Combined long-curved ostectomy in the inferior mandibular border and angle of the mandible with splitting corticectomy for reduction of the lower face.
ABSTRACT In Asian countries, a square-shaped face is considered unattractive. Many operative techniques have been developed and reported for reduction of the lower face, including mandibular angle ostectomy and splitting corticectomy. Many surgeons have performed the operation in the angle region using one of the aforementioned techniques, which may not lead to effective results. This report mainly discusses the standard procedures of surgery.
To overcome the drawbacks of conventional procedures and to perform ostectomy accurately, proper preoperative analysis and design were implemented for 159 patients with square-shaped faces. Based on a new type of classification and concepts for mandible reduction, long-curved ostectomy combined with splitting corticectomy was used for reduction of the lower face. A series of standard procedures was developed during the operative process.
The majority of patients were satisfied with both their frontal and lateral appearances. The gonial angle and the mandibular plane angle were increased effectively. No major complications such as fracture or facial nerve damage occurred. Lip numbness occurred for 15% of the patients.
The authors' series of standard procedures allows surgeons to perform accurate, safe, and reproducible ostectomy and to obtain reliable and stable effects.
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ABSTRACT: Mandibular angle osteotomy is commonly used for prominent mandibular angle contouring. Because of difficult control of the line, shape, and amount of osteotomy, many complications such as asymmetry, undercorrection, overcorrection, and formation of a second mandibular angle after surgery occurred commonly. In addition, it is more difficult to implement osteotomy exactly the same as preoperative design in curved osteotomy owing to the arc-shaped osteotomy line. Therefore, further studies are needed to explore ways to make osteotomy accurately identical with preoperative design. In this report, a case of curved osteotomy guided by a stereolithographic template for unilateral prominent mandibular angle is described. We established the osteotomy line, the shape, and the volume with Mimics software for the right prominent mandibular angle; fabricated individual osteotomy template with computer-aided design/computer-aided manufacturing (CAD/CAM) technique; and performed curved osteotomy with the template. A secure fit of the template on the bone surface was found during the operation. Computed tomographic scan after the surgery revealed that bilateral mandibular angles were symmetric, that the right mandibular angle had a natural curve, and that the osteotomy line, shape, and amount were in accordance with the preoperative design. It is suggested that CAD/CAM template could guide curved osteotomy for prominent mandibular angle accurately, improve efficiency, and avoid complications in osteotomy.The Journal of craniofacial surgery 05/2013; 24(3):e289-e292. · 0.81 Impact Factor