From Seoul National University Hospital.
Seoul Cheil Plastic Surgery Clinic.
Plast Reconstr Surg. 2024 Jan 1;153(1):54e-63e. doi: 10.1097/PRS.0000000000010505. Epub 2023 Apr 11.
The authors' main aim was to analyze soft-tissue response of the chin following genioplasty with anterior segmental osteotomy, which enables optimal surgical planning of genioplasty.
Sixty-two patients who underwent genioplasty with concomitant anterior segmental osteotomy were divided into three groups depending on the direction of pogonion (Pog) movement: G1 (without sagittal change), G2 (advancement genioplasty), and G3 (setback genioplasty). All genioplasties included height reduction. Hard- and soft-tissue measurements with cephalometry were performed at T1 (before surgery), T2 (after surgery), and T3 (after orthodontic treatment) for the analysis of sagittal and vertical changes. Correlation and regression analyses were conducted to analyze soft- to hard -tissue movement and soft-tissue thickness changes.
During the T1 to T2 period, the horizontal soft- to hard-tissue ratio at Pog was 0.85 in G2 and 0.80 in G3, and the vertical ratio at menton (Me) was 0.9 for all groups. The correlation coefficients were 0.64 (G2) and 0.83 (G3) at Pog and 0.9 (all), 0.85 (G1), 0.95 (G3) at Me. There was no significant correlation between initial soft-tissue thickness and soft-tissue response ratio. During the T2 to T3 period, no significant relapses were observed, which demonstrates the stability of anterior segmental osteotomy combined genioplasty.
Clinically and statistically significant soft-tissue responses were demonstrated at Pog and Me. The higher values in G3 in particular suggest that setback genioplasty with anterior segmental osteotomy is an effective treatment alternative to conventional two-jaw surgery in some patients with bimaxillary prognathism with macrogenia.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
作者的主要目的是分析颏成形术伴前段骨切开术后颏部软组织的反应，这有助于优化颏成形术的手术规划。
62 例接受伴前段骨切开术的颏成形术患者根据颏前点（Pog）的移动方向分为三组：G1 组（无矢状向变化）、G2 组（前徙颏成形术）和 G3 组（后退颏成形术）。所有的颏成形术都包括高度降低。在 T1（术前）、T2（术后）和 T3（正畸治疗后）进行头影测量硬组织和软组织测量，以分析矢状和垂直变化。进行相关和回归分析，以分析软硬组织的移动和软组织厚度的变化。
在 T1 到 T2 期间，G2 组和 G3 组颏部的水平软硬组织比率分别为 0.85 和 0.80，所有组颏下点（Me）的垂直比率均为 0.9。相关系数分别为 0.64（G2）和 0.83（G3）在 Pog 处和 0.9（全部）、0.85（G1）、0.95（G3）在 Me 处。初始软组织厚度与软组织反应比之间无显著相关性。在 T2 到 T3 期间，未观察到明显的复发，这表明前段骨切开术联合颏成形术的稳定性。
在 Pog 和 Me 处显示出临床和统计学上显著的软组织反应。G3 组的数值较高，表明对于一些双颌前突伴颌骨肥大的患者，与传统的双颌手术相比，后退颏成形术伴前段骨切开术是一种有效的治疗选择。
临床问题/证据水平：治疗，IV。
