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Evaluation of ultrasonic and conventional surgical techniques for genioplasty combined with two different osteosynthesis plates: a cadaveric study

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Abstract

Objectives

The aim of this study was to compare genioplasties performed using traditional saw or piezosurgery combined with different osteosynthesis plates.

Materials and methods

Thirty-two genioplasties were first performed on fresh human cadavers using a saw or piezosurgery, followed by chin osteosynthesis with bending or pre-shaped plates. The time required for osteotomy and plate fixation was measured, and the suprahyoid pedicle was inspected.

Results

The mean time required was 204 s (SD 43) with the saw and 52 s (SD 67) with piezosurgery. Osteosynthesis fixation time was 100 s (SD 31) for pre-shaped plates and 124 s (SD 24) for individual plates. Statistical differences were found between both osteotomy techniques (p < 0.001) and osteosynthesis plates (p = 0.025). Injuries of the suprahyoid muscle pedicle were found in 10/16 saw cases and 3/16 piezosurgery cases (p = 0.012).

Conclusions

Although piezosurgery is more time consuming compared with saw osteotomy, it is still adequate in time and allows a reduction of the suprahyoid pedicle injuries. Therefore, piezosurgery seems to be a viable alternative technique for genioplasty. From a clinical point of view, the time difference for osteosynthesis fixation has no significance.

Clinical relevance

The time taken for ultrasonic surgery is suitable for clinical use and leads additional to less damage to the suprahyoid pedicle.

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References

  1. McCarthy JG, Kawamoto HK, Grayson BH, Colen SR, Coccaro PJ and Wood-Smith D (1990) Surgery of the jaws: In McCarthy, J.G., editor. Plastic Surgery Philadelphia: W.B. Saunders:1188–1200

  2. Trauner R, Obwegeser H (1957) 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 surgery, oral medicine, and oral pathology 10:677–689 contd

    Article  PubMed  Google Scholar 

  3. Kawamoto HKJ (2000) Osseous genioplasty. Aesthet Surg J 20:509–518

    Article  Google Scholar 

  4. Cohen SR (2000) Genioplasty. in: BM Achauer, E Eriksson, B Guyuron et al., (Eds) Plastic Surgery: Indications, Operations and Outcomes, Mosby, Philadelphia 5:2683–2703.

  5. Shaughnessy S, Mobarak KA, Hogevold HE, Espeland L (2006) Long-term skeletal and soft-tissue responses after advancement genioplasty. Am J Orthod Dentofac Orthop 130:8–17. doi:10.1016/j.ajodo.2004.11.035

    Article  Google Scholar 

  6. Strauss RA, Abubaker AO (2000) Genioplasty: a case for advancement osteotomy. J Oral Maxillofac Surg 58:783–787. doi:10.1053/joms.2000.7266

    Article  PubMed  Google Scholar 

  7. Ward JL, Garri JI, Wolfe SA (2007) The osseous genioplasty. Clin Plast Surg 34:485–500. doi:10.1016/j.cps.2007.05.009

    Article  PubMed  Google Scholar 

  8. Seifeldin SA, Shawky M, Hicham Nouman SM (2014) Soft tissue response after chin advancement using two different genioplasty techniques: a preliminary technical comparative study. J Craniofac Surg 25:1383–1388. doi:10.1097/SCS.0000000000000863

    Article  PubMed  Google Scholar 

  9. Möhlhenrich SC, Heussen N, Kamal M, Fritz U, Hölzle F, Modabber A (2015) Limitations of osseous genioplasty in relation to the displacement distance: a computer-based comparative study. Oral Surg Oral Med Oral Pathol Oral Radiol 120:670–678. doi:10.1016/j.oooo.2015.06.040

  10. Möhlhenrich SC, Heussen N, Kamal M, Peters F, Fritz U, Hölzle F, Modabber A (2015) Influence of setback and advancement osseous genioplasty on facial outcome: a computer-simulated study. J Craniomaxillofac Surg 43:2017–2025. doi:10.1016/j.jcms.2015.10.017

    Article  PubMed  Google Scholar 

  11. Coghlan KM, Irvine GH (1986) Neurological damage after sagittal split osteotomy. Int J Oral Maxillofac Surg 15:369–371

    Article  PubMed  Google Scholar 

  12. Van Butsele BL, Mommaerts MY, Abeloos JS, De Clercq CA, Neyt LF (1995) Creating lip seal by maxillo-facial osteotomies. A retrospective cephalometric study. J Craniomaxillofac Surg 23:165–174

    Article  PubMed  Google Scholar 

  13. Lindquist CC, Obeid G (1988) Complications of genioplasty done alone or in combination with sagittal split-ramus osteotomy. Oral Surg Oral Med Oral Pathol 66:13–16

