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Facial Contour Refining after Surgery-First SSRO with Computer-Assisted Design in East Asians

  • Original Article
  • Facial Surgery
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Abstract

Background

Surgery-first sagittal split ramus osteotomies (SF-SSRO) are an effective treatment for patients with dental malocclusion. However, some patients with mandibular prognathism usually have facial deficiencies which cannot be corrected completely after orthognathic surgery. These are not accepted because the remaining facial contours are in disharmony.

Methods

Twenty-five patients, who were unsatisfied with their appearances after SF-SSRO and orthodontics, were included. The preoperative CTs were used to investigate patients for facial deformity. To achieve a harmonious facial contour, mandible long-curve osteotomy/mandible U-shaped osteotomy, genioplasty or facial autologous fat grafting was selected depending on patients’ contour deformities with the assistance of CAD.

Results

Among the patients who underwent osteotomy, the gonial angle was improved from 111.16° ± 9 to 111.58° ± 9.06 after SF-SSRO because of distal fragment setback and rotation. After facial refine surgery, the gonial angle was significantly increased to 121.69°±2.41 (p < 0.05). And the mandibular width was decreased from 11.29 cm ± 0.44 to 10.45 cm ± 0.39 (p < 0.05) after mandibular outer plate griding. All patients were shown no signs of infection, massive bleeding, and osteonecrosis in the early stage. After follow-up time, they were all satisfied with their results and most of them recovered from lip numbness.

Conclusions

This study indicated the clinical feasibility of two-stage orthognathic and facial bone contouring surgery for the treatment of dentofacial deformities. Two-stage facial contouring surgery can provide esthetic improvement for more accuracy in refining the facial contour.

Level of Evidence IV

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Authors and Affiliations

  1. Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.33 Badachu Road, Shijingshan District, Beijing, People’s Republic of China

    Chenzhi Lai, Guodong Song, Xianlei Zong & Xiaolei Jin

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  1. Chenzhi Lai
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  2. Guodong Song
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  3. Xianlei Zong
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  4. Xiaolei Jin
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Correspondence to Xiaolei Jin.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the hospital research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Patient consent was obtained from all participants. The poll of patients in this study and patient's data have not used in other published papers.

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Lai, C., Song, G., Zong, X. et al. Facial Contour Refining after Surgery-First SSRO with Computer-Assisted Design in East Asians. Aesth Plast Surg 45, 1564–1572 (2021). https://doi.org/10.1007/s00266-021-02181-y

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  • DOI: https://doi.org/10.1007/s00266-021-02181-y

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