학교 의과대학 치과학교실 구강악안면외과)
  • Received : 2012.07.29
  • Accepted : 2012.11.27
  • Published : 2012.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this setback genioplasty study is to develop a prediction method for the calculated osteotomy angle using horizontal and vertical changes as well as to evaluate the proportion of hard and soft tissue changes. Methods: Twelve patients who had received setback genioplasty with other maxillofacial surgery were examined. Three lateral cephalograms were taken just before surgery, immediately after surgery, and 3 months later surgery. A reference line was established to the reference point of the inner most point of the lingual symphysis cortex, incisor tip, and 2nd molar cusp tip. Measuring was conducted from pogonion (Pg), menton (Me), labrale inferius (Li), Mentolabial fold, soft tissue pogonion (Pg'), and soft tissue menton (Me') to the reference lines. Results: In setback genioplasty, the skeletal Pg moved posteriorly 5.07 mm. The ratios of soft tissue to hard tissue movement were 36% posteriorly and 62% inferiorly at Pg', 67% posteriorly and 104% inferiorly at Me', and 34% anteriorly and 164% posteriorly at Li. In reduction & setback genioplasty, skeletal Pg moved posteriorly 4.63 mm and skeletal Me moved superiorly 3.63 mm. The ratios of soft tissue to hard tissue movement were 76% posteriorly and 18% superiorly at Pg', 68% posteriorly and 42% superiorly at Me', and 44% anteriorly, 124% posteriorly at Li. The calculated mean slope angle, based on ${\Delta}H/{\Delta}V$ ratio, was 61.25 and the measured mean slope angle was 60.17. Thus, the calculated and measured slope angles have a similarity. Conclusion: In setback genioplasty, soft tissue moves posteriorly and inferiorly. In particular, at the Me' and Pg', the inferior movement of the soft tissue is greater than the posterior movement. Also, the predictable results (measured slope angle) after operation can be achieved by the calculated slope angle. Thus, the relationship of soft and hard tissue changes must be considered as the results are predictable.

Keywords

References

  1. Hofer O. Operation der Prognathie und Mikrogenie. Deutsche Zahnarztl Mund Kief 1942;9:121-32.
  2. Trauner R, Obwegeser H. The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 1957;10:677-89. https://doi.org/10.1016/S0030-4220(57)80063-2
  3. Hinds EC, Kent JN. Genioplasty: the versatility of horizontal osteotomy. J Oral Surg 1969;27:690-700.
  4. Johan PR. Essentials of orthognathic surgery. Seoul: Koonja; 2005. p.31.
  5. Hershey HG, Smith LH. Soft-tissue profile change associated with surgical correction of the prognathic mandible. Am J Orthod 1974;65:483-502. https://doi.org/10.1016/0002-9416(74)90031-1
  6. Kim KR, Kim SS, Son WS, Park SB. Soft tissue changes associated with advancement genioplasty in skeletal class III individuals receiving mandibular set-back surgery. Korean J Orthod 2008;38:104-20. https://doi.org/10.4041/kjod.2008.38.2.104
  7. Lee ET, Kim SN, Min SK, Lee DK, Song JM. A clinical study on stability between wire and plate/screw osteosynthetis in genioplasty. J Korean Assoc Maxillofac Plast Reconstr Surg 2002;24:226-36.
  8. Hohl TH, Epker BN. Macrogenia: a study of treatment results, with surgical recommendations. Oral Surg Oral Med Oral Pathol 1976;41:545-67. https://doi.org/10.1016/0030-4220(76)90307-8
  9. Talebzadeh N, Pogrel MA. Long-term hard and soft tissue relapse rate after genioplasty. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:153-6. https://doi.org/10.1067/moe.2001.112392
  10. Edwards RC, Kiely KD, Eppley BL. Resorbable fixation techniques for genioplasty. J Oral Maxillofac Surg 2000;58: 269-72. https://doi.org/10.1016/S0278-2391(00)90049-1
  11. McDonnell JP, McNeill RW, West RA. Advancement genioplasty: a retrospective cephalometric analysis of osseous and soft tissue changes. J Oral Surg 1977;35:640-7.
  12. Choi EZ, Lee JG, Rhee SH, Hwang BN. The study of the soft tissue change according to skeletal change follow BSSRO with advanceing genioplasty. J Korean Assoc Maxillofac Plast Reconstr Surg 2000;22:51-5.
  13. Keeling SD, LaBanc JP, Van Sickels JE, Bays RA, Cavalieros C, Rugh JD. Skeletal change at surgery as a predictor of long-term soft tissue profile change after mandibular advancement. J Oral Maxillofac Surg 1996;54:134-44. https://doi.org/10.1016/S0278-2391(96)90433-4
  14. Shaughnessy S, Mobarak KA, Hogevold HE, Espeland L. Long-term skeletal and soft-tissue responses after advancement genioplasty. Am J Orthod Dentofacial Orthop 2006; 130:8-17. https://doi.org/10.1016/j.ajodo.2004.11.035
  15. Chaushu G, Blinder D, Taicher S, Chaushu S. The effect of precise reattachment of the mentalis muscle on the soft tissue response to genioplasty. J Oral Maxillofac Surg 2001;59:510-6. https://doi.org/10.1053/joms.2001.22678
  16. Park HS, Ellis E 3rd, Fonseca RJ, Reynolds ST, Mayo KH. A retrospective study of advancement genioplasty. Oral Surg Oral Med Oral Pathol 1989;67:481-9. https://doi.org/10.1016/0030-4220(89)90261-2
  17. Busquets CJ, Sassouni V. Changes in the integumental profile of the chin and lower lip after genioplasty. J Oral Surg 1981;39:499-504.
  18. Bell WH, Brammer JA, McBride KL, Finn RA. Reduction genioplasty: surgical techniques and soft-tissue changes. Oral Surg Oral Med Oral Pathol 1981;51:471-7. https://doi.org/10.1016/0030-4220(81)90003-7
  19. Shoshani Y, Chaushu G, Taicher S. The influence of the osteotomy slope on bony changes after advancement genioplasty. J Oral Maxillofac Surg 1998;56:919-22. https://doi.org/10.1016/S0278-2391(98)90649-8
  20. Johan PR. Essentials of orthognathic surgery. Seoul: Koonja; 2005. p.292.