Original article
Long-term skeletal and soft-tissue responses after advancement genioplasty

https://doi.org/10.1016/j.ajodo.2004.11.035Get rights and content

Introduction: The objectives of this cephalometric study were to assess the skeletal stability of advancement genioplasty 3 years after surgery and to evaluate the predictability of soft-tissue changes. Methods: The subjects comprised 21 consecutive patients who had no additional orthognathic surgical procedures. Lateral cephalograms were taken at 5 times: immediately preoperative, immediately postoperative, 6 months postoperative, and 1 and 3 years postoperative. Results: Mean surgical advancement at pogonion was 8.4 mm. Three years after surgery, mean relapse at pogonion was 8% of the surgical advancement. Part of this change was most likely due to bone remodeling. No patient demonstrated a clinically significant postoperative change at pogonion. The soft tissue of the chin was found to follow bony movement in a ratio of 0.9:1. Great individual variability was observed. The mentolabial fold depth increased as a result of the treatment. Effects of advancement genioplasty on the lips were small. Conclusions: A prediction ratio based on long-term skeletal changes is likely to generate an estimate that is more appropriate to present to the patient.

Section snippets

Material and methods

Our subjects were 21 patients (7 male, 14 female) who underwent advancement genioplasty from 1985 to 2000. They were selected from the files of the Department of Orthodontics at the University of Oslo in Norway. Surgery was performed in the Department of Maxillofacial Surgery at Ullevaal University Hospital in Oslo. A criterion for inclusion in the study was the availability of standardized lateral cephalograms of adequate quality and resolution taken according to a strict data collection

Results

Mean changes in the various cephalometric parameters immediately at T2 and in the subsequent observation periods for the 21 advancement genioplasty patients are given in Table IV; mean changes for selected landmarks are illustrated in Figure 2.

Skeletal changes

The results indicate a relapse at Pg representing 8.2% of the surgical advancement at Pg. This agrees with other studies that have attempted to assess the amount of skeletal relapse after advancement genioplasty.9, 10, 12, 14, 18, 20, 22 These studies generally showed that there is good stability of the bone segment after advancement genioplasty.

It is difficult to differentiate between changes due to segmental instability and changes caused by bone remodeling in the area. It seems reasonable,

Conclusions

  • 1

    Advancement genioplasty appears to be a fairly stable procedure. Three years after surgery, mean relapse at Pg was 8.2% of the surgical advancement. Part of this change is most likely due to bone remodeling.

  • 2

    The soft tissue of the chin was found to follow the bony movement in a ratio of 0.9:1.

  • 3

    Mentolabial fold depth increased as a result of the treatment.

  • 4

    Effects of advancement genioplasty on the lips were small. No change in lip thickness could be noted.

References (29)

  • W.H. Bell et al.

    Correction of dentofacial deformities by surgery in the anterior part of the jaws; a study of stability and soft-tissue changes

    Am J Orthod

    (1973)
  • C.E. DeFreitas et al.

    A retrospective study of advancement genioplasty using a special bone plate

    J Oral Maxillofac Surg

    (1992)
  • W.J. Houston

    The analysis of errors in orthodontic measurements

    Am J Orthod

    (1983)
  • K.A. Mobarak et al.

    Soft tissue profile changes following mandibular advancement surgerypredictability and long-term outcome

    Am J Orthod Dentofacial Orthop

    (2001)

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