Comparison of Rigid and Semirigid Fixation for Advancement Genioplasty
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COMPARATIVE STUDY
Comparison of Rigid and Semirigid Fixation for Advancement Genioplasty Mahaboob Shaik • N. Koteswar Rao N. Kiran Kumar • G. Prasanthi
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Received: 17 March 2012 / Accepted: 25 July 2012 Association of Oral and Maxillofacial Surgeons of India 2012
Abstract To compare the skeletal stability of rigid versus semirigid fixation for advancement genioplasty by the assessment of vertical and horizontal measurements preoperatively and post-operatively on lateral cephalometric radiographs. The study comprised of patients who underwent standard advancement genioplasty by inferior osteotomy of the chin with broadest musculoperiosteal pedicle with either rigid fixation or wire fixation. The displacements of vertical and horizontal measurements resulting following surgery was derived by calculating the difference between preoperative, immediate post-operative and 1 year post-operatively on lateral cephalometric radiographs. Preoperative measurements were marked as T1, immediate post-operative as T2, 1 year follow up post-operative as T3. In the semirigid group a mean horizontal advancement of 5.97 mm was accompanied by a relapse of 1.623 mm during a period of minimum 1 year. The mean superior repositioning of menton was 0.7 mm. This was
accompanied by a relapse of 0.325 mm during a period of 1 year. In the rigid group a mean horizontal advancement of 4.815 mm was accompanied by a relapse of 0.2 mm during a period of 1 year. The mean superior repositioning of menton was 0.975 mm. This was accompanied by a relapse of 0.1 mm during a period of 1 year. This study confirms the findings of several previous studies that contribute data specific towards the use of rigid fixation in advancement genioplasty. In our study we also observed that, in cases where large advancements are necessary, wire fixation may offer insufficient means of fixation particularly if the movement is complex and asymmetrical, in which case rigid fixation devices are more helpful. Keywords Genioplasty Rigid and semirigid fixation Advancement Resorption
Introduction M. Shaik G. Prasanthi Department of Oral & Maxillofacial Surgery, St Joseph Dental College & Hospital, Eluru, Andhra Pradesh, India M. Shaik (&) Andhra Hospitals, Governorpet, Vijayawada 520010, Andhra Pradesh, India e-mail: [email protected] N. Koteswar Rao Department of Oral & Maxillofacial Surgery, Dr Sudha Nageswar Rao Institute of Dental Sciences, Chinoutpalli, Gannavaram, Andhra Pradesh, India N. Kiran Kumar Rims, Ongole, Andhra Pradesh, India
Genioplasty is a surgical procedure carried out to reshape or change the size of the chin that involves both bony and soft tissue components. The advanced genial segment has traditionally been stabilized with wire osteosynthesis. Studies have shown that this method affords good stability. Kirschner wires and Steinman pins have also been used and are also thought to produce good stability. Bone plate osteosynthesis and screw fixation are other stabilization methods now widely used. In all cases, the chin has to be rigidly
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