Aesthetic outcomes and morphological changes in chin parameters after mandibular distraction and subsequent advancement genioplasty in patients with mandibular micrognathia

Abstract

Despite the wide uses of mandibular distraction osteogenesis (MDO), no study appears to have evaluated the use of MDO and subsequent advancement genioplasty. This study addressed lower facial third aesthetics in a consecutive series of subjects with micrognathia who underwent MDO and subsequent advancement genioplasty. Standard cephalometric measurements were performed pre-MDO, at the end of consolidation, and at 1 week, 6 months, and 12 months after genioplasty. At the end of follow-up, questionnaires were given to measure patient satisfaction. Forty patients were included, 33 of whom underwent genioplasty. The mean patient age was 22.35±1.12years. Pre-genioplasty cephalometric measurements showed that all patients had a deficient chin position and projection; they were dissatisfied with their facial aesthetics. Post-genioplasty cephalometric measurements showed that the hard and soft tissue pogonion had moved significantly: 8.4±2.3mm and 11.0±2.11mm, respectively. According to the questionnaire, the patients were satisfied with the final results. The MDO reduced the amount of chin advancement and minimized relapses; the soft tissue response of the lower facial third was more sensitive to genioplasty than isolated MDO. MDO and genioplasty lead to a modest horizontal chin movement that achieves the preferred pogonion position and projection.