    Article  PubMed  Google Scholar 

  14. Wolford LM, Bates JD (1988) Surgical modification for the correction of chin deformities. Oral Surg Oral Med Oral Pathol 66:279–286

    Article  PubMed  Google Scholar 

  15. Cunningham LL, Tiner BD, Clark GM, Bays RA, Keeling SD, Rugh JD (1996) A comparison of questionnaire versus monofilament assessment of neurosensory deficit. J Oral Maxillofac Surg 54:454–459 discussion 459-60

    Article  PubMed  Google Scholar 

  16. Bell WH, Brammer JA, McBride KL, Finn RA (1981) Reduction genioplasty: surgical techniques and soft-tissue changes. Oral Surg Oral Med Oral Pathol 51:471–477

    Article  PubMed  Google Scholar 

  17. Stubinger S, Kuttenberger J, Filippi A, Sader R, Zeilhofer HF (2005) Intraoral piezosurgery: preliminary results of a new technique. J Oral Maxillofac Surg 63:1283–1287. doi:10.1016/j.joms.2005.05.304

    Article  PubMed  Google Scholar 

  18. Kotrikova B, Wirtz R, Krempien R, Blank J, Eggers G, Samiotis A, Muhling J (2006) Piezosurgery--a new safe technique in cranial osteoplasty? Int J Oral Maxillofac Surg 35:461–465. doi:10.1016/j.ijom.2005.12.006

    Article  PubMed  Google Scholar 

  19. Landes CA, Stubinger S, Ballon A, Sader R (2008) Piezoosteotomy in orthognathic surgery versus conventional saw and chisel osteotomy. Oral Maxillofac Surg 12:139–147. doi:10.1007/s10006-008-0123-7

    Article  PubMed  Google Scholar 

  20. Landes CA, Stubinger S, Rieger J, Williger B, Ha TK, Sader R (2008) Critical evaluation of piezoelectric osteotomy in orthognathic surgery: operative technique, blood loss, time requirement, nerve and vessel integrity. J Oral Maxillofac Surg 66:657–674. doi:10.1016/j.joms.2007.06.633

    Article  PubMed  Google Scholar 

  21. Gilles R, Couvreur T, Dammous S (2013) Ultrasonic orthognathic surgery: enhancements to established osteotomies. Int J Oral Maxillofac Surg 42:981–987. doi:10.1016/j.ijom.2012.12.004

    Article  PubMed  Google Scholar 

  22. Spinelli G, Lazzeri D, Conti M, Agostini T, Mannelli G (2014) Comparison of piezosurgery and traditional saw in bimaxillary orthognathic surgery. J Craniomaxillofac Surg 42:1211–1220. doi:10.1016/j.jcms.2014.02.011

    Article  PubMed  Google Scholar 

  23. Eggers G, Klein J, Blank J, Hassfeld S (2004) Piezosurgery: an ultrasound device for cutting bone and its use and limitations in maxillofacial surgery. Br J Oral Maxillofac Surg 42:451–453. doi:10.1016/j.bjoms.2004.04.006

    Article  PubMed  Google Scholar 

  24. Gonzalez-Garcia R (2012) Endoscopically-assisted subcondylar and vertical ramus osteotomies for the treatment of symmetrical mandibular prognathism. J Craniomaxillofac Surg 40:393–395. doi:10.1016/j.jcms.2011.07.003

    Article  PubMed  Google Scholar 

  25. Wittbjer J, Rune B (1989) Changes of the profile after advancement genioplasty. Scand J Plast Reconstr Surg Hand Surg 23:65–70

    PubMed  Google Scholar 

  26. Van Sickels JE, Smith CV, Tiner BD, Jones DL (1994) Hard and soft tissue predictability with advancement genioplasties. Oral Surg Oral Med Oral Pathol 77:218–221

    Article  PubMed  Google Scholar 

  27. McDonnell JP, McNeill RW, West RA (1977) Advancement genioplasty: a retrospective cephalometric analysis of osseous and soft tissue changes. J Oral Surg 35:640–647

    PubMed  Google Scholar 

  28. Scheideman GB, Legan HL, Bell WH (1981) Soft tissue changes with combined mandibular setback and advancement genioplasty. J Oral Surg 39:505–509

    PubMed  Google Scholar 

  29. Reyneke JP, Johnston T, van der Linden WJ (1997) Screw osteosynthesis compared with wire osteosynthesis in advancement genioplasty: a retrospective study of skeletal stability. Br J Oral Maxillofac Surg 35:352–356

    Article  PubMed  Google Scholar 

  30. Talebzadeh N, Pogrel MA (2001) Long-term hard and soft tissue relapse rate after genioplasty. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91:153–156. doi:10.1067/moe.2001.112392

    Article  PubMed  Google Scholar 

  31. Aravind RJ, Venkataraman S (2011) Stabilization of genial segments after advancement genioplasty. A comparative study with plate and wire J Indian Acad Dent Spec Res 2:4–7

    Google Scholar 

  32. San Miguel Moragas J, Oth O, Buttner M, Mommaerts MY (2015) A systematic review on soft-to-hard tissue ratios in orthognathic surgery part II: chin procedures. J Craniomaxillofac Surg 43:1530–1540. doi:10.1016/j.jcms.2015.07.032

    Article  PubMed  Google Scholar 

  33. Polido WD, de Clairefont RL, Bell WH (1991) Bone resorption, stability, and soft-tissue changes following large chin advancements. J Oral Maxillofac Surg 49:251–256

    Article  PubMed  Google Scholar 

  34. Mommaerts MY (2013) Prediction of the facial profile. Prediction of the facial profile In: The surgical art of facial makeover Vol. I. Sint-Martens-Latem: Orthoface R&D, 77e90

  35. Reddy PS, Kashyap B, Hallur N, Sikkerimath BC (2011) Advancement genioplasty—cephalometric analysis of osseous and soft tissue changes. J Maxillofac Oral Surg 10:288–295. doi:10.1007/s12663-011-0233-x

    Article  PubMed  PubMed Central  Google Scholar 

  36. Park HS, Ellis E 3rd, Fonseca RJ, Reynolds ST, Mayo KH (1989) A retrospective study of advancement genioplasty. Oral Surg Oral Med Oral Pathol 67:481–489

    Article  PubMed  Google Scholar 

  37. Vedtofte P, Nattestad A, Svendsen H (1991) Soft tissue changes after advancement genioplasty performed as pedicled or free transplants. J Craniomaxillofac Surg 19:304–310

    Article  PubMed  Google Scholar 

  38. Vercellotti T, De Paoli S, Nevins M (2001) The piezoelectric bony window osteotomy and sinus membrane elevation: introduction of a new technique for simplification of the sinus augmentation procedure. Int J Periodontics Restorative Dent 21:561–567

    PubMed  Google Scholar 

  39. Hölzle F, Franz EP, Lehmbrock J, Weihe S, Teistra C, Deppe H, Wolff KD (2012) Thiel embalming technique: a valuable method for teaching oral surgery and implantology. Clin Implant Dent Relat Res 14:121–126. doi:10.1111/j.1708-8208.2009.00230.x

    Article  PubMed  Google Scholar 

  40. Peuker ET, Werkmeister R, Pera F, Joos U, Filler TJ (2001) Surgical procedures in mouth, jaw and facial surgery in Thiel embalmed body donors. Mund Kiefer Gesichtschir 5:141–143

    Article  PubMed  Google Scholar 

  41. Rashad A, Kaiser A, Prochnow N, Schmitz I, Hoffmann E, Maurer P (2011) Heat production during different ultrasonic and conventional osteotomy preparations for dental implants. Clin Oral Implants Res 22:1361–1365. doi:10.1111/j.1600-0501.2010.02126.x

    Article  PubMed  Google Scholar 

  42. Stelzle F, Frenkel C, Riemann M, Knipfer C, Stockmann P, Nkenke E (2014) The effect of load on heat production, thermal effects and expenditure of time during implant site preparation—an experimental ex vivo comparison between piezosurgery and conventional drilling. Clin Oral Implants Res 25:e140–e148. doi:10.1111/clr.12077

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthodontics, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

    Stephan Christian Möhlhenrich & Ulrike Fritz

  2. Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

    Stephan Christian Möhlhenrich, Nassim Ayoub, Frank Hölzle & Ali Modabber

  3. Institute of Molecular and Cellular Anatomy, Medical Faculty of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

    Andreas Prescher

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  1. Stephan Christian Möhlhenrich
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Correspondence to Stephan Christian Möhlhenrich.

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All author declare that they have no conflict of interest.

Funding

The study materials were provided free of charge by Medartis AG (Bassel, Switzerland) and Mectron Medical (Carasco, Italy).

Human and animal rights and informed consent

This article does not contain any studies with living human participants or animals. Institutional approval was given.

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Möhlhenrich, S.C., Ayoub, N., Fritz, U. et al. Evaluation of ultrasonic and conventional surgical techniques for genioplasty combined with two different osteosynthesis plates: a cadaveric study. Clin Oral Invest 21, 2437–2444 (2017). https://doi.org/10.1007/s00784-016-2040-8

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  • DOI: https://doi.org/10.1007/s00784-016-2040-8

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