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A Journal on Dentistry and Maxillofacial Surgery
Minerva Stomatologica 1999 July-August;48(7-8):311-8
Outer cortex split osteotomy of the gonial angle in mandibular asymmetries
Pelo S., Moro A., Foresti M., Mosca R.
Background and aim. Patients with facial asymmetries undergoing maxillo-mandibular surgery may have residual asymmetries in the gonial region, body and blade of the mandible that call for further surgery. Other patients may present asymmetries of the lower third of the face that are not associated with occlusal alterations, for which there are no indications for maximally osteotomy. In these cases the authors propose using osteotomy of the outer mandibular cortex to resolve the aesthetic defect.
Methods. A retrospective study was made using a clinical and radiographical evaluation of 7 patients undergoing this operation. The follow-up ranged between 3 and 16 months. The study was performed in 4 patients with residual asymmetry after mono or bimaxillary surgery for facial asymmetry and 3 patients with mandibular asymmetry not associated with occlusal alterations. Surgery included the realisation of osteotomy of the outer cortex of the mandibular angle, with repositioning according to set values and synthesis through rigid fixation. The increased gonial diameter, the degree of reabsorption and the cosmetic results were evaluated.
Results. Surgery succeeded in recreating a satisfactory facial symmetry without resorting to extraoral incisions, without using alloplastic materials and minimising the harvesting of autologous material.
Conclusions. The proposed technique enabled the asymmetry to be corrected by maintaining the natural marginal morphology, eliminating the risks of infection, extrusion or deplacement that may occur when using alloplastic materials.