Bertossi Dario, Albanese Massimo, Mortellaro Carmen, Malchiodi Luciano, Kumar Narendra, Nocini Riccardo, Nocini Pier Francesco
Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Verona.
Department of Health Sciences "A. Avogadro," University of Eastern Piedmont, Novara, Italy.
J Craniofac Surg. 2018 Nov;29(8):2156-2159. doi: 10.1097/SCS.0000000000004773.
The chin is the most prominent and median sector of the lower third of the face giving harmony to nose and lips. The authors present the application of piezoelectric scalpel for the correction of different chin deformities. The distinctive characteristics of this device allow the authors to avoid or reduce the immediate genioplasty complications.
Fifty-five patients of defective chin have been treated from January 2006 to April 2008. Intraoral genioplasty was performed during the correction of dentofacial dysmorphisms or associated with nasal surgery. The authors used a piezoelectric cutting device to perform different osteotomies and if necessary, interpositional graft was used to stabilize bony segments.
Piezosurgery has been associated with a fewer number of postoperative complications, especially as regard intraoperative bleeding, nerve injuries (immediate and late), hematomas and seromas, asymmetry (immediate and early). The mean time for completing the complete procedure of genioplasty with piezosurgery was almost the same compared with the saw and drill.
Genioplasty represents one of the most common ancillary procedures and may be associated with corrective surgery of dentofacial dysmorphisms. Mental nerve injuries, asymmetries, intraoperative bleeding are the main immediate complications of genioplasty. Distinctive characteristics of ultrasonic piezoelectric osteotomy are selective cut of mineralized structure with less risk of vascular and nervous damage (microvibrations), intraoperative precision (thin cutting scalpel and no macrovibrations), blood free site (cavitation effect). In the authors' experience, piezoelectric scalpel, compared with saw and drill, enables them to reduce or avoid immediate complications of chin surgery, helping the surgeon to reach patients' satisfaction.
下巴是面部下三分之一最突出的中间部分，使鼻子和嘴唇协调。作者介绍了压电手术刀在不同下巴畸形矫正中的应用。该设备的独特特性使作者能够避免或减少即刻颏成形术的并发症。
2006年1月至2008年4月，对55例下巴有缺陷的患者进行了治疗。在牙颌面畸形矫正期间或与鼻部手术联合进行口内颏成形术。作者使用压电切割设备进行不同的截骨术，必要时使用植入物来稳定骨段。
压电手术术后并发症较少，尤其是术中出血、神经损伤（即刻和晚期）、血肿和血清肿、不对称（即刻和早期）。与锯和钻相比，使用压电手术完成整个颏成形术的平均时间几乎相同。
颏成形术是最常见的辅助手术之一，可能与牙颌面畸形的矫正手术相关。颏成形术的主要即刻并发症是颏神经损伤、不对称、术中出血。超声压电截骨术的独特特性是选择性切割矿化结构，血管和神经损伤风险较小（微振动）、术中精度高（薄切割刀且无宏观振动）、无血手术部位（空化效应）。根据作者的经验，与锯和钻相比，压电手术刀能使他们减少或避免下巴手术的即刻并发症，有助于外科医生达到患者满意的效果。
