Mandibular Basal Osteotomy: New Designs and Fixation Techniques

Lopez, P.; Guerrero, C.; Mujica, E.

doi:10.1016/j.joms.2010.11.038

Cited by 11 publications

(6 citation statements)

References 7 publications

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“…Lopez et al2 suggested mandibular basal osteotomy correction of deficiency, excess, and/or asymmetry of the inferior mandibular border. So, we incorporated the basal osteotomy with the principles of DO using the D1 and D2 to increase the height of the mandible.…”

Section: Discussionmentioning

confidence: 99%

“…DO has been used for the correction of the mandibular corpus length and ramal deficiency, but there is no previous report stating its use in increasing the height of the mandible 1. Basal osteotomy of the mandible has been reported for reduction of the height of the mandible and advancement of the mandibular corpus 2. We present a method incorporating the basal osteotomy with the principles of DO to correct hemimandibular hypoplasia associated with HFM type I.…”

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confidence: 99%

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Lower Face Asymmetry: Can We Distract the Mandibular Lower Border?

Rao

2015

Craniomaxillofacial Trauma & Reconstruction

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Hemifacial microsomia (HFM) is a chromosomal abnormality with an incidence of 1:5,600. Bone grafting, alloplastic grafting, orthognathic surgery, orthomorphic surgery and distraction osteogenesis (DO) are the various options available for the management of HFM. DO has been used for the correction of the mandibular corpus length and ramal deficiency, but there is no previous report stating its use in increasing the height of the mandible.1 Basal osteotomy of the mandible has been reported for reduction of the height of the mandible and advancement of the mandibular corpus.2 We present a method incorporating the basal osteotomy with the principles of DO to correct hemimandibular hypoplasia associated with HFM type I. Case ReportA 20-year-old male patient presented with a chief complaint of asymptomatic asymmetry of the face first noticed in the childhood that worsened over the period of time. He has no history of trauma or major hospitalizations. He presented with gross asymmetric face with decreased lower facial height on the left side. The chin was deviated to the right side (►Fig. 1).On temporomandibular joint (TMJ) evaluation, jaw movements were normal bilaterally. On orthopantomograph (OPG), the mandible on the left side was smaller in size with maintained anatomy. Condyles were symmetrical, and teeth were symmetrical which was reconfirmed using study models.Audiometry revealed decreased hearing capability on the left side. No cardiac abnormalities, no abdominal, or visceral abnormalities were noted. An IQ score of 86 was obtained on Stanford-Binet Intelligence scale suggesting low average. The condition was diagnosed as asymmetry secondary to mandibular hemihypoplasia associated with HFM type I. Surgery PlanningGrummon cephalometric analysis and analysis on the OPG showed a deficiency of 9 mm in the anterior region and 5 mm in the posterior region. Patient was planned for surgical management sequenced in two stages with addressing the hard tissue corrections in the first stage and soft tissue corrections in the second stage. Basal osteotomy followed by distraction was planned to increase the height of the mandible using an alveolar distractor (D1) intraorally and a mandibular internal distractor (D2) extraorally. Procedure Stage IUnder general anesthesia with nasal intubation, 2% lignocaine with 1:200,000 adrenaline was infiltrated and submandibular incision was placed. Inferior border of the mandible was Keywords ► asymmetry ► distraction osteogenesis ► hemifacial microsomia AbstractOrthognathic surgery and alloplastic grafting are the main stay in management in hemifacial microsomia. Distraction osteogenesis is used to increase the ramus and corpus length in the management, but here we have described a technique to increase the height of the body of the mandible using the principles of basal osteotomy and distraction osteogenesis.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Lower Face Asymmetry: Can We Distract the Mandibular Lower Border?

Rao

2015

Craniomaxillofacial Trauma & Reconstruction

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“…42 In their 2011 article, Lopez et al describe an angle-to-angle osteotomy of the mandibular lower border as a complementary technique in orthognathic surgery for vertical and transverse augmentation of the lower third. 35 The proposed osteotomies are designed to reposition the osteotomized fragment for various purposes. Instead, we propose eliminating the ostectomized fragment (Fig.…”

Section: Ementioning

confidence: 99%

Facial Gender Confirmation Surgery: The Lower Jaw. Description of Surgical Techniques and Presentation of Results

Simón

Capitán

Bailón

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Of the primary procedures associated with facial gender confirmation surgery, those involving the mentomandibular complex have received the least attention in the literature. Methods: The authors present their experience with 837 trans feminine patients operated on for facial gender confirmation surgery who underwent mandibular bone contouring procedures, including bone contouring, chin and mandibular body and angle ostectomies, and osteotomies to reposition the chin. The authors describe the surgical techniques and materials used, and present a customized lower border–supported cutting guide designed by their team and used with 205 patients. A femininity perception score was calculated preoperatively and 12 months postoperatively, and satisfaction with the results was measured 12 months postoperatively. Results: The postoperative follow-up ranged from 12 to 110 months. The mean femininity perception score increased from 47.86 preoperatively to 76.41 at 12 months postoperatively (p < 0.001). No emergency surgical operations were required. In no case was there any permanent damage to the mental or inferior dental nerve. The reoperation percentage because of problems detected during the postoperative period was 2.63 percent (22 patients). Conclusions: With facial gender confirmation surgery of the jawline and chin, it is possible to modify the transverse and vertical components of the jaw; soften the gonial angles; change the format, bone volume, and position of the chin; and harmonize the entire mandibular line. The facial feminization achieved high satisfaction scores regarding the results and feminine gender appearance 12 months after surgery. The future of mandibular bone contouring techniques includes planning with virtual software and surgical support with patient-specific cutting guides.

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“…Mandibular basal osteotomy is an innovative predictable technique for correction of deficiency, excess, and/or asymmetry of the inferior mandibular border, decreasing morbidity, and many other complications of traditional bone grafts and alloplastic techniques [74]. In extended genioplasty dissection and exposure of the chin, mental nerve and body of the mandible is recommended by a degloving incision.…”

Section: Extended Genioplasty/mandibular Basal Osteotomymentioning

confidence: 99%

Orthognathic Surgery for Mandible

Mani

2021

Oral and Maxillofacial Surgery for the Clinician

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Mandible, a horseshoe shaped bone of the facial skeleton, is one of the sturdy bones in humans. Prominent chin is a unique feature of anatomically modern man in comparison with his anthropological ancestors. The simian shelf has reduced to two genial tubercles to which two muscles are attached. The neck of the condyle has narrowed and acts as a buffer to budge by fracture if there is a severe force on the prominent chin. These evolutionary changes facilitated increased space for the tongue as men started articulation. It articulates with the temporal bone by two inter-dependent Temporo-mandibular joints. Mandible is important in both function and aesthetics.Mandible can be cut into multiple pieces and re-arranged and fixed to achieve aesthetic and functional changes. Facial bones have a tremendous capacity to regenerate and heal provided proper blood supply is ensured to the cut segments. Ostoetomies of the mandible can be done on ramus, body, chin, dento-alveolar region, inferior border, etc. Most of these procedures are done intraorally. Technological advancements have aided orthognathic surgery at large. This chapter envisages to elaborate different techniques of osteotomy of mandible.

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Mandibular Basal Osteotomy: New Designs and Fixation Techniques

Cited by 11 publications

References 7 publications

Lower Face Asymmetry: Can We Distract the Mandibular Lower Border?

Lower Face Asymmetry: Can We Distract the Mandibular Lower Border?

Facial Gender Confirmation Surgery: The Lower Jaw. Description of Surgical Techniques and Presentation of Results

Orthognathic Surgery for Mandible

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