Segmental chin osteotomy (SCO): from virtual planning to realization with surgical positioning guide to be published in: Oral and maxillofacial surgery cases

Abstract

Background: Chin osteotomy is a routine orthognathic surgical procedure that usually performed in addition to BSSO of the mandible and sometimes as isolated procedure. The aim of the chin osteotomy is harmonization of facial profile by balancing of size and form of the lower third of face. This surgical procedurе is well studied and described. Nevertheless simple planar chin osteotomy couldn't always allow surgeon to achieve perfect shape and contour of the lower third of face, because of limited and predictable movement of mobilized anterior part of chin, bone steps formation. Materials and methods: Three patients underwent segmental chin osteotomy: 1 case – correction of facial asymmetry, 2 cases of chin reshaping and augmentation procedures. The 3D reconstruction of the CBCT images, and the surgical simulation were performed using the SIMPLANT O&O software (Materialise N.V., Belgium). 3-D model of the skull was printed and intraoperative surgical guide was designed and printed for proper positioning of the fragments. SCO was done precisely and then the bone parts of chin were fixed to surgical guide by screws. After accurate positioning all parts, fixation was done. Created bone gaps were filled by cortical bone particles of xenogenous origin. Results: SCO was used after precise virtual planning. All patients were satisfied by the aesthetic outcome of the procedure. Usage of the surgical positioning guide allowed achieving predictable aesthetic results. Conclusion: Segmental chin osteotomy with surgical positioning guide provides accurate and predictable aesthetic result in correction of different mandible anterior deformities. Keywords: Genioplasty, Segmental chin osteotomy, Facial deformity, Surgical virtual planning, Surgical positioning guide