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

Abstract

The aim of this study was to compare genioplasties performed using traditional saw or piezosurgery combined with different osteosynthesis plates. 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. The mean time required was 204s (SD 43) with the saw and 52s (SD 67) with piezosurgery. Osteosynthesis fixation time was 100s (SD 31) for pre-shaped plates and 124s (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). 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. The time taken for ultrasonic surgery is suitable for clinical use and leads additional to less damage to the suprahyoid pedicle